New to the board, not CPAP.

[codemajic]

Hi im a 26 yo male 5'10 230 pounds. Work out 4-6 times a week practice wrestling and lift weights. 

I self diagnose myself with sleep apnea 3 years ago and without insurance I came up with the sleep apnea problem self diagnosis and bought a resmed 10 airsense APAP off craiglist and after different masks i finally settled with a dreamwear pillows with tape over my mouth. that kept my AHI under 5.0 for a a year and a half. I felt way better than without using CPAP but still the pillows were very leaky. The tape helped but I was still leaking.

Fast forward to around March I finally had a job with good insurance and got a inhome sleep study done. My AHI came back 9.6 events per hour and my oxygen was dropping to 89% sometimes. I got a free Resmed Airsense 10 APAP with a fullface mask Amara view mask after I explained that I was a mouth breather and could not help it at all. I decided to keep using my regular old machine which is the same exact model since I still had low hours on it. I got put on flonase as well. Flonase helped the allergies but i still openeing my mouth while sleeping. My mouth had never been that dry before. 

Even though the leaks had almost come to a complete zero with the full face mask compared to the pillows alone and my AHI was lower than 3.0 most days I felt more tired and when I was on the pillows and had more leaks. Its so weird. 2 days ago i tried to tape my mouth again with the full face mask and my sleep improved from tapeless with the full face mask. I noticed my mornings are super groggy lately as well. I just feel like maybe my settings are not right and maybe you guys can help.

I attached my last 2-3 nights from OSCAR and my last night settings were the following:

Machine Settings
 
Please Note: All settings shown below are based on assumptions that nothing has changed since previous days.
Mode
APAP
Pressure Min
12.20 cmH2O
Pressure Max
20.00 cmH2O
Antibacterial Filter
No
Climate Control
Manual
EPR
Full Time
EPR Level
3 cmH2O
Humidifier Status
On
Humidity Level
1 
Mask
Pillows
Patient Access
Yes
Ramp
Off
Smart Start
Off
Temperature
30 ºC
Temperature Enable
1 



Awesome board btw. Thanks!

[DreamDiver]

Welcome! It looks like you're already pretty familiar with what's going on.

As you probably already know, it can take some of us a while to bounce back from accumulated sleep debt. So part of the loginess / feeling tired may involve patience as your body catches up.

Not sure I understand what's going on in your graphs from one standpoint. You have your Min set to 12.2, yet the min in your left stats sidebar says 16.0 on two days and 19.0 on one day. That's not consistent with what I'm seeing in your actual graphs. Perhaps they're a little squished to get a good reading.

Your large leak looks reasonably managed. If this were my data, barring aerophagia, I'd consider upping the Min pressure 1cm, if I were sure I understood how your min pressures aren't consistent with your settings pressures. I'm going to hang back before making suggestions. Hopefully someone else will parse what's going on between the left sidebar and your graphs and we'll both learn something.

Your images include graphs that may be less useful. The ones that are most useful in order from top to bottom are:
Event flags (usually pinned at the top)
Flow Rate
Pressure (not mask pressure)
Leak Rate
Flow Limitations

If you could stretch these five to fit your window for screen capture and squirrel the other graphs 'below the fold', we'll have a quicker glimpse of your information.

The data suggest you're well on your way to good sleep therapy!

Chris

[codemajic]

Hi sorry yes I have been messing with the pressures. My latest setting has been between 16 and 19 with APAP this was for MAY 19 and the settings i posted were for last night as well. Sorry for the confusion I was just tired of being tired with a new mask and almost no large leaks.

As of now im sticking to my air pressure between 16 and 19 unless anyone else has some suggestions. Please im open minded!

[DreamDiver]

Sounds like the best plan is to keep things where you've had them for now.

I guess I'm curious about how this happens where Min is set to 12.2, but Statistics show that your minimum pressure all night was 16.00. I'm not sure what data to trust if the machine settings don't match the stats. Hence my being tentative about giving suggestions. 





Here's an example of graphs that could be useful for the AS10 Autoset. I like flow rate to be a little taller, but so long as everything fits in the graphs pane, that's what's important. Notice how the pressure graph shows both red and green lines. Somehow your graph truncated the red line. I'm not sure how that happened other than trying to squeeze lots of graphs into the space provided. Also notice that the Min Setting matches the Min Stats below. 



Good data help us give you better feedback!

Sleep well,

Chris

[milboltnut]

Let's see you central Apneas on your flow rate fully expanded. Even though there are few... just curious how long they are. Legit ones are 10 seconds.

[codemajic]

Sorry about the confusion. Maybe I should have waited a few more days or a week and kept this 16-19 rate and post screeshots then. 

Here is a screenshot of the sleepyhead version of my graph for today and you can see the flow rate as requested and the settings which should show 16-19 (not sure why the OSCAR program is doing that)

[milboltnut]

Sorry about the confusion. Maybe I should have waited a few more days or a week and kept this 16-19 rate and post screeshots then. 

Here is a screenshot of the sleepyhead version of my graph for today and you can see the flow rate as requested and the settings which should show 16-19 (not sure why the OSCAR program is doing that)

if you left click, multiple times until the chart is fully expanded, and then hold cursor on the central flag in your event flag chart marked CA purple flag... a red box will be around it. Click on it and the flag will appear in you flow rate chart, not quite centered, so you'll have to find it with the right and left arrows to center it.

[Sleeprider]

Don't worry about some anomalies in the OSCAR display. You have self-ttrated to 16-20 with EPR 3 so pressure is fairly high but effective. Focusing on comfort, how do you feel with these settings? Prior to raising pressure, what kind of events did you have that kept your AHI around 3.0? With pressures at this level, your could justify bilevel, which would allow lower pressure using more pressure support if the events were hypopnea, flow limits or RERA.

A couple alternatives to taping to consider. The Knightsbridge double chin strap seems to work for some members to keep the jaw closed, without the elastic pressure pulling back. Another way to achieve pressure on the jaw is a soft cervical collar.

[milboltnut]

Don't worry about some anomalies in the OSCAR display. You have self-ttrated to 16-20 with EPR 3 so pressure is fairly high but effective. Focusing on comfort, how do you feel with these settings?  Prior to raising pressure, what kind of events did you have that kept your AHI around 3.0?  With pressures at this level, your could justify bilevel, which would allow lower pressure using more pressure support if the events were hypopnea, flow limits or RERA.

A couple alternatives to taping to consider. The Knightsbridge double chin strap seems to work for some members to keep the jaw closed, without the elastic pressure pulling back. Another way to achieve pressure on the jaw is a soft cervical collar.

OP says...

 I noticed my mornings are super groggy lately as well

AHI was lower than 3.0 most days I felt more tired

I was gonna say chin strap forgot....

In my experience, may not be yours, however, as pressures are raised, could raise central apneas and pop up more in numbers. So its a good idea to watch out for them.

[codemajic]

I will def consider a chin strap soon. I havent knocked it yet maybe it will work for me!

I have always noticed a lot of hypoapneas and clear airways with a facemask and pillows along with the obstructive apneas. As far as comfort I mean I sleep normally and not too bothered, even though when I first start therapy everytime i dont know if its the pressure but I hold my breathe or dont breathe until i catch myself gasping for air and almost take my mask off...this has only happened with the face mask and at this high pressure (16-19) and with my mouth taped...i want to think its because of the high pressure. really weird.