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Hello again folks. I wanted to open a new thread since it's been a long while since my last one and I think it's no longer getting any views. I've finally been able to connect some sp02 data and wanted to return here for some advice. Long story short I've been really compliant with treatment, I actually found it surprisingly comfortable from day 1. It seems my apnea may be quite positional as I learned from some good advice given on the forum here, I started using a soft cervical collar and that helped quite a bit.
So, the bad news is I am still quite tired, waking up anxious in the mornings and feeling unrested. My blood oxygen usually averages quite high but seems to dip as low as 88% during the night with a lot of spikes in my heart rate. I've seen the doctor about my general health and my bloodwork is good. Generally I'm in pretty good shape but just really tired. Any further treatment advice would be appreciated.
Hey. Thanks for your suggestions, I appreciate the help. I tried these settings last night and subjectively I think things were a little worse actually, I woke up a few times towards the morning with a high heart rate. Here are my charts from last night.
You hit the pressure maximum two times. Your OA and flow limit figures improved while the CAs became worse. The latter can be considered treatment emerging and will go away with time. However, your HR and SO2 deteriorated a bit, which explains your feeling.
I suggest the following tuning:
Ramp off
EPR=2, full time
Pressure minium: 14 cm
Pressure maximum:16.6 cm
Update time! I tried what you suggested and I also tried some positional therapy stuff that I used to do before CPAP. I had one of those inflatable backpacks that stops you sleeping on your back so I gave it a try last night and I think it really helps. I side slept all night with it. Now it seems I still am having arousals and spikes in my heart rate quite often through the night that are not flagged as events which seem to line up with whenever I have mask leaks. Do you think I should continue to tweak my settings or focus on getting the leaks figured out first? I am unsure on what to do at this point. Maybe since I am sleeping on my side I can lower my pressure and get less leaks? I appreciate the help
Today, 09:38 AM (This post was last modified: Today, 09:44 AM by G. Szabo. Edited 1 time in total.)
RE: Treatment advice, still tired
Your leaks are well below the problematic limit. Hence, you can tweak your settings, but your figures are excellent and desirable. I would wait for a week or two to settle into this setting.
Increase the minimum pressure to reduce the OAs further, and eventually, try simultaneously increasing the EPR to 3. Positional therapy helps, indeed. I have copied my findings below.
Have you tried mouth taping yet? It helped me with the OAs.
Thanks! I will try this for some nights. I feel considerably better today than I did yesterday after using the backpack to force me on my side so I think that's good progress.
The thing that still bothers me is I woke up several occasions during the night with a high heart rate, nothing crazy but enough to bring me out of my sleep. I think I may be very sensitive to microarousals possibly caused by the remaining leaks or pressure changes, I seem to be able to zoom in on every leak on my chart and find a HR spike along with it. I'll attach an example below, maybe it's nothing but I am seeing quite a pattern. Wondering what you think?
I really like your solution for the improvised backback, I think I will have to do something similar soon as mine is wearing out and I don't want to have to keep on buying these every few months, the straps wear out, I'm not sure they were designed to be used long term. I have a running vest with space on the back for things to be added, I will try to improvise something with that maybe.
Your leaks are not related to your HR spikes. Instead, disturbances in your flow rate trigger HR changes. I have been seeing this issue on my charts for years.
Thanks. I'm just trying to wrap my head around what this means for trying to improve it. I'm guessing this could be improved by trying other positional things, maybe pillow height or is this something that is addressed with a pressure increase?
According to detailed studies, the average person changes sleeping position 11 times during an average night. If I recall correctly, this figure increases with age.
These position changes interrupt the breathing pattern, which affects HR. This is normal.
