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+--- Thread: wickedsleepy - Sleep Therapy Analysis (/Thread-wickedsleepy-Sleep-Therapy-Analysis)
RE: wickedsleepy - Sleep Therapy Analysis - wickedsleepy - 12-30-2023
Hi everyone. I hope you’re all enjoying the holidays. Here’s a quick update on how treatment is going, along with a few questions.
Currently, I am using my Evora mask, min pressure 8, max 20, epr 2. I have been shaving the “soul patch” below my lower lip and keeping my mustache extremely short, which has helped with leaks. I also purchased a Cpap pillow (Contour CpapMax 2 in 1). The first few nights, I thought this was THE solution I was looking for. It is great when sleeping on my side, but it definitely causes chin tucking when I roll onto my back. OAs are relatively low but Hypopneas are higher and they often cluster around the few OAs. AHI around 2.5 which is okay but leaves me a bit foggy and feeling like I was strangled in the night.
I thought I would lower the pillow. This made is less supportive while on my side, and when I rolled on my back my head was less elevated, which led to worse apneas and high spikes in pressure (up to 20) which practically blew the mask off my face and woke me up with loud fart-sounds.
I’m not really sure what to do. The flatter my head is, the apneas go way up, but with the head more elevated from pillows I get way more Hypopneas. Cervical collar is just not something I’ve been able to sleep with so I’m just using the cpap pillow and mask. Any suggestions? Do they have cpap pillows that elevate both thr head and neck/shoulders when on your back but are also high enough to support the head and keep airways straight when laying on your side? I am an active sleeper: left, back, then right, then repeat over and over. It seems at this point that most of my issues are positional in some way since the pressure doesn’t correct it. Maybe a low wedge pillow to elevate my head and shoulder? Anyone have any ideas or products that have worked for them with this?
Also, have you noticed that diet results in higher ahi’s? If I eat right before bed, especially sugary stuff, I seem to do worse that night. Also if I have more than one coffee in the day, I seem to do worse?
RE: wickedsleepy - Sleep Therapy Analysis - UnicornRider - 12-30-2023
You are correct about diet, certain foods are triggers for some people , timing of the last meal and amount of fluid consumed after ~5 to 6pm, or 3 to 4 hours before bedtime.
No caffeine after 10am for me, other people may be able to handle it later in the afternoon.
IKSTAR Cervical Neck Pillow for Neck Pain, is the pillow I use, works for me at this time.
https://www.amazon.com/gp/product/B0C9Q2M35C/ref=ppx_yo_dt_b_search_asin_title?ie=UTF8&th=1
They have a very liberal try it and return it policy on that pillow. On top of Amazon's return policy. Everything has to be in your personal Goldilocks zone, Mask fit, Pillow, Collar, room temp, weight of blankets. Once you find it you can view a granular 3 minute view across your Flow Rate waveshape and be able to read your nights sleep.
RE: wickedsleepy - Sleep Therapy Analysis - wickedsleepy - 12-31-2023
Thanks, again, UnicornRider. I might check that one out!
I tried something different last night. As I studied my charts, it's plain to see that my OA's and hypopneas are somehow positional -no amount of pressure was resolving them. I also noticed that the Evora mask's lower straps pull my chin back, which is exacerbated when on my back. On a hunch, I dug out an old mouth-guard/mandibular advancement device that I ordered from Amazon a couple years ago. It's adjustable, but to minimize pain on my teeth, I just kept it so top and bottom teeth are aligned, preventing my lower jaw from falling back.
Results? My AHI dropped from around 2.5 to 0.1! The thing that interfered with my sleep and had me up at 5:30am was the headache I had from my headgear. I get those often but it was worse last night, clearly because the mask was tighter due to my jaw not being regressed. I loosened the straps to try this again, tonight. My teeth were a bit sore in the morning, but it's awesome to finally single out and address one of the main issues. My pressure range was also much lower. I maxed out around 13 rather than the usual 18 or 19.
Here are my charts from last night. Just ONE CA, no other events.
[attachment=57809][attachment=57810]
RE: wickedsleepy - Sleep Therapy Analysis - Sleeprider - 12-31-2023
For a pillow I use a duck down 650 fill power pillow from Costco. Really comfortable and adjustable for both back and side sleeping. Regardless of the pillow, you've come a long way with the therapy.
RE: wickedsleepy - Sleep Therapy Analysis - PeaceLoveAndPizza - 12-31-2023
At the risk of stating the bleeding obvious, if your teeth hurt from the mask then it is too tight.
Regarding the Evora fit. I have found it works well for me if I keep the top head strap just snug enough to hold my nose in the dip and not slide around too much, the middle strap a bit tighter, and the bottom strap even a bit tighter. I can pull it away from my face about 2mm so that when I turn on the machine the pressure inflates the silicon cushions against my face.
I have a full beard and trim the hairs where the cushion sits to about 3mm with no noticeable leakage. I also wear a soft cervical collar more to keep my neck aligned, which has helped with flow limitations. And a retainer at night.
Welcome to the club!
RE: wickedsleepy - Sleep Therapy Analysis - UnicornRider - 12-31-2023
You would be wise to do as that Cat-Man-Do, PL&P says Evora FFM does not need to be painfully tight to seal, Like a hovercraft, it should float just above the surface and as the side skirts inflate they should seal against your face. I run my Evora FFM at 18 to 22 (cmH2O), once I found the sweet spot on my head gear I marked the ends of the velcro tabs with ink, as the head gear stretches I have to readjust the velcro tabs, make sure you have found the new sweet spot before you remark the headgear.
I would also suggest you clean your mask, first thing in the morning, minimize the time those face oils are on the mask, then wash your face just prior to putting the mask on. I have gotten about 8 weeks on this cushion, normally I change the cushion every 3 to 4 weeks.
I thought I was happy with a Medium size mask , until this last mask when the CPAP Resupply Specialist, my Sleep Diagnostic Center representative embedded with the DME, suggested I try a Large size mask cushion and gave me a free sample. Although the Medium do work for me, I am more comfortable with the Large size. She stated that sometimes a size up or down from what we were fitted for, will fit better. Maybe she is clairvoyant and knew that between the Halloween Candy Spree and the Holiday Food Fest Season, I would put on enough weight to fill it out. I guess we will see what the spring garden season will bring.
I wish you well
RE: wickedsleepy - Sleep Therapy Analysis - wickedsleepy - 12-31-2023
Haha well the teeth pain was more from the mouth piece that was holding my jaw from sliding back, but yes I agree that headaches shouldn’t be required from tights straps to avoid leaks. Preventing the jaw slide prevented all the leaks, as well, so I’m hoping that tonight I can get away with a much looser fit!
Happy News Years, everyone!
RE: wickedsleepy - Sleep Therapy Analysis - wickedsleepy - 01-02-2024
I'm pleased to report I'm still having success keeping my AHI under 1.0. It was 0.6 last night, with no CA's, no OA's and only a few hypopneas. The mouth piece has really done the trick for stabilizing my jaw and helping the CPAP do it's job. My mask straps for the Evora are much, much looser, and my leaks are almost nothing. I feel a bit dizzy and irritable today, which I'm not sure why, but I can't argue with the numbers. This seems to have made the difference. The operating pressure range is still much lower than it was even just last week before digging this dental appliance out. Low 8's to maybe 13.5 on a few spikes. So much better and easier to sleep with than the 19's I was getting.
Just for comfort, I'm going to try some other pillow suggestions because this Contour one is a bit rough after using it for a few weeks. Other than that, my plan is to get established with a new dentist and inquire about a dental appliance as a more long-term solution than this one I ordered on Amazon a few years ago. Who knew this would do it?? Thanks everyone for your ongoing help.
RE: wickedsleepy - Sleep Therapy Analysis - wickedsleepy - 01-04-2024
Nothing is simple, I suppose. I'm still doing relatively well, score-wise, with the somewhat uncomfortable mouth device keeping my jaw from falling back. I do notice that I wind up on my back and my mouth gapes open with it, at least once or twice in the night. I usually wake up with that after a bit. Still, my AHI was 0.2 last night and my leak is almost zero. I looked at the OSCAR chart and I see exactly 1 hypopnea, but no other events.
So with the events almost completed eradicated, why do I feel dizzy and brain foggy? It's been like that for the last few nights. First night was good, but last few nights the brain fog and dizziness (especially when I close my eyes) is a lot. Do any of you have any experience with what could cause this? I wonder if my SpO2 is getting low for some reason? I have no idea why it would. I do notice I always wind up on my back, even though I try everything to stay on my side. I'm not obese, I have no other health issues, my blood pressure has lowered even with my difficulties getting used to this thing over the past 5 months. I don't get it. Any thoughts on what I should try or look for? Anything on the OSCAR charts that might speak to why I feel dizzy, have brain fog, can't remember anything, etc. even though my events are almost zero?
I should add that, although I don't have an O2 sensor that can track my oxygen levels, I do notice I still have periods where my respiration rate is up at like 50, though they have seemed less/for shorter periods during the night for the past few nights. Not sure if related to this.
Just thought of this, since I know I've woken up with rapid shallow breathing before... perhaps my Evora is not evacuating the CO2 enough, and I'm rebreathing too much of it?
RE: wickedsleepy - Sleep Therapy Analysis - wickedsleepy - 01-04-2024
Adding charts from last night. Disregard the left portion of the graphs - that was from me messing around during the day.
[attachment=57949][attachment=57950]