First night using APAP. Still slept like garbage.

[QuirkyTurtle]

Hello folks,

Last night was my first night using an APAP. I've attached a screenshot of my OSCAR data. Please let me know if I need to change it.

I've done 2 sleep studies, at home and in a lab. One was an AHI or around 7 and the other an AHI of around 12. I can attach them if it helps, they are in Spanish though so I'll have to do some translating. Probably relevant, I also have Asperger's (recently diagnosed) which has a strong link to insomnia. I've just started taking around 1g one hour before bed time of L-Tryptophan to help with this. Still not sure if my crap sleep is OSA, Insomnia/Aspergers, or a combination of both.

I'm using the N30i as I thought it might be the best for me as I'm an active sleeper. The mask seemed comfortable enough. I know I did wake up several times from air escaping out of my mouth. I had a piece of vertical tape but tonight I might try a longer piece of horizontal tape.

My 'doctor' prescribed me the following settings:

Range 4 - 12 cmH2O
15 Min ramp from 4cmH2O.
APE/EPR/C-Flex adjustment: level III
Humidification: level 4

I didn't use the humidifier last night and I changed the ramp time to Auto as it takes me a little while to fall asleep.

I'm wondering if 4cm is too low.

Anyways this is my first post. If anyone has any comments I would greatly appreciate it and I am EAGER to learn more about OSCAR and how to interpret the data.

[PeaceLoveAndPizza]

You feel like a dogs breakfast mainly due to your machine not being optimised. Your leaks do not currently look bad. Use of humidity is a personal choice, so do what feels right.

Try setting your machine to a range of 7-12, EPR 1 full-time for comfort, no ramp. A bit more pressure, a bit of pressure support, and you should notice the difference.

The main reason you feel funky is you are not used to CPAP. It takes months to get used to it, so give yourself time.

[QuirkyTurtle]

Thank you! Will try tonight! I know nothing about OSCAR (yet) but my pressure graph looks 'off' to me.

[PeaceLoveAndPizza]

Your pressure chart is fine.

The pressure is being adjusted by the machine in response to flow limitations. As the airway occludes and meets a set criteria, the machine raises pressure slightly to keep the airway open to avoid apnoeic events. If we add a bit of pressure support through EPR it will reduce the flow limitations and reduce the pressure swings you see.

[QuirkyTurtle]

Night #2.

Some unintenial large leaks. I scratched my nose forgetting I was wearing the mask and it came off. Also I taped my mouth horizonally (whole mouth) but the tape also came undone again so I will have to use different tape, or more of it.

Though I am a little weary of doing mouth taping now with the APAP because of power outage. It is a little difficult to break through the nasal mask when there is no power. I wouldn't want this happening in the night so I might pick up a cervical collar in place of the tape.

Also my throat was pretty dry! I have the humidifier but I am trying to change the least amount of variables at once, also if I can get away without using the humidifier I will, makes things simpler. Hopefully it is just my body getting used to treatment.

[QuirkyTurtle]

As mentioned in this thread I am wondering if something like the AlaxoStents might work for me, though mine looks more like a flutter and not so a complete collapse. My DISE report showed:

Patient in dorsal decubitus position, under sedation with propofol. Sleep endoscopy is performed. According to the VOTE scale, at level 1, palatal flutter and anteroposterior collapse greater than 50% are observed, which improves significantly with the Esmarch maneuver. At level 2, anteroposterior collapse with a slight lateral component less than 50% is observed. Levels 3 and 4 show no collapse. The procedure was well tolerated by the patient. They are removed from the operating room with a saturation of 98% in ambient air.

Their recommendation was to use a MAD but I declined due to what I had read.

A zoom in of some parts of last nights charts where no events where recorded. Most of my Flow Rate looks like Class 6.
[url=https://www.apneaboard.com/wiki/index.php/OSCAR_-_The_Guide][/url]
I also seem to breath out, pause, the continue breathing out.

---

A few more.

[PeaceLoveAndPizza]

I think you are doing grand. Nice consistent flow rate, low AHI. You should be quite chuffed.

I am not seeing much in your chart to touch, so suggest you leave it as is through the weekend and let's see how it goes. Fight the temptation to tweak things for now.

I know the square root of bugger all about stents and such things. I'll let others comment on it. I personally don't want folks mucking about with my nose or throat unless it is absolutely necessary, especially as I can get similar results with a CPAP machine.

[QuirkyTurtle]

I'll definitely try not to change anything for a bit and see how I go. I already ordered a soft cervical collar though.

I think everything looks ok but I am not an expert and I wonder if it still tells the whole story. I've attached a few more charts. I wake up numerous times per night, I'm not sure if that is reflected in the charts.

I would probably try the stents but not for a few months until I move country.

[PeaceLoveAndPizza]

You have used the bloody thing two nights now? Put down the pencil for a few days and let's give it a chance.

[DancesWithCats]

I spent the first week in utter misery. "prevents sleep apnea by preventing sleep" was the apparent function. Got my 4 hours of misery in to be "compliant" and took the blasted thing off.

Wrong mask for my face, causing severe discomfort. My (frankly awful) DME finally admitted (they had concealed that, and I didn't find this place till years later, and only signed up today, another year or so on) that we could try a different mask. 1000% better with the full-face hybrid (mouth and nose, but not on the bridge of my nose) and the hose at the top of my head, rather than a hose coming off the front of my face.

Your Mileage (or Kilometerage) May Vary.

Much later (after I found this place) I fooled around with the pressure range, and soon concluded that raising the bottom pressure made no useful difference to my results (contrary to my expectations) - I have since let the APAP do the "Automatic" part of its job.