Started CPAP treatment - Would like advice on my sleep study and OSCAR information

[OpalRose]

Have you always slept on your stomach?  Are you able to sleep on your side, preferably your left side as this aids in digestion, and may help with the Aerophagia.

Your charts look great number wise, but you may be causing/aggravating the sinus problem.  Could your mask be pushing up against your nose too much and causing pressure on your nose by sleeping on your stomach? I also see some mask movement on your graph which may cause you to swallow air.

This is just a suggestion to try..... many folk that suffer with Aerophagia use a straight (static) pressure.  You could keep the machine in Apap mode, but use minimum 8 and
maximum 8.  Use EPR 2.   The reasoning for keeping it in Apap mode is that Cpap mode with the S9 may not show flow limitation.  

So... consider side sleeping and the static pressure.

[Mythique]

Thank you OpalRose. I didn't get the chance to see your message yesterday. I usually sleep on my stomach, I get to sleep faster this way.

I tested the new mask (Resmed AirFit N20) last night. And I did not have as much bloating this morning, barely noticeable and not bothersome. So that's a good point. It forced me not to sleep on my stomach I think, I slept mostly on my back, on my side and a weird in between side/stomach.

Unfortunately the new mask is loud compared to the previous one. I was surprised by how much air is going out from the front. It seems normal though? And obviously the mask is bulkier than the previous one.

I'll check tonight with the "old" mask if I can find a sleep position that will reduce aerophagia, following your advice OpalRose. And if I can't I might keep the new mask (or try the static pressure).

Sinus pressure and headache is unfortunately still there, and still tired this morning. Hopefully I'll be able to talk to a doctor this week... I'm so desperate to have a good night of sleep.

[Mythique]

Hello everyone,

I'm coming back a few months later. I eventually bought a Resmed AirSense 11 after my previous post. It did not change much for me to be honest. I thought I would try to get more advice to see if there are things I can improve that would help : I still wake up tired and almost always with a headache.

When I bought the new device we decided to reduce the pressure because I still have aerophagia (often there depending on my sleep position during the night - and can prevent me from going back to sleep sometimes).

I attached to this post two screenshot from OSCAR.

[Mythique]

Hi,

I'm attaching to this message another night. Let me know if you find anything that could be helpful. I doubt there's something to be done regarding the CPAP, but I currently have no other options to explore and find what is causing my horrible sleep.

[Mythique]

Hi everyone,

Another week, another post with a recent chart from OSCAR. I hope this is fine.

To add a bit more information. I mentionned sinus pain a while ago, fortunately it went away and I think it was unrelated to the CPAP use. Here are a list of symptoms I still have :
- Headache when waking up. The intensity varies. And it can persist during the day.
- Feeling tired when waking up. If I wake up and dont get at list 7-8h it's way worse (like in the night in the image I attached to this post).
- Difficulty concentrating during the day.
- Dizziness when standing.
- Irritability.
- Still a kind of brain fog.
- Aerophagia caused by the CPAP, depending on my sleep position during the night.


Before buying the Resmed Airsense 11, I wasn't sure if the CPAP was really helping me, and tried a night sleep without it. It felt worse, so I decided to buy it anyway even if the symptoms were not improved by much. I also went to the doctor to do some blood test and there was nothing out of the ordinary.

Right now I don't know if there's something I can improve with my CPAP, or if I have another issue (I should have an appointment to a hospital to check for chronic fatigue, but it's taking a long time).

I am currently really struggling, and would appreciate any help or advice.

[Expat31]

Hi,

I have not been though any of previous posts in this thread, so apologies in advance if anything I suggest has already been covered.

A quick look at your graphs shows obviously quite a few central apneas and just a few other events.

I consider the first line of defence is the level of minimum pressure. It may therefore be helpful to increase this to at least 7. 

This may help to clear the few remaining hypopneas and obstructive events.

As you probably know, central apneas are not really treated by pressure by a "simple" CPAP. 

I think that this is really the domain of a bilevel machine

However, what is possible is to reduce the EPR on a CPAP which should help somewhat. 

Currently you are on level 2. Try switching this off to see if this helps. 

I expect you have already seen the various posts on the forum on the benefits and disadvantages of EPR and CO2 "washout". If so, again apologies in advance.

Regards

[Mythique]

Thank you for your thorough answer. I will try the new settings tonight and see if it made any improvement and will probably post in a week with a new chart.

[BoxcarPete]

Your median tidal volume is really low. Have you seen an ENT to have your airway scoped? The initial study indicates that you have resistance to airflow that is not causing your oxygen to desaturate, which is similar to my experience. If they rated my events by a drop in O2 I would have had an AHI of 0, since I never dropped below 95% and my nighttime average was 97% during my sleep study. I had most all the same symptoms as you, maybe not quite so many headaches but all the rest for sure. Aerophagia was worse for me with a FFM but happened some with nasal mask and mouth tape. I would need a solid 8-9hr night to feel like a human being at all.

After 3 years of trying various things including MAD and finally getting serious about CPAP with underwhelming results, I went to an ENT and within a minute he figured out that my nose was simply not permitting air through it as it should, and that he could correct it with surgery. I had occasional sinus pain as well, which he figured was likely related to the bone spur shooting off from my septum. The operation was last week and I already feel the difference. It's worth checking.