Something went very wrong early morning - kept feeling pressure pulses waking me up

[MyronH]

Something seriously went wrong early this morning with my therapy. I kept waking up feeling the "pressure pulses" of the machine. I guess it was checking if I had an OA/CA. This is not typical for me, and I was not laying any different in bed to have OA's more tonight.

As long as there are no leaks, how accurate can it determine the OA's vs CA's? Did I really have all those OA's, or did I have CA's and stop breathing? Because the mask pressure went flat.

What is also weird, is that my O2 sensor never showed any drops during these times, even though I had up to 35 second OA's.
Usually my O2 drops like a fly with any OA/CA. And my PR remained around 50bpm. 

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[PaulaO2]

You were having bad leaks. During leak events, the data collected during and, if close together, those in between. The machine cannot accurately determine what is going on.

With the flat-ish tops to the leaks, I would say you were mouth breathing. The machine sends the pulses to try and determine what is going on. With your mouth open, it was sending more than you are used to.

[MyronH]

You were having bad leaks. During leak events, the data collected during and, if close together, those in between. The machine cannot accurately determine what is going on.

With the flat-ish tops to the leaks, I would say you were mouth breathing. The machine sends the pulses to try and determine what is going on. With your mouth open, it was sending more than you are used to.

Thanks. Are you saying the OAs around 35sec could actually be mouth breathing? Because it looks like I wasn't getting any air at all. At least to me.

Last night was worse. I'll post a chart later that shows I had a lot of OAs in a row with no leaks. And my machine topped out at 14 pressure. And it still couldn't get past the oa. Not sure why I had blockage last night. Maybe it's my recessed chin Or tongue or something getting in the way. I wish I could get consistent good nights. Even with AHI 2.2 last night I feel sleepy and tired today.

[MyronH]

Ok how about these screenshots from last night?
I didnt have leaks during this time, but had a lot of OA's according to the machine. 25-49 second long.

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[tedvpap]

Ok how about these screenshots from last night?
I didnt have leaks during this time, but had a lot of OA's according to the machine. 25-49 second long.

They are most likely real.  Zoom in more showing 90 seconds to see for sure.

[MyronH]

Ok how about these screenshots from last night?
I didnt have leaks during this time, but had a lot of OA's according to the machine. 25-49 second long.

They are most likely real.  Zoom in more showing 90 seconds to see for sure.

Yeah they seem real. I was wearing my oximeter and it showed some massive O2 drops to lower 80's during these events.

I'd like to know I could avoid these obstructions completely? Would more starting pressure help to keep airway open the entire night? Problem is the machine couldn't open my airway even with 14 pressure. And sometimes the higher pressures create CA's. 

Other nights I seem fine at low pressures and I've been sleeping the same way on my back with an ergonomic pillow and to tilt my head back. I can't sleep on my side, due to it giving me palpitations and racing heart for some reason. 

I just got a dental appliance but I haven't been able to wear it long without making me gag. I can't wear it at night currently.

[MyronH]

How does the machine truly know that it is an OA and not a CA where I quit breathing?

[mesenteria]

I'm no expert, believe me, but in reading the responses of some of the experts here to charts that look like your last two, it looks like your OA's are clustered, often indicating position-related.  As in, on your back....mebbe….probably.  Or, you tuck your chin as I do and that closes off your windpipe juuuuuuuuuusssstt enough.  You might wish to attempt the relief provided by a cervical collar.  Still, I'd wait for the 'good guys' to chime in over the next several hours before you go running off to try stuff or buy stuff.  

[tedvpap]

The mask pressure is calculated based on the pressure and flow rate (both measured at the machine). Mask pressure goes flat during an OA or CA since the air flow rate is not changing during the apnea event.

I believe that OA events are almost always accurately scored if the breathing shows sleep before and after. Look just prior to the event for signs of obstruction.

[PaulaO2]

You may want to consider also increasing your max pressure. you are tapping that line quite often during the OA events.

The CPAP sends out pulses when it thinks you have an apnea event. It then uses the "echo" of that pulse to determine if it is OA, CA, or HI.

So, one, try a pressure increase and perhaps increase the minimum. Your median inhale is 8. Try 7 and 15 or 16 for about ten days

Two, work on your leaks.