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Lately (last week or so) I have started to be awakened by snoring. They usually occur near the early morning working themselves into a dream of throat vibrations. I have attached a couple of Oscar files.
Looking at the leak rate chart it shows several flat lines which seems to suggest leakage out of the mouth. I am a mouth taper and I don't think the air is escaping.
Things I have tried and/or what I think my be a factor:
1) Changed my pressure from 11-14 to 12-14. Did not improve.
2) Noticed the last several months an increase in my post nasal drip and mucus in my throat. I had a deviated septum diagnosed by an ENT several years ago, but I opted not to have surgery and have been using Nasacort daily.
Possible relevant info:
I have been using the Airfit P10 for at least the last 5 or 6 years.
I recently tried the Amara View minimal contact full face mask, but have had a difficulty getting used to it.
I don't use the humidifier.
I have never used a cervical collar yet.
On this particular chart, I'm seeing very few snores, and the ones that occurred don't seem correlated with the breaks in therapy. Of course, they may be waking you up anyhow, but I do wonder whether what's waking you up is something more like throat-clearing. Is that possible?
Do you suspect you have allergies? It might be worth consulting with an allergist about getting symptomatic relief for your postnasal drip. You might mention that it's especially bothersome for you given your PAP use. I had a similar problem and good good relief from the drip using Flonase and Azalastine sprays, plus a Singulair pill at night. You could change out the Nasacort for Flonase to see whether you do better with the one than with the other. (These coriticoid sprays may need a couple of weeks to become effective.)
When you remove the mouth tape in the morning, is it at all damp? Are there places that seem not to have adhered fully? Also, are you using Somnifix, which has a little vent in the middle?
Finally, the headgear for the P10 can get stretched out, as you probably know. Is it time to wash it, which can shrink it a little? Time to replace it? Time to try out pillows one size smaller?
A final question: what is the lowest your minimum pressure has been, and what was your AHI like at that minimum? Flow limitations? Your AHI is excellent, and the FLs don't seem remarkable. so if the posted chart is typical, I see no reason not to reduce your minimum pressure.
(01-10-2021, 01:27 PM)Dormeo Wrote: On this particular chart, I'm seeing very few snores, and the ones that occurred don't seem correlated with the breaks in therapy. Of course, they may be waking you up anyhow, but I do wonder whether what's waking you up is something more like throat-clearing. Is that possible?
Yes possibly. It does feel like a snore though.
Do you suspect you have allergies? It might be worth consulting with an allergist about getting symptomatic relief for your postnasal drip. You might mention that it's especially bothersome for you given your PAP use. I had a similar problem and good good relief from the drip using Flonase and Azalastine sprays, plus a Singulair pill at night. You could change out the Nasacort for Flonase to see whether you do better with the one than with the other. (These coriticoid sprays may need a couple of weeks to become effective.)
Yes I do have allergies as diagnosed by the ENT. I'll consider Flonase, Azalastine, and Singulair.
When you remove the mouth tape in the morning, is it at all damp? Are there places that seem not to have adhered fully? Also, are you using Somnifix, which has a little vent in the middle?
Yes quite often it is damp and starts to curl off, but I always thought my lips were still held closed. No I never used Somnifix. I always thought it was too expensive so I just use a medical tape instead.
Finally, the headgear for the P10 can get stretched out, as you probably know. Is it time to wash it, which can shrink it a little? Time to replace it? Time to try out pillows one size smaller?
Yes I'm aware of the headgear stretching out issue. I found a hack that works quite well. I now use the headgear for the N30 mask and it has an adjustment clip on it. I normally use the medium size pillows, but have experimented with the small and large cushions. With the small it seemed like the force of the air was too much and the large was popping out of my nose causing even more leaks. I'll try some more experimenting maybe with different pressures with the large and small sizes.
A final question: what is the lowest your minimum pressure has been, and what was your AHI like at that minimum? Flow limitations? Your AHI is excellent, and the FLs don't seem remarkable. so if the posted chart is typical, I see no reason not to reduce your minimum pressure.
I'll get back to you on this after trying out lower pressures. So you think I should try lower instead of higher pressures?
IMO going higher is probably not going to help if this is a typical chart. Going lower to the point where events start popping up then going back up in pressure slightly has the possible effect that it may address disturbances. That's why I'd try dropping it in this case and see the effects.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Re pressure, I was mostly responding to your raising your minimum. But actually I agree completely with Dave; why not see how low you can take the minimum while still preventing obstructive events? As he says, this may help you sleep more soundly. Do it methodically: drop down to a minimum of, say 10, and stay there a week. If all is well, go down to 9. And so forth. You can play with increments of .2 when you get in the zone where events start to crop up.
It sounds to me as though air is escaping through the damp tape. Two ideas: be sure to purse your lips before applying the tape, and consider wiping the skin around your lips with an alcohol prep pad to remove skin oils. Is the tape you're using water-proof? I know that some forum members think that's a good idea. (Me, I use Somnifix.) On Amazon, search using "waterproof medical tape" and see if something looks OK to you. I see one tape that also has some stretch to it, which might be good.
Regarding the tape: a taped mouth is no guaranty for not having mouth leaks. Take care that there are no wrinkles on the tape. Also use a tape which is strong enough: for me, 3M's micropore didn't work; now I use Fixomull stretch with great success.
Good news so far. I went down to a pressure of 10 last night and the mask leaks improved dramatically. I also made sure my face was clean shaven before applying my 3m Transpore tape.
Thanks for pointing out that it was not snoring (it sure did feel like snoring), but most likely air leaking out of the mouth due to a pressure that was too high combined with tape not adhering properly.
In addition, my congestion and stuffy nose seemed to improve after turning on the humidifier.
I'll try this out for a week then try to dial the pressure down even further. I do remember that I started with a pressure of 9 when I first started CPAP therapy in 2007.
OSCAR chart looks very good and also your feedback that it's doing well clearly indicates things are headed the right way. Congrats and may successes continue.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(01-11-2021, 03:19 PM)SarcasticDave94 Wrote: OSCAR chart looks very good and also your feedback that it's doing well clearly indicates things are headed the right way. Congrats and may successes continue.
