Fighting Leaks and Other Challenges

[Brennie]

Hi Dear Helpers,

I have been struggling lately, longing for a good night of sleep. A big piece of tape is not helping--the pressure I need is too much for the tape.

I have shots of the past 3 nights. I varied the settings, looking for a solution.

Thanks for your time and advice.

Brennie

[PeaceLoveAndPizza]

Changing settings night over night will only add to the frustration. Approach it methodically.

One thing that does stand out is you have positional apnoea. Keeping your airway more open with a flatter pillow, using a soft cervical collar or other action to stop chin-tucking, will go a long way helping.

The leaks are likely from mouth drops, which a FFM or cervical collar will help with as well as the positional apnoea.

Consider doing a few nights of self-titration to find the range that works for you.

Mode APAP
Min pressure 7
Max pressure 15
EPR 3 full-time
No ramp

Use that for a few nights and post some charts. From there folks can help zero in on the pressure range that works well for you.

[Brennie]

Hi, friend PLP, so good to hear from you!

Q:  What is a CA that would be concerning? I had shut off the EPR for fear of CAs being too high. One night it was 1.50, so I got worried. I will turn that back on.

I tried the cervical collar before and it made things worse. I do not use any pillows.

I will set the machine as you recommended and let that ride for a while.

Q:  When I am due for new supplies, I am going to ask for an F40. Do you have any other recommendations for a FFM?

Thanks so much for your input.

With appreciation,
Brennie

[PeaceLoveAndPizza]

How much AHI one can tolerate and still get a good nights rest is an individual thing. What comprises it is the same. Some are fine with an AHI of 2 and others need it less than 1. Generally the lower the better, but sometimes we need to stop tweaking and give things a chance to settle in.

From the leaks I’m seeing in OSCAR if tape nor a collar is tolerated, then a full-face mask is the next step. Resmed’s F40 has mixed reviews from some members and has high marks from others. The best advise I can give is to watch some YouTube videos on masks and see what looks interesting. 

The goal is not perfect numbers, but as good a nights rest as you can get.

[Phaleronic]

Hi Brennie,

You're best night of that group was when running constant pressure mode with EPR off, you eliminated the CA events and have just the hypopneas and reras. You do need to get the leakage figured out so yes a flat pillow with another one to wedge under your chin and chest and shoulder to prevent chin tucking/drops. I would raise cpap pressure to 14.8cm and turn EPR on at 1 to see if you sleep better and if the cas crop back up-this extra pressure will help with the hypopneas and potentially the reras.

And you pretty much already titrated yourself before moving to cpap mode. How did cpap mode feel-did you sleep any better? I personally sleep very well with 15.5cm of water on cpap mode

[Phaleronic]

'your'

[Brennie]

Thank you Phaleronic, for replying. It's a tricky balance, isn't it? Strangely, on some of the very recent nights, even though the stats look bad and the leakage is high, I have felt pretty good. A month or so ago, I was feeling awful--had to take crash naps.

But I want to feel GREAT. At the beginning of the year, for a couple of months I did feel great, with a CPAP of 12 and EPR 2.


I hope I can figure out the leak problem. I do wear tape. I wonder if I need to change the tape?  Does your mouth fill with a bubble of air, and you have to blow it out through the tape? Or maybe you don't use tape.


Last night (before I had read any of the recommendations here), I had the machine set at CPAP 13 with 2 EPR. I had LOTS of leaking. But I feel fairly well today.  AHI was .78



I sure appreciate the recommendations. I try the recommendations on the forum to see if they will help.


As others have said, my sleep NP has been no help at all (with due respect to her.) I am so appreciative of this forum.  


Brennie

[Phaleronic]

You're doing very well Brennie You can get there for sure, I'm pretty dialed in and tried many different machines/vendors/modes and pressure settings. I would keep it then at 13cm and focus on fixing those leaks and getting your sleeping position dialed in too. I cannot use tape or a cervical collar so I have to use a full face, my ahi is down under 1 and I feel good but it took a long time to finally figure it out ha

[Brennie]

Thanks for the encouragement and hope!

Brennie