Sudden CPAP Intolerance?

[jstro84]

I've been using CPAP since September 2023 and it's been a dream. No problems getting acclimated or with compliance, even when I changed machines in February. I'd been sleeping 7-8 hours per night with CPAP and feeling so much better.

Then April. The entire month I haven't been able to keep the mask on for more than 2 hours a night. I am SO tired and cranky and desperately need rest. I am so frustrated. 

I haven't changed the settings on my machine so it's not that. I suspect my mask/headgear may be worn out so ordered a few new mask setups (FFM and nasal masks with the hose coming off the top instead of the front) but they have yet to arrive. Maybe it's seasonal allergy related? I've been taking flonase/fluticasone nasal spray and an OTC allergy med to shrink my sinuses.


What gives?!

Any advice or commiseration appreciated 

[PeaceLoveAndPizza]

Please post some OSCAR charts. Good chance that the headgear and/or mask need to be replaced, but let’s see some data before ruling out other possibilities.

[staceyburke]

Have you changed your sleep position or pillows, bed.  If so you may have positional apnea.  We need to take a look at your charts (oscar) a totally free down load and not charge software to evaluate what is happening.

[jstro84]

Bed is the same. Pillow is the same. I have some challenges with positional apnea but this is nothing new and has never affected my compliance. Literally nothing externally changed from last month to this month. 

I don't know which charts are most useful here, so any more specific guidance would be helpful. It doesn't seem like a daily snapshot view would be helpful for analyzing a long-term problem. So I attached an overview where you can see things just...drop off in April after months of high compliance.

Note the previous months of everything going swimmingly. 

Settings for the last 60 days: 

APAP Min 13.0 Max 20.0 (cmH2O)
EPR: Full Time 3 cmH2O

Maybe its just allergies? Has anyone had a similar experience?

[SarcasticDave94]

Let's try the daily details OSCAR chart. I think if while viewing, you can reset the order to a standard default look, which should remove the pie chart and calendar on the left panel. It would then show Events, Flow Rate, Leaks, Flow Limit, Pressure, etc. No zooming in just yet.

That would give us a great snapshot of your data.

[jstro84]

Here's the charts for last night and for comparison a more average night from late March, if this gives you any insights. 

I use a nasal mask. I know I mouth breathe and I do tape but lately I've had issues with mouth taping because I literally drool so much the tape de-adheres. Yes, I use cover-roll and my toxic drool seeps through it my sleep!

[SarcasticDave94]

OK comparing these 2 charts, the big difference I'm seeing is leak rate.

March chart leaks median 3.6, 95% at 14.4

Recent April chart leaks median at 8.4 and 95% at 22.8

Probably significant enough to address. Start with the simple stuff. How new is the cushion?

[Deborah K.]

I need to use mouth tape too, but I learned the hard way that I have to use 2-inch wide tape cut about 5 1/2 inches long.  Maybe your mouth needs to be very well covered too.

Also, your flow limits are high.  I can't see your settings, but you need to be using EPR full-time set at 3.  If you are using ramp you need to turn it off.

[jstro84]

I think the cushion replacement is on the right track. I just put a new one on and the seal is much better. I'll update tomorrow morning, hopefully with good news!