[Treatment] New user struggling to wake up refreshed

[THEVGE]

In the mean time I have gotten used to mouth taping without the "chipmunk cheeks". A collar helps a lot.

Attached is what I see in Oscar a lot, which correlates with my awakenings (as I have sometimes timed/noted myself, or picked up by my Pixel Watch 3). Can anybody explain to me what is happening here and what I could do about it? I am not really sure how to interpret this as the issue seems to be with exhalation......

Typical flow rate identified as my main challenge for a good nights sleep:
   

[SeePak]

Hi vge

Looks like you could have palatal prolapse, something to do with the nasal cavity.
I also have this.
On exhalation, you close up, pressure has to go somewhere, so out the mouth it goes, if possible....

And mouth taping will, can make it worse i think. ( i am doing it too! )

You can clearly see mouth breathing on chart, when Leak Rate goes up and flattens out AND flowrate reduces as well.

See, taping the mouth has some downside.
That pressure has nowhere to go, and possibly/probably causes an arousal !?

I am going thru this myself, but i dont want to get rid of the mouth tape cause it saves my therapy ! or so i think....

Cause i have had good nights sleep even with my mouth opening at times ( as it needs to due to the blockage ) when using MYOTAPE, check it out!
Patrick McKeown.
He described the need for air to escape when this happens due to OA.

This tape allows mouth to stay closed for most times until necessary to open with this condition.

Also , hope not to p*** you off, and i have read thru your thread a few times,
I dont see a need to chase the breath sine wave, flow limit route.

Get rid of obstructive events, as you have, and run with as low a pressure as you can, without EPR.
This gives the least amount of flow changes that could disrupt your sleep.
Then give it a few days to see how your rest goes, and sleep.

If you still have feeling of not rested, try getting into breathwork ( i see you have exposure to Buteyko )

I am doing that now, and my stress levels have never been better!
Very little anxiety.

My charts sometimes look like crap, but i still feel great!
And no naps during the day.
Breathing exercises help so much, cause even if i am a little tired, getting the CO2 in my system gets my O2 into my blood and cells, which includes the brain
( think brain fog !!)

Anyway, wondering how you are recently making out, interested in your current conditions..?

[THEVGE]

Hi SeePak,

Thanks for your elaborate reply, and no, you did not p*** me off. Likewise, I hope I won't myself with my reply.

Palatal prolapse: I will check it out and discuss with my ENT/sleep doctor this week. DISE should give clarity.

Mouth taping: I found, as long as I have no AHI, I can safely use it. I am aware of the risks. For now I will keep doing it.

Myotape: I actually tried this, does not do much for me. I also read his book and will soon implement it in my breath work (BOLT ;-)). I had much better results using a collar, and I combine it with taping.

Breath flow rate: This is where we have to agree to disagree. My inspiratory flow rate is horrid on CPAP, even at P 11. I need a minimum PS of 4,8 to get a decent flow rate (at any given pressure basically). It seems it is really hard for me to get air in. And what you do not know, but if me flow rate is bad I will get Afib attacks.....and if you ever had these, you will understand I will take zero risk of triggering them. It is only recent I have found out the Afib attacks are related to a period of bad breathing. I even had 2 Afib attacks that I could stop by increasing EPAP by 2 cm. Hence my experiments to increase pressure further. My body basically says "NO" to low P and PS. I am happy for you it works, but for me it is not an option. I might try higher EPAP with lower PS at some point, but not low IPAP and surely only in smal 0,2 cm steps downward to absolutely not trigger Afib. But this is low on my list.

Buteyko: High on my list but no energy to pick it up. Hopefully soon! I am doing some limited breath work already, mainly to calm down, and it works well. But seeing your positive results I have to think about starting this up!

All that being said, I tried a lot and I solved AHI, CA, leak, chipmunk cheeks, bloating, aerophagia, flow rate, SpO2 dips, ..... but I feel as crap as every day, independent of the settings. It is driving me crazy, as if I am chasing a ghost (maybe I am?). The only path I still plan is training higher EPAP and see what that does, ASV, ENT (DISE) and non-apnea stuff such as breath work and relaxation methods as my body is pretty stressed after so many years of non-restorative sleep.

I don't know what else to do.....

[THEVGE]

Reading on PP I now understand why you said turn of EPR/PS.......hmmm, needs to sink in.

[SeePak]

Thevge

Checked out AFib and I have immediately come across that mouth breathing contributes to that AFib.

That looks to me like something worthwhile getting fully under control for you and as far as the flow goes whatever you got to do you got to do I wouldn't want to interfere in that for sure

By the way mouth breathing doesn't apply only for sleep also during the day!
 try it out become fully conscious of mouth breathing all day for at least one or two days and see how you feel I think you'll be shocked.

For you with the afib I would give that number one priority.

Here's the link

https://healthunlocked.com/afassociation...b-ectopics

[THEVGE]

Hi SeePak,

Honestly, there are so many causes and triggers for Afib it is near impossible to say what is the cause. But it is logical of course to assume it is related to my sleep breathing disorder. Due to my breath work I am very aware of the need for nose breathing, and as far as I know I am not a mouth breather unless forced like in my sleep. I do not think I can improve here, except for solving my forced mouth breathing during sleep.

I want to thank you for your replies, as you put me on a new path potentially explaining why my therapy does not work. Later this week I have 3 separate health appointments related to my sleeping issues, and without you I would not have been able to clearly point to this breathing issue as part of the discussion.

I intend to show some more data later in this thread to show my challenges for sleep for advice from this awesome board

Regards,

Hoeksel