Mouth tape and data from OSCAR

[angelitos]

Mr. Bonjour,
Thank you for your encouraging message.  It is good to know that those obstructive apneas were not too significant.
Also I appreciate the link to the cervical collar info which i have downloaded and your assessment of my need for that.
I tried the mouth tape again but had another difficulty --  I could not fall asleep. I find that after I have a good night sleep (perhaps 6-7 hours sleep and feel rested) the following night my body punishes me by not letting me fall asleep very quickly, or if I fall asleep i wake up in a couple of hours and can't go back to sleep. I think my ENT doctor said this is  an age-related issue == i am over 70  .  Obviously  not a cpap issue, correct?   Looks like I went off topic here -- perhaps this should be on a new thread>?

[angelitos]

OpalRose,
Thank you = I was wondering about that.  It seems that disturbances in the flow rate pattern (not sure if i have the right terminology) coincide with low pressure, so i will definitely try raising the minimum pressure .... I think i will go directly from 4 to 6.6 or 7.....  I still feel sleepy but i figure that is because if am not  sleeping long enough,(because i often can't fall back asleep during wee morning hours once I wake up).  I sleep maybe 5.5-6.5 hours on average.  Who knows, maybe with the higher minimum pressure i'll sleep straight through the night, (I also increased maximum slightly).

[angelitos]

I've found that my jaw still drops with mouth tape. Personally, I still have to wear a cervical collar. The collar stops my jaw dropping and the 2" 3M tape stops that air leaking out of my lips. MY AHI is 2-3 higher without the cervical collar.
Worth a try with both for week and compare averages with and without.

Ah, yes, that makes a lot of sense.  Thank you for your sharing your experience.  However, I'm trying to simplify my equipment at this stage so I am
going to hold off on the collar for now i think.

[Gideon]

Min pressure should not be less than 4 + EPR = 4 +3 =7 since your EPR = 3.
It can be higher. And I feel that without a specific reason, min pressure for adults should never be less than 6.

[angelitos]

Min pressure should not be less than 4 + EPR = 4 +3 =7 since your EPR = 3.
It can be higher.  And I feel that without a specific reason, min pressure for adults should never be less than 6.

Oh no, looks like I  have been under-oxygenated for  some time.  I have turned up the min to 7 ...   where does the "4" come from in the equation?
Thanks,

[OpalRose]

"4" is the lowest the machine can go, so example...if you set your minimum pressure to 6 and EPR to 3, you will not get the full benefit of the EPR, because the machine can't go lower than 4.  You wouldn't realize the benefit of EPR 3 until the machine reached a pressure of 7cm. (7 minus 3 = 4)

Your median pressure is around 10cm, so a good minimum pressure of 7 makes sense.

[angelitos]

Thank you OpalRose & Bonjour, I see the logic of moving to 7 although it is hard to understand how I made it 3 years
with minimum set at 4 and no benefit from EPR.

Last night I took your advice to increase MINIMUM pressure from 4 to  7.  A very common pattern
happened again  -- I was very sleepy at bedtime but woke up in about 2 hours. Machine was noisy and seemed fast.  
I couldn't go back to sleep for about 2 hours - and used earplugs to help with noise.  Total sleep about 5 hours I think, 
Still somewhat drowsy on awakening,   And in afternoon I catch myself falling out of my
chair because i have dozed off.
   Did I do something wrong>  Perhpas you meant to go gradually (titrate?) from 4 to 7.   I will attach 2 graphs of last night:
one for close up and the other for big pic if that is helpful,
I apologize  to all for the subject title  of mouth tape -- originally my concern was about mouth tape but it morphed into something else--
minimum pressure,  I have temporarily gone back to chin strap to minimize new variables as i struggle with correct pressure.

   
   

[Dormeo]

It will be good to see what happens when you start using Somnifix. I'm going to guess the leaks contribute to the unrefreshing character of your sleep.

I doubt whether your raising your minimum in one go had anything to do with your wake-up two hours in, and if the new setting was comfortable for you, then that's fine.

Your flow limitation chart was very active, and it may be the FLs that are keeping your pressure up against your max for so much of the night. Do you have a cold or sinus or allergy problem that has developed recently?

The noise -- your type of machine is generally very quiet. What kind of noise was it? Can you describe it for us?

[Osiris357]

I had an AHI of 2 with annoying constant small flow limitations also but I was still exhausted and couldn’t wake up the next day along with bad anxiety. If you still feel awful then a soft cervical collar may be able to help. It helped me greatly and now my AHI is below 1 and my flow limitations are nonexistent and I feel great in the morning, finally. If you’re still falling asleep early in the day your small flow limitations may be to blame. They were for me. 


As for the pressure, I have mine at 11 because any lower and my obstructives and hypopneas like to pop up again and I actually prefer the higher pressure. I feel like I’m getting plenty of air and it’s very relaxing. If I’m off base I’ll be corrected but I think you would benefit from an increase to 10-14 cm since your 95 percentile and median is 11. From my perspective it’s worth a shot at not falling asleep in the middle of the day.

For your noise issue my girlfriend bought a sound machine that has ocean waves, rain, thunderstorms, distant trains and the like. The exhale noise for me is very bothersome and that does a perfect job of concealing it.

The most important thing to remember is you won’t notice significant changes in how you feel immediately after making adjustments so I don’t think you did anything wrong.