Starting out - can you have a look at my OSCAR data?

[vanillagorilla]

Hi everyone.

I had a Level 2 polysomnography a couple of months ago, the results of which I have attached. I had an AHI of 21.3/hour during REM and 4/hour during non-REM - 99% hypopneas. They didn't give me a number for my respiratory arousals (RERAs?) but they are graphed. I went to the sleep doc attempting to get a diagnosis of UARS but they didn't know what that is. So I am being treated for mild obstructive sleep apnea and have just received my CPAP, a Fisher & Paykel SleepStyle Auto. I am using the Evora mask which covers the mouth but has nasal pillows.

For some backstory, I have been having unrefreshing sleep for about 16 years. I had an oximetry test done 10 years ago but no issues were found. I had another oximetry test 5 years ago and again, 0 AHI but a remark of 'upper airways resistance'. I was finally able to get this PSG done and what do you know, I do have a problem! I have been suffering from chronic exhaustion, ADHD symptoms, digestive issues, dissociative issues and intense anxiety (especially upon waking). I have traced these issues back to when I had extractions and retractive orthodontics at 15. I can't prove that is the cause but afterwards my jaw became recessed and I had less tongue-space. I also have a chronically congested nose.

I have attached the OSCAR data of the two nights of sleep I have had so far. They were pretty bad and it was difficult to sleep with the machine as I am a very light sleeper. On the second night I used Afrin for my nose so it was much clearer than usual.

Please let me know your thoughts!

   

   

[staceyburke]

I am not familiar with your machine so I won't give you setting advice. But the first night I see 2 things that were a problem. The first are large mouth leaks. If this continues to be a problem you may need to try tapping. You can search threads on this, there are many people who do this to stop mouth leaks.

The second is positional apnea... You are having positional apnea. You can see positional apnea where either H or Oa events are clustered together. Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.

You only had it one of the nights so it is something You need to be aware of. If you have an increase in AHI look for the grouped H and Oa events in the chart.

[HalfAsleep]

I’m no good with setting suggestions. Trust others for those.

There are some skills involved in xPAP therapy which tend to be harder to adjust than pressure settings and are very individual. Here are my thoughts.

It looks like you’re having a fight with your mask, and neither the unit nor your body likes it. It creates over-reaction in both. And voilà, the easy (maybe the only) solution is to throw off the mask.

I recommend putting on your mask and firing up your unit (at the settings recommended by AB advisors) for maybe an hour a day while awake. Watch TV or read; something that lets you be steady and relaxed. Learn how to breathe with the unit. Adjust the humidity and temp to something that feels good to you; perhaps it even calms you a bit, something you can now look forward to every single night! Learn how to tell if your mask is leaking and what to adjust. Your face will have a different shape when you’re asleep, but these are transferable skills, and if you get adept at adjustments, you will spend more time asleep, and less getting razzed up and cursing the whole nasty mess that’s been visited on you. You will avoid the annoying feed back loop of big leaks—high apneas—high pressure that will sabotage your night.

FWIW…to determine if you have a mask leak, trace your finger around the mask with the unit blowing at pressure. As you trace, you’ll come across spots that hiss like your bicycle tire when you’re fiddling with the valve. You can adjust the mask accordingly, but not too tight; little by little. If a big leak can’t be adjusted out, you need a different mask.

[vanillagorilla]

---

I am not familiar with your machine so I won't give you setting advice.  But the first night I see 2 things that were a problem.  The first are large mouth leaks.  If this continues to be a problem you may need to try tapping.  You can search threads on this, there are many people who do this to stop mouth leaks.

The second is positional apnea...  You are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

You only had it one of the nights so it is something You need to be aware of.  If you have an increase in AHI look for the grouped H and Oa events in the chart.

Thanks for your reply. Yes, from my sleep study I found my AHI gets much higher on my back. But I think I roll onto my back because it's easier to breathe through my nose that way. Which would explain why I didn't have that problem the second night because I used nasal spray. Either way I guess I'll have to stop myself from moving onto my back!

[vanillagorilla]

I’m no good with setting suggestions. Trust others for those.

There are some skills involved in xPAP therapy which tend to be harder to adjust than pressure settings and are very individual. Here are my thoughts.

It looks like you’re having a fight with your mask, and neither the unit nor your body likes it. It creates over-reaction in both. And voilà, the easy (maybe the only) solution is to throw off the mask.

I recommend putting on your mask and firing up your unit (at the settings recommended by AB advisors) for maybe an hour a day while awake. Watch TV or read; something that lets you be steady and relaxed. Learn how to breathe with the unit. Adjust the humidity and temp to something that feels good to you; perhaps it even calms you a bit, something you can now look forward to every single night! Learn how to tell if your mask is leaking and what to adjust. Your face will have a different shape when you’re asleep, but these are transferable skills, and if you get adept at adjustments, you will spend more time asleep, and less getting razzed up and cursing the whole nasty mess that’s been visited on you. You will avoid the annoying feed back loop of big leaks—high apneas—high pressure that will sabotage your night.

FWIW…to determine if you have a mask leak, trace your finger around the mask with the unit blowing at pressure. As you trace, you’ll come across spots that hiss like your bicycle tire when you’re fiddling with the valve. You can adjust the mask accordingly, but not too tight; little by little. If a big leak can’t be adjusted out, you need a different mask.

Thanks for your response. I will try those things!