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Newly diagnosed with Obstructive Sleep Apnea - alva360 - 09-30-2021
Hello!
I little bit of background, I am a 33yo male, active, 150lbs. short beard.... I have been told my entire life that I snore a lot and that sometimes I stop breading in the middle of the night. I finally decided to get a sleep study done, I did it twice, one to determine if I had Apnea and another one with a cpap machine. From what I remember from the study, my events were 19 and my oxygen saturation level dropped to 70ish% during that night.
Last week I received my Resmed AirSense AUTOSET 10, with a P&F Full Face mask as the nasal one does not work for me (mouth breather). I struggled with the mask for days (feeling air escaping on my nose and blowing my eyes, etc) so I asked them to send me a different size, issues persisted. I decided on my own to get a new mask, a ResMed AirFit 20n that feel way better and I dont notice any leaks.
However, I still see 16 events per night event with the new mask. The leak is 41l/m per the latest report and I have no idea how to fix that as I do not notice any leaks when I go to sleep. I actually do tests before I fall sleep and all indicates mask seal is good (I get a happy green face). But once I wake up my report is always bad. My machine is setup to a fixed 8 pressure, won't go above that. I am frustrated that I can't get the events down, I am not certain if it is a mask issue, a pressure issue, a combination of both etc. I called my doctor and he won't see me after a month, so I was told to continue trying or stop using it as I feel more tired than when I was not using cpap.
Please see attached reports for more information. Any advice will be greatly appreciated. It was costly me so much to get to this point and I don't want to give up.
Some of the issues I see with the OSCAR software:
- Large Leaks - Regardless of how good my seal is before sleeping, the report shows large leaks constantly, sometimes for 35mins)
- Too many Clear Airways - Not sure what is this is.
- too many AHI events, sometimes 16.
LINK TO REPORT: (sorry I cant post links as I am a new user).
RE: Newly diagnosed with Obstructive Sleep Apnea - staceyburke - 09-30-2021
I won’t speak for the central - there are a number of very knowledgeable people who will help with that
What I see is positional apnea. Positional apnea is when your chin drops down to your Sternum and cuts off your airway. There is nothing any machine can help this problem. You must find a way to stop getting into that position.
Back sleeping or high pillows can cause your chin dropping. You may be able to con trol that with easy changes. But if not many people have found that they will do great with a collar. Please look at the link below in my signature. It shows people without a collar and the same people with collars. Huge difference.
RE: Newly diagnosed with Obstructive Sleep Apnea - staceyburke - 09-30-2021
By the way your leaks are NOT a problem. They are Momentarily large but not long so no problem.
RE: Newly diagnosed with Obstructive Sleep Apnea - OpalRose - 09-30-2021
Hi alva360,
Welcome to Apnea Board!
Do you have a copy of your sleep test? If you do, please upload it here. What we're looking for is if you had Clear Airway events during your test. It's always a good idea to obtain of copy for your records. Clear Airway events are when your airway is open, but you are making no effort to breathe.
First, turn off the Ramp feature. Every time you wake up, you are starting over with ramp at a low pressure.
Second, what I see is "positional apnea." See the clumps of OB (Obstructives) on your graph. This happens when you tuck your chin to your chest and in turn cut off your air supply. You may be rolling over on your back or using a pillow that is too tall, which in turn can tilt your head forward with the same affect. You'll have to find a way to avoid this, or possibly start using a soft cervical collar which help align your neck.
http://www.apneaboard.com/wiki/index.php?title=Soft_Cervical_Collar
The ClearAirway events need to be dealt with. Try turning the EPR setting back to 1 and see if that helps. There may be a chance you are not on the correct machine. An ASV machine may be needed to treat your Central Sleep Apnea.
Your leak rate is ok. Some of it is caused from movement or restless sleep.
So for now... ramp off and EPR set to 1.
I'm not sure why you are using a static pressure, but that can be changed later.
RE: Newly diagnosed with Obstructive Sleep Apnea - SarcasticDave94 - 09-30-2021
Welcome and ditto.
Positional events, leaks aren't too bad on this chart.
I suggest for your sanity to abstain from the crazy PAP mask test. Grinning ghouls are void of info. They're basically wanna be cheerleaders and fail.
Centrals AKA CA need a bit of attention by avoidance. Kill off the Ramp and drop EPR to 1. Show us an OSCAR tomorrow minus calendar, it's blocking info. Tell us how you feel as well, regarding PAP therapy and sleeping. Basic grunt answers of I'm ok aren't going to help us, we'll need a bit more details.
RE: Newly diagnosed with Obstructive Sleep Apnea - alva360 - 09-30-2021
Thank you all for your responses. I will follow the advice and turn ramp off and lower EPR to 1 (tried just a second and makes it a bit hard to exhale).
One question, I did (sorry) increased my pressure from 8 to 10 last night to see if I had any improvements. Should I go back to my prescribed 8 (i just dont want to make too many changes at the same time so we can find what the issue was. I will probably get in trouble with the Dr, but they are just ignoring my concerns at this point.
Is interesting that you point out positional sleep apnea, I do tend to open my mouth and lower my jaw when sleeping, Ill check more info about the cervical collar and chin straps (at this point I will be sleeping with so many things on me LOL)
I do not have the report, I will try to get a copy this week and share with you.
RE: Newly diagnosed with Obstructive Sleep Apnea - SarcasticDave94 - 09-30-2021
Just a learning pointer, you can obtain your detailed diagnostic and if done the Titration report. Be specific, request the detailed reports. And if they refuse, tell them HIPAA law permits you to request and receive it. No isn't the acceptable answer. Just say HIPAA says... When can they be ready?
RE: Newly diagnosed with Obstructive Sleep Apnea - mesenteria - 09-30-2021
Those tidal volumes look mighty impressive. In fact, I'd say they're too high. Any comments?
RE: Newly diagnosed with Obstructive Sleep Apnea - SarcasticDave94 - 09-30-2021
I see your point, Max at 1636 on the one I saw just now. Yes that could be a bit high.
RE: Newly diagnosed with Obstructive Sleep Apnea - alva360 - 10-01-2021
Hello All,
Here's an updated report on last night with Pressure at 8 and EPR at 1. I did find a bit difficult to exhale on this setting and made me take my mask off a few times (see attached report).
I don't feel as tired as I used to wake up even though I woke up through the night. I am pretty sure I could be better tho. Anyways, please take a look at the report and let me know what you see. I saw a decrease in OA, but increase of unclassified apnea and RE events.
I did buy the cervical collar but it was not very comfortable, I am trying to get a slim pillow too.
Thanks