Tobiathan therapy thread

[tobiathan]

Tried one pillow instead of two. 
   

Detail showing a mix of events in one three-minute period. 
   

[Jay51]

One pillow should (in theory) produce better results than 2 because it will cause less chin tucking.  

Interesting on the 2nd close up chart.  A leak precedes every one of the 4 breathing disturbances.

[Old Steve]

I read your posts again and saw that I had missed that you said that you had started taking Bustar.  I looked the drug up and found this report for Buspirone.  

 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8946643/

I have no idea if this article is accurate or not, but it appears from the article there might be a connection with Buspirone and your change in sleep quality.  Due to possible changes in REM sleep.  Anyway , it might be worth checking out...

[tobiathan]

Interesting about the BuSpar; I’m not sleepwalking, but I had some insomnia problems when I first started taking it and when I increased the dose. I need to dig into the details when I’m a little more awake. I need to stay on it, but if it’s a factor in my sleep quality, that’s helpful to know. 

I took another look, mask leaks definitely seem to be a factor in the most recent chart, and maybe some of the others. I’m not sure that holds true across the board, I need to take a closer look. Some nights are leakier than others but the AHI doesn’t seem to directly correlate. The P10 is pretty leaky for me, I wonder if I need to find a more secure nasal pillows mask or try the FFM again. The F20 is problematic for my periodontal issues (started noticing a little mobility in lower front teeth, possibly related to having the mask put pressure there). I may try it again for a night or two. I recall seeing more clusters, fewer leaks, more CA events. 

Meanwhile, flat pillow the last two nights has not seemed to move the needle on the AHI so far. :/

[Old Steve]

I normally use a n20 nasal mask and mouth tape.  I will occasionally shift back to my old f20 FF mask.  To stop leaks with it I have to use a mouthguard as the mask pushes against my jaw and makes my mouth open. With the mouth guard I rarely have a leak.

Anyway, what I was going to say was that I normally run in CPAP mode no APAP at a constant pressure. So I do not have any pressure increases like APAP.  Although the machine increases pressure when you have a leak to compensate/maintain in my case the set pressure.  About 90% of the time when I have a leak, even a small one I have at least a minor arousal.  So leaks can make a difference.

As to the BuSpar article, what caught my attention was that it said it might lengthen your time in REM sleep. Which may or may not cause a sleep problem. I do not know, but I thought it would be worth checking out.

[tobiathan]

Good morning guys! 

The leak thing seems like a good variable for me to try to work on. I switched back to the F20 mask for last night since I've achieved zero or near-zero leakage on it for many nights, to see what the effect would be. Ironically, I had leak problems worse than the P10 has been lately, so I need to make some adjustments. Or, better yet, I ordered a Nuance Pro mask, which looks like it may be more secure than the P10, which seems to get jostled a lot when I move around in my sleep.

Otherwise, the differences are similar to what I've seen before — lower AHI, way more RERAs, fewer OAs — and oddly, fewer CAs last night too. The graph looks pretty different depending on which mask I use.

I'm running out of attachment space, I'll zoom in on one event for now:
   

Maybe I can remove some of the earlier attachments to make room?

[Jay51]

Pretty good chart here.  You can remove more old charts to make room for uploading new charts by:

1.  Click on UserCP
2.  Click on manage attachments
3.  Select the box(es) of the attachments that you want to delete
4.  At the very bottom of the page click on delete selected attachments.

[tobiathan]

I deleted a few attachments to make some room... I should have the Nuance Pro mask by the weekend and will post charts when I get some data with that. Likely I'll be using the F20 for a bit because of congestion (I seem to be getting sick). I did use the P10 mask last night and am getting increasingly frustrated at how often it seems to be getting dislodged in the night.

[tobiathan]

Got the Nuance Pro nasal pillows mask. Super noisy when I initially tried it. Made some adjustments, hoping to make it work for tonight and see how it performs.

[tobiathan]

Update: Not sure the Nuance mask is any more secure than the P10, both of them are tricky to keep in place when I move around. Ordered a P30i to try and, on impulse, a Wisp. Maybe the varying masks are a distraction and I need to focus on other variables or else accept "AHI mostly under 5" as an acceptable outcome. I see other folks' posts and realize maybe I shouldn't be settling for those numbers though.