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(08-09-2023, 11:16 AM)Dormeo Wrote: Higher EPR can reduce flow limitations and increase comfort; lower EPR, or no EPR, can reduce CAs. Again, I'd say just stick with 3 if that's comfortable for you.
You're pressure variations are minimal, so I doubt whether tightening the range will make any difference to you. But there's not harm in giving it a try. You could try min = max = 10 and give it a few nights to see whether it helps you.
I think I do need to keep a range, as I recently went from experimenting with fixed pressures between 15-13 for several weeks, and once i went back to having a variable range between 10-15 it seems to have helped my events significantly. It looks like during events i'm not exceeding 13 right now? So i'm wondering if maybe i reduce my range to min 9 and max 14 it might help....
Also, of course, after I got my one "good"-feeling day yesterday, I was so awake at bedtime that I couldn't fall asleep. After an hour of tossing/turning i took an ambien. It knocked me out as usual,but I think i slept on my back most of the night...checked my O2 this morning and i spent 3.5 HOURS below 95% (as opposed to 39mins the night before). Events look basically the same (CA's around sleep/wake with barely any OAs). Brain fog and fatigue are back with a vengeance. It's my Saturday (due to my work schedule) and it feels like a complete waste of the day. Very frustrating...sigh. Maybe tonight I'll be tired enough to fall asleep without medication and will breathe better...
So, I think things are improving somewhat with my therapy as I'm having some more frequent "good" days. Not a lot, but it does seem as though they're happening a little more often.
However, I think there is still some room for improvement... Looking at my flow rate, it still looks quite spiky and uneven despite the machine not detecting any events or changing the pressure at all. Perhaps this inconsistency is resulting in some of the fatigue and brain fog issues I'm continuing to experience? I'm trying to learn about RDI (as opposed to AHI) but I can't seem to figure out how to get OSCAR to report RDI's (or is that dependent on my machine?)
I'm glad to hear things are going somewhat better for you. In the snippet, you held your breath a couple of times and had brief periods of arousal breathing. There is nothing that indicates the mini-arousals are related to a respiratory problem.
Brief arousals are normal. We have more of them as we get older. There's lots of good information here:
The normal number of arousals per hour for people without sleep disorders runs from around 10 for people in their twenties to around 20 for people over 60.
I will be interested to hear how things go for you. My guess is that you'll see uneven results day to day but with an improving trend. (Even when you want to focus on a snippet, it's often helpful to see the context, which means a screenshot of the whole night, including the side panel and the graphs for events, flow rate, pressure, leaks, flow limitations, and snores.)
Thank you Dormeo for your continued interest and for following my thread.
I have an interesting update.... I can't believe I haven't tried this sooner, but, yesterday I was able to obtain some Breathe Right nasal strips after I had read a while ago that it might help for those of us using nasal masks...
All i can say is, WOW, what a difference it makes for my nasal breathing! Its truly remarkable. It makes such a difference that I suspect I may need to start lowing my pressures with the nasal mask (they were lower when i was using FFM also).
Unfortunately the difference was so remarkable, that I woke up around 5am this morning after only 3.5h of sleep and could NOT get back to sleep for several hours, i was so wide awake. I did end up getting another couple hours from ~7am-9am but woke up a few times throughout. Including in my screenshot only the first 3.5h window because I feel it was most representative of "normal" sleep.
Most importantly, I have some energy today and reduced brain fog. I think this is a really important development and I'm 100% going to be using this going forward. I dont know what this suggests about the structure of my nasal passages... my ENT/sleep doctor said after a quick look that they were fine, and shouldn't be causing me any problems......needless to say I am requesting a new sleep doctor as mentioned previously and perhaps may look at getting a DISE before considering if maybe surgical options of my nasal passages might make sense for long term improvements... but for now, I'm happy to keep using the strips and I hope I continue to see benefits from them!
Not sure if my flow rates look any cleaner or not, but I do know i feel better today!
Well, that is both surprising and wonderful! I hope you get in more hours of that restorative sleep going forward.
I wonder whether you might benefit from nasal rinses (like Neilmed) and/or Flonase. If you try Flonase, try using it about an hour before bedtime, and be patient -- it can take a few weeks to kick in.
Flowrate will naturally look more volatile, inconsistent, etc. during REM. Just because you can't take a straight edge to it at all times, doesn't translate to there always being an issue.
RDI = AHI + RERAs
With regards to your success with nasal strips and the decongestant, this suggests to me that nasomaxillary expansion might be a suitable surgery for you. Improved nasal patency engenders higher CPAP success and compliance. Always remember: you should always, always, always, always be breathing through your nose, and, if you can't, then you have an issue that needs addressing. The mouth is for emergencies, and by all metrics except volume it's second place.
Don't get too hopeful with doctors in Canada. Most of them don't know what they're talking about with sleep medicine. I think you should consult with someone highly specialized in sleep apnea from the States. Have you had any CT or CBCT scans done of your head/neck/airway?
(08-17-2023, 09:48 PM)jwest Wrote: Some machines will flag RERAs, others won't.
Flowrate will naturally look more volatile, inconsistent, etc. during REM. Just because you can't take a straight edge to it at all times, doesn't translate to there always being an issue.
RDI = AHI + RERAs
With regards to your success with nasal strips and the decongestant, this suggests to me that nasomaxillary expansion might be a suitable surgery for you. Improved nasal patency engenders higher CPAP success and compliance. Always remember: you should always, always, always, always be breathing through your nose, and, if you can't, then you have an issue that needs addressing. The mouth is for emergencies, and by all metrics except volume it's second place.
Don't get too hopeful with doctors in Canada. Most of them don't know what they're talking about with sleep medicine. I think you should consult with someone highly specialized in sleep apnea from the States. Have you had any CT or CBCT scans done of your head/neck/airway?
Thank you for your input. I have not had any CT/CBCT scans done, no. I dont know if I will be able to afford to consult with a provider in the USA as I would imagine that would be quite expensive. Also it is unlikely I will be able to take the time away from work for that purpose, unfortunately. The respiratory therapist that gave me my equipment said from the perspective of insurance, they would consider to me to be adequately treated due to low AHI and unlikely to fund or approve anything further than what I'm currently doing right now. Perhaps when I get my new sleep doctor in September I can request a CT/CBCT scan to be done.
So, some new developments....
I'm sick this week with a common cold. I've been using the nasal strips every night. I've been watching my oxygen saturation/drop numbers each night as always, along with time spent below 95%.
Using the strips for the first couple of nights didn't seem to make a massive difference in O2 stats, surprisingly, although it did seem to help in my general sense of restfulness, brain fog, and wellbeing (until i got sick, anyway).
Now, I have had some issues in my personal life arise which have affected my anxiety and insomnia, resulting in me having extreme difficulty falling asleep the last couple of days. Two nights ago, I took melatonin and later trazodone as I simply could not shut my brain off to sleep otherwise after several hours. I then checked my O2 stats in the morning, and bizarrely, they have never been so good?! I didnt have the cleanest night in terms of events, and my O2 ring ran out of battery around 5am, but it literally only recorded a SINGLE drop above 4% and only 6 minutes under 95%. I'm floored.
And despite being sick, I feel.... pretty good? How much of that is residual effects of the SNRI in the trazodone vs actually getting good oxygen through the night...I have no idea. But it wasn't a fluke.... next post will be last nights O2 stats and data.
08-23-2023, 12:00 PM (This post was last modified: 08-23-2023, 12:06 PM by Uphold9887.)
RE: Extreme fatigue despite "low" (<5) AHI
Here is last night's data. Last night: still using the nasal strips, no melatonin, but I did take trazodone again (which wasn't enough to get me to sleep, f*** anxiety), and eventually I had to take an ambien which knocked me out as usual.
As you can see, almost 9 hours of measurement this time and only 21 minutes below 95% (as opposed to "normal" for me being anywhere from 1-4hours). ALMOST NO drops (as opposed to most nights having double digit drops of both 3% and 4%). 91% minimum O2 (as opposed to usually 87-89% minimum every night). Weirdly, it looks as though OSCAR is reporting many desaturations but I think it seems to be using 98% as the desaturation baseline which I think is probably too high. The O2 ring app itself seems to be more accurate.
It seems like the consistent factor here is the trazodone....but why should that impact my O2 levels through the night? It doesn't make sense to me why that should matter. And I dont really want to have to take or rely on an SNRI to ensure my O2 stats remain good. I guess its a little too early to tell if theres truly a pattern here. I'm going to keep an eye on it, of course, and see if my stats are worse when I go a night without the trazodone.
I'm just wondering if anyone would have any ideas what could be going on here?
I also found a suprising benefit from using nasal strips! Further to this, I yesterday had my first review with the hospital, and they immediately told me my F20 FFM was not the right size - this was a suprise, as I really like it and get minimal leakage, albeit I normally wear it fairly tight.
However they recommended I try an F30 FFM, which fits beneath the nose, and I immediately noticed that, although it feels a little strange, and will take a few nights to get used-to, it really seemed to hold open my nostrils and promote good flow into my nose - even more so than the nasal strips... I nights sleep, and one afternoon nap has been the only test so far - but it looks hopeful!
“Men fight for liberty and win it with hard knocks. Their children, brought up easy, let it slip away again, poor fools. And their grandchildren are once more slaves.” - DH Lawrence
