Help! started great, now poor

[rorielly]

I started out my first month quite good.  My AHI was great and I was feeling awesome.  But at about the month mark, I caught my son's cold.  This stuffed up my nose at least partially and then the trouble started.  My nose is almost clear now but it still isn't 100%.  That said, I'm breathing fine enough.  However, ever since the initial cold, my AHI has been poor...I've woken up feeling like I'm suffocating and then taking the mask off...so my total time with the mask has dropped from 6 to 7 hour nights to 2 to 4 hour nights.  I have no idea what's going on...Sleepyhead stats in the links below...I really don't know what I should be looking for.  One thing I notice is the machine seems to be picking up a lot of central apneas which is something I did not have a month ago.  I am hoping that someone knowledgeable here can help me understand what's happening so I can correct it.

https://app.box.com/s/u1qpozh0gvpoauibpi1qshavv2xv53sl

https://app.box.com/s/3go28lgqj46385z2ndbfer0ewktc0a8v

https://app.box.com/s/qihn71tl5huk0w7hwuwjojz7hvlqn765

This is what I used to get: https://app.box.com/s/o6zxbj9d7fjvm3ze0altrudegsbshrp5

Thanks!

[Gideon]

It looks like most of your CA is while you are awake/falling asleep.

You said "I've woken up feeling like I'm suffocating " and given your recent history of cold/sinus issues I'd think of raising your min pressure to 10cm to "push thru" 'till you more thoroughly recover.  I will bump my pressure up when I'm sick with sinus issues, it helps me breath better.

That said are you taking any "new" meds?

Fred

[rorielly]

No meds. First two nights I took cold meds but after that no. Interesting I do at times notice as I fall asleep that I feel like I'm stopping breathing. Which again, I didn't notice that sensation before. Is it just because I'm coming off sinus issues?

[Gideon]

No meds.  First two nights I took cold meds but after that no.  Interesting I do at times notice as I fall asleep that I feel like I'm stopping breathing.  Which again, I didn't notice that sensation before.  Is it just because I'm coming off sinus issues?

When we turn over or move we tend to hold our breath, which our machines tend to interpret as CA events.  This typically stops when we fall asleep.  I might guess that you are moving around more because you are not feeling comfortable.

A suffocating feeling frequently occurs when pressure is too low.  This I believe is from your sinus issues.

Fred

[rorielly]

Ah that makes sense. I'll bump up my pressure to see if it helps.

[Sleeprider]

Your pressure settings are relatively low, and the Philips is not fast enough to catch up when obstruction begins. Part of the reason is that the machine is not detecting flow limits or snores that might increase pressure ahead of time. You look like you should be at 9.5 minimum. What is your Flex setting?

[rorielly]

Currently at 2 flex setting but changed it to 1 and it didn't make any difference so I put it back to 2

[Sleeprider]

That's fine, and good that you tried alternate settings there. I didn't see any obvious signs that Flex would be a problem. Hopefully additional minimum pressure helps. All of this could easily revert back to normal once your cold fully clears up.

To spitball a few other ideas; you use a full face mask, and there is probably a good reason for that, did you ever try a nasal pillows mask? What are your humidity settings, and have you tried increasing or reducing humidity? This can affect congestion.

[rorielly]

That's fine, and good that you tried alternate settings there.  I didn't see any obvious signs that Flex would be a problem. Hopefully additional minimum pressure helps.  All of this could easily revert back to normal once your cold fully clears up.  

To spitball a few other ideas; you use a full face mask, and there is probably a good reason for that, did you ever try a nasal pillows mask?  What are your humidity settings, and have you tried increasing or reducing humidity?  This can affect congestion.

I was initially suggested a ResMed F10 mask.  Everything was done based on an in-home sleep test and the results didn't mention anything about mouth breathing.   I didn't go to the clinic for a fitting or anything because their cost was pretty high compared to what I could purchase online (like twice the cost) and my insurance has a limit on the cost.  So I did everything by myself and made my own choices with respect to the mask.  Initially, I didn't like the idea of something jammed into my nose and was worried I would mouth breathe (it turns out that I mouth breathe only if stuffed up).  I chose an Amaraview mask because of its reviews and small profile.  I don't mind it so much and have considered trying a nasal pillow style mask, but haven't researched that much yet.

I have experimented with humidity values from 0 to 5 and found that at 0 to 2, my throat gets dry (like there's a scratchy lump in it), and if it's 4 or 5, I seem to get stuffed up.  I've settled on a humidity setting of 3.  I'm also using the adaptive setting.  

I set the machine last night to min 9.5 and my AHI was better (down to 7.4 and 6:06hrs usage).  The Clear airway apneas are a lower percentage as well (I can post the sleepyhead stats on it later if needed).  Over the 6hr 6min period, I had 4 CA, 14 OA and 27HA

[quiescence at last]

Interesting I do at times notice as I fall asleep that I feel like I'm stopping breathing.

it is kind of an interesting sensation to be aware or awake when your brain and body shift to sleepy-type breathing.

some have posted that their sleep-partner also say they noticed they stopped breathing.  But, the machine report shows both inhale flow and exhale flow.

so, what is it?

During sleep your inhale is a brain/body triggered event, but exhale is not a forced event.  Hard to believe, but once the forced inhale has occurred, the 'balloon' that just got blown up now simply deflates 'on its own'.

Since you are not remembering (or feeling) a forceful exhale, it seems as if you are not exhaling (or not exhaling enough).

QAL