MrIvanDrago - CPAP|Bi-PAP Therapy Journey

[MrIvanDrago]

Still need a nap most days, sleep looks good on OSCAR, but I have been waking up just about every hour through the night. I was diagnosed with mild SA, 11 AHI, but seemed to sleep better prior to using the machine.

[zaienk]

For example, on your night of the 11/26/23, could you provide a zoomed view of 5 minutes breath between 00:40 and 00:45?

[MrIvanDrago]

Here you go.

[attachment=57675]

[zaienk]

Are you a mouth breather? If not did you suspect palatal prolapse?

Your breathing pattern matches this which is either expiratory mouth breathing or palatal prolapse

You can find more information about it below :

https://sites.google.com/view/palatal-prolapse/

[MrIvanDrago]

Definitely a mouth breather once I fall asleep. I've tried tape and other things, but now using a hybrid mask.

[MrIvanDrago]

Are you a mouth breather? If not did you suspect palatal prolapse?

Your breathing pattern matches this which is either expiratory mouth breathing or palatal prolapse

You can find more information about it below :

https://sites.google.com/view/palatal-prolapse/

Thanks for the information. After reading through all of it, is it better to try a static cpap pressure vs. a pressure support of 4.0? Doesn't seem to say what could possibly help?

[zaienk]

Everyone can react differently.
In my case, the PS didn't change that much anything regarding the palatal prolapse. Below an EPAP of 12, it happens very often, with EPAP of 12, it rarely happens, and with a EPAP above 12, it doesn't really happen anymore.
But some people even with high EPAP and no PS could not solve it only with PAP.

[MrIvanDrago]

Everyone can react differently.
In my case, the PS didn't change that much anything regarding the palatal prolapse. Below an EPAP of 12, it happens very often, with EPAP of 12, it rarely happens, and with a EPAP above 12, it doesn't really happen anymore.
But some people even with high EPAP and no PS could not solve it only with PAP.

Back in November I tried lower pressures and that's where we see it. The past few weeks I upped the pressure to 16.0/8.0 PS 4.0 and I don't see any of those waveforms in the flow rate. Maybe I will up the pressure to 16.0/10.0 PS4.0 and see if it impacts my sleep in some way and have less arousals? Not really sure but may be something to experiment?

[zaienk]

If you manage well this pressure ranges regarding leak and aerophagia, that's definetly something I would try!
Also you don't need to keep the variable pressure range as you will be upper the pressure that prevent you from restrictive event, like 14/10 PS 4
Also maybe you should increase of 1 every 3 or 2 days from your today pressure to this new pressure to better tolerate this new pressure

[MrIvanDrago]

Ok thanks. I will give it a try tonight. The hardest part about the higher pressures is the leaks, but usually can get it under control. When I first started with the bi-level, I was at 17.0/13.0 PS 4.0, but that was a bit too much, as I attempted to go lower with the pressures. Just trying to find that sweet spot now. Will keep this thread updated. Thanks for all the input!