First night with nasal mask/tape, check my charts please?

[cdplatt]

It's hard to say without seeing your charts. Stopping melatonin can cause rebound insomnia if you were taking a heavy dose. It shouldn't take much melatonin to help you get to sleep. Most of the OTC products have excessive doses. You might want to look for low dose melatonin and try to titrate yourself down.

[Uphold9887]

It's hard to say without seeing your charts.  Stopping melatonin can cause rebound insomnia if you were taking a heavy dose.  It shouldn't take much melatonin to help you get to sleep. Most of the OTC products have excessive doses.  You might want to look for low dose melatonin and try to titrate yourself down.

I have 10mg gummies, which I usually try to take half or less than half of.  I can't risk another sleepless night tonight, so I'm going to do half of one again and then try to get down to 1/3's afterwards I guess... I also take magnesium nightly which usually helps me sleep but didnt do anything to keep me asleep last night.  Frustrating situation but after this experience last night, I'd rather rely on melatonin in the short term than deal with 2-3h of sleep again.

My next purchase is going to be an O2 monitor, as I want to make sure I'm not being woken up due to low oxygen causing my heart rate to increase, which could be making me restless.  However it seems as though my options are limited in Canada.  There are many "LOOKEE" brand products available, which seem to be affiliated with Wellue?  The association is somewhat unclear.  Anyway, I found something called the following: "LOOKEE® Wrist Sleep Monitor & Tracker with Vibrating Alarm for Low O2 or Sleep Apnea Events | Overnight Tracks Heart Rate, Oxygen Saturation Level, and Sleep Treatment Effectiveness" through an online retailer.

Does anyone know if this will work with OSCAR?  Its not listed on Pulse Oximeter wiki page, however LOOKEE also produces a Wellue O2Ring version which I believe *is* OSCAR supported.  I'd like to purchase the wrist monitor though because it attaches to the finger with a sleeve and the rest is on the wrist, as opposed to the whole device being on the finger... I think that would probably be more comfortable for me perhaps?

[Uphold9887]

Okay, here are the last two nights' usage with nasal mask+tape, and oximeter data.  Unfortunately I can't get my oximeter to sync with OSCAR just yet, but i'm hopeful maybe this information can still be helpful:

Apr 29:

   

   

Keep in mind OSCAR is reporting the wrong pressures, they are actually 10min-14max now.

[Uphold9887]

And a second post because I can't upload 4 pictures in one post, here is last night's data:

       

I'm still feeling very tired and mild headaches most days.  Oxygen saturation last night seemed less than ideal, dropping as low as 88% and most of the time spent in 90-95 vs 95%+

Should I be considering upping my pressures further?

[cdplatt]

I don't think upping your pressure will accomplish anything. The pressure while you're sleeping isn't bumping up against the max you have set. You may try dropping your EPR to 2.
10mg is quite a bit of melatonin. Most recommendations are for .5 to 3, maybe up to 5 mg. Headache and fatigue are reported side effects of melatonin. I doubt if your O2 levels are causing your headaches. If I take melatonin, I'll start with .25mg tablets and got to .5 if necessary, but I generally avoid it unless I'm managing jet lag.

Try backing way down on the melatonin and just stick with your therapy. You should start to get more comfortable with it and sleep better.

[Uphold9887]

I don't think upping your pressure will accomplish anything.  The pressure while you're sleeping isn't bumping up against the max you have set. You may try dropping your EPR to 2.  
10mg is quite a bit of melatonin.  Most recommendations are for .5 to 3, maybe up to 5 mg.  Headache and fatigue are reported side effects of melatonin.  I doubt if your O2 levels are causing your headaches.   If I take melatonin, I'll start with .25mg tablets and got to .5 if necessary, but I generally avoid it unless I'm managing jet lag.

Try backing way down on the melatonin and just stick with your therapy.  You should start to get more comfortable with it and sleep better.

I dont ever take the full 10mg, at most only half.  Regardless, i've purchased some new herbal sleep aids, one formula without melatonin and one that only has 1.5mg melatonin.  I have always had a tendency towards insomnia, so it seems clear that I do need something to help me sleep, especially after that other night I tried to sleep with nothing and ended up only having ~2hrs.  Going to try to wean down further as I go and I guess I'll be in a better position to judge the efficacy of the nasal mask once melatonin is out of the picture.

So my oxygen concentration doesn't seem to be a concern at these levels?

[Crimson Nape]

There is a trick of increasing the EPAP pressure to aid in increasing tidal volume. The technique is called Positive end-expiratory pressure (PEEP).  The premise is while using a bi-level setting, you increase your pressure range on both the EPAP and IPAP upward, until you achieve an acceptable tidal volume.  I know this trick has to have some practical limit, but I hit my sweet spot before this occurred, so I can not tell you how far to try this.  I sure at some point the tidal volume will plateau.  You might try a setting of a min = 12 / max = 14.  It is not that drastic of a change from your current pressures.  See if this helps.

As always, please keep us informed.

- Red

[Uphold9887]

There is a trick of increasing the EPAP pressure to aid in increasing tidal volume. The technique is called Positive end-expiratory pressure (PEEP).  The premise is while using a bi-level setting, you increase your pressure range on both the EPAP and IPAP upward, until you achieve an acceptable tidal volume.  I know this trick has to have some practical limit, but I hit my sweet spot before this occurred, so I can not tell you how far to try this.  I sure at some point the tidal volume will plateau.  You might try a setting of a min = 12 / max = 14.  It is not that drastic of a change from your current pressures.  See if this helps.

As always, please keep us informed.

- Red

Thank you for your input, but i'm not sure how to go about changing those pressures specifically on my machine.  I think I can only adjust the main pressure settings, and there is an EPR setting of 0-3 i can adjust?  My original prescription was from 5-15 min/max pressure, and I have continued to adjust over time.  I can of course adjust up again, just wanted you to be aware that perhaps further adjustments are in the realm of "drastic"ly away from my original prescription lol

[Crimson Nape]

Hold down both the big knob and the button below the screen for about 5 seconds. This will put you in the clinician's menu. You will need to read the screen because it will default to the exit option when you enter it.

You need to request a Clinician Setup Manual.

Here is the link: https://www.apneaboard.com/adjust-cpap-p...tup-manual

This link can be found at the top of every page here, "CPAP Setup Manuals".

Just follow the directions and look in Section 3 for instructions.

- Red

[Uphold9887]

Hold down both the big knob and the button below the screen for about 5 seconds.  This will put you in the clinician's menu.  You will need to read the screen because it will default to the exit option when you enter it.  

You need to request a Clinician Setup Manual.  

Here is the link: https://www.apneaboard.com/adjust-cpap-p...tup-manual  

This link can be found at the top of every page here, "CPAP Setup Manuals".

Just follow the directions and look in Section 3 for instructions.

- Red

After reviewing the clinician's menu, it seems I can only change min and max pressure, and the EPR value.  So I'm simply adjusting pressures upward again?  I left settings unchanged last night, and O2 sats were slighly improved (nothing below 90%), however still fairly fatigued.  I also dialed back on the melatonin and magnesium which I think may have helped somewhat.

Here's last nights data (with oximeter imported):