wickedsleepy - Sleep Therapy Analysis

[SarcasticDave94]

If the F&P Evora is anything like the Vitera, you don't want it tightly strapped. I'm not sure if you're doing that or not. I myself found F&P with Rollfit cushions to flex and break seal much less than masks from ResMed.

[wickedsleepy]

Thanks, I am definitely going to see about a soft cervical collar.  The Evora mask is awesome, so much better for me than the F30 I was using.  I still get leaks though at times.  I have facial hair and keep it to barely a stubble around my mouth, I wash my face right before bed, and I wash the cushion nightly, but I still gets some leaks.  I believe they happen on my back almost exclusively, probably from jaw dropping when on my back, thus changing the shape of the face.

I’m Leary of dropping the max pressure just because of how bad I’m feeling.  

Is there a favorite kind of soft cervical collar that you all like?

[wickedsleepy]

"Your OA's were definately clustered possibly 5 each. The number beside each event is the duration in seconds."

Wow, that seems like a lot!  So that means four or five apneas in a row, ranging from 25-ish seconds to around 40-something.  Could that alone make me feel like a zombie, today?  My sleep doc told me that everyone is different so while some people don't even realize they have sleep apnea, others may have mild or moderate apnea but really feel the affects of the events on the body and on mental clarity.

[UnicornRider]

Zoom in on that area of the Events, look at the Flow Rate graph wave shapes, yes, Apnea is absence of breathing. Try holding your breath like that.

Zoom in on your Hypopnea & Respiratory Effort Related Arousal (RE), look at the Flow Rate Graph for those, then scroll ahead and behind that to see all of the distorted wave shapes. That is where the Flow Limits are derived, your breath is not totally cut off, but very restricted.

      "Could that alone make me feel like a zombie, today?" 

Yes your Doctor was right, some people with UARS, who do not show an AHI score can suffer severely.

That is why we sometimes ask for a zoomed in views of various lengths from 2 minutes to 6 or 8 minutes around events.

Check out "The Guide"


Post back.

[SarcasticDave94]

And I only had one 90 second Apnea on my test in 2017. The other 147 Apnea were a bit less in time.

[UnicornRider]

Hi guys,
You can find the "Knightsbridge Sleep Solutions Chinstrap" at Supplier #37.

Knightsbridge is in some type of power struggle over management, many disappointed customers lately. I would hold off ordering for a month or so. Check online for additional info, Lefty Lanky had some info.

[wickedsleepy]

So, essentially the hypothesis is that these four apneas are positionally caused, and this may be the reason I feel like I'm brain-dead, today?  And the CPAP cannot correct for these because... because they are perhaps due to chin-tucking or some other positional factor?

This kinda sucks.  If I could stay planted on my side all night, I think I would be all set, but I am an active sleeper.  

I went to four different places this evening looking for a soft cervical collar.  I struck out on all four places.  We'll see what tonight brings.

   

[UnicornRider]

So, essentially the hypothesis is that these four apneas are positionally caused, and this may be the reason I feel like I'm brain-dead, today?  And the CPAP cannot correct for these because... because they are perhaps due to chin-tucking or some other positional factor?


[/quote]

Sometimes you need to zoom in further, notice my Flow Rate graph vertical axis (Y-Axis) is scaled +80 to -80, The time scale on the bottom is ~6 minutes. The first OSCAR Report is good looking wave shapes, I can breath that all night long.
   

This next OSCAR you will see some Flow Limits popping up in the bottom graph and the Flow Rate wave forms are not as smooth, that is robbing me of much need O2 , not a complete Apnea, but still limiting the amount of free air flow.
   

Now on this OSCAR you will see an Obstructive Apnea, but look at the Flow Rate wave shapes prior to and after the OA. So I was not getting full air flow before and after the complete Apnea. Those little ones add up. Notice the Y-Axis scale on my Flow Limits. 
   

Now look at your Flow Limits, check out your Y-Axis scaling for both Flow Rate & Flow Limit graphs Zoom in for ~6 minute view and use your "greater than" and "less than" keys to scroll across your Flow Rate and see how many nice wave shapes you have and how many distorted wave shapes that correspond to Flow limits you find.


Those Flow Limits are also of concern. Look up Upper Airway Resistance Syndrome.

People with UARS usually complain of snoring, daytime sleepiness, cognitive impairment, un-refreshing sleep, and frequent arousals from sleep.

[wickedsleepy]

Thanks, UnicornRider, for the detailed explanation.  As a reminder, flow limits just mean the system detects some kind of resistance which may or may not be apnea?  I will read more about UARS.

Last night, as I mentioned, I was not successful in finding a soft cervical collar.  I may have to order one.  To encourage me to stay on my side, I dug out a 2 inch memory foam mattress topper, hoping that would help.  It made no difference.  I also lowered the floor of my pressure range to 11, with EPR still at 3.  It was a bit more comfortable than at 12, and I didn't see many more CA's.

The results appear around the same as I've seen lately -not necessarily the same as the night before, but similar to other nights in the past two weeks. I feel a little better than I did yesterday, but I still feel like my brain is "floating" and have difficulty with short-term memory (which sucks because my memory has always been one of my strengths).  It does appear that my flow limits are still generally kept under 0.50, with a few outliers.  I need to read up on what is "good" for flow limits.

As far as leaks go, I feel like the Evora ffm leaked less when I first got it, which was only 3 weeks ago, today.  I notice that, aside from the jaw opening, my smile relaxes while on my back, and the corner of my mouth widen beyond the inner edge of the seal.  That seems to break the seal.  I have a L-size cushion.  Maybe tonight I will shave all the stubble off around the mouth to see if that helps.  I also wonder if the higher humidification sort of "lubricates" it.  

Anyone else with Evora ffm experience leaking issues like this?  It is still by far better than the F30, but I do get leaks and seal breaks when I go on my back, for apparently more than one reason.

Also, check out my respiration rate, however, at the bottom of the second screenshot.  This is another thing I have noticed on other nights. On nights like last night, it gets high and stays high, sometimes even when there aren't events at the beginning.  Any idea what that is all about?


       

[DaveL]

I'm chasing good performance with the same mask.
F&P Evora Full. Full face mask.
I have two of them now.

I tried 2 DME suppliers. The second one suggested I clean them more. So I bought cpap wipes from them. They were only after fees and sales; I went back to the DME supplier I've used for years. I bought my second mask from them.

I have to be extremely careful putting it on. I've checked settings and made sure that the straps on the top are equal length. And the straps on the bottom are too. If I adjust the mask while I'm lying down I never get the straps equal length. And I might as well forget about a night's sleep.

On a good night I wake up 4 times. Once awake I may be awake for an hour, once. So sleep quality is terrible, while my numbers are adequate.

I get better sleep with my ResMed N20 nasal mask on. I tape my lips. Taking the tape off, I ended up with a bleeding cut below my lower lip. Thanks 3M for your tape. So back to the F&P Evora Full full face mask. And I put my Knightsbridge Dual Band on over the headgear. (Won't fit with the cap on first, and mask over the cap.) Back to waking up 4 times a night....and if anything happens all that stuff comes off.


Final thoughts....I've marked the headgear showing where the straps were when the mask worked. Pay attention to the strap on top. Don't forget to adjust it too.

It ain't easy being compliant.