Need Help Optimizing Therapy

[donewithbeingtired]

Update:

Got the p10 nasal pillows and really like how small and unobtrusive they are. Also seem to get a good AHI (~1-2) with them at only 4 or 5 apneas/hypopneas each night.

But they are a pain to get settled into my nose when I lie down. Always seems to be a small leak blowing air into my eye or onto my hand etc. Have the right size pillows attached after trying all the options and have played with the head gear. I get it settled in after a few mins of playing with it, but I usually only make it about 4-5 hours before it dislodges and then wakes me up. At that point I am not doing another 5 min round of screwing with it so I just take it off for the last 2-3 hours.

Not ideal I know, but its where I am.

I am going to switch back to a few nights of the Wisp to see how that goes. Headgear is much more substantial and I am hoping I can work up to 7.5-8 hours with it on.

Not giving up on the P10 but want to compare. The AHI with each is low but I need to find somehting I can TOLERATE for a full night sleep. Funny the FFM was great for this, but the AHI sucked.

Last thing, taping. Just a small 1" strip of athletic tap horizontally across the middle of my lips seems to do it. It only covers maybe 3/4 of my mouth. Dry mouth is gone so that's a nice improvement.

Not really asking a question here, but if anyone has any tips on the how they made the P10s work I would appreciate it.

Thx, T

[donewithbeingtired]

I've had a week now on the wisp with the same pressure setting as the P10 and its going well. The AHI is 1.1 average over the 7 days and I sleep pretty well, not really being woken up by it.

My only issue at this point is duration of sleep. I am getting to sleep consistently around 11pm, but then am waking up at 4:30-5:00am, and not able to go back to sleep with the mask on. It seems to be leaking air somewhere on the side or up toward my eye and I can't seem to get it re-adjusted. Not sure why its like this after 5-6 hours, when it seemed to be fine until then. So I have just been taking it off the mask and sleeping the last 2 hours without it until I get up. I feel pretty awake at 5am, but am then pretty tired when I go to get up at 7am.

Do I just need to stick it out and give it a few more weeks, or should I be doing something different? I don't want to go try a bunch of crazy stuff at this point, things seem pretty optimal, I just want to get to 7.5-8 hours of sleep.

Appreciate any tips/advice.

--T

[Wulfman...]

I've had a week now on the wisp with the same pressure setting as the P10 and its going well. The AHI is 1.1 average over the 7 days and I sleep pretty well, not really being woken up by it.

My only issue at this point is duration of sleep. I am getting to sleep consistently around 11pm, but then am waking up at 4:30-5:00am, and not able to go back to sleep with the mask on. It seems to be leaking air somewhere on the side or up toward my eye and I can't seem to get it re-adjusted. Not sure why its like this after 5-6 hours, when it seemed to be fine until then. So I have just been taking it off the mask and sleeping the last 2 hours without it until I get up. I feel pretty awake at 5am, but am then pretty tired when I go to get up at 7am.

Do I just need to stick it out and give it a few more weeks, or should I be doing something different? I don't want to go try a bunch of crazy stuff at this point, things seem pretty optimal, I just want to get to 7.5-8 hours of sleep.

Appreciate any tips/advice.

--T

Have you been analyzing your downloaded data reports to determine why you're being awakened? By going back to sleep without the mask you're undoing some of the therapy you've been getting during the night.

Please refresh my memory.......what ARE you doing?

Some people, after they start therapy (speaking from experience) have found that they get better sleep with shorter hours. But, that may only go so far. In my first year, I struggled to average more than 6 1/2 hours. Lots of stuff going on at work, shorter nights (at least all but a few were over 4 hrs.)......trying to make up for some of it on the weekends. At some point, the number of hours began increasing and I was REALLY enjoying this new way of sleeping and breathing. Like I've said before......it's "baby steps". You need to stick with it and monitor your therapy. Figure out what works and what doesn't.


Den

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[donewithbeingtired]

Straight CPAP pressure of 9. Did a week of P10 but had trouble getting it to seal, so just finished a week of Wisp mask. I think both can work, but the Wisp seems to be easier for me right now.

I also use a small...maybe 1" piece of athletic tape horizontally across my mouth and that seems to keep things sealed and prevent dry mouth issues.

AHI is average 1.1 over the last 2 weeks, I check it each day. Mostly hypopneas and no large leaks reported.

Have narrowed it down to this after trying a FFM with a much higher pressure and also APAP mode.

I fall asleep quickly and stay asleep until I get to that ~6 hour mark.

Looking for ideas on how to get it to ~8 hours.

Is there something else I should be looking at in the data to try and understand why I am waking up?

Thanks,

[Wulfman...]

Straight CPAP pressure of 9. Did a week of P10 but had trouble getting it to seal, so just finished a week of Wisp mask. I think both can work, but the Wisp seems to be easier for me right now.

I also use a small...maybe 1" piece of athletic tape horizontally across my mouth and that seems to keep things sealed and prevent dry mouth issues.

AHI is average 1.1 over the last 2 weeks, I check it each day. Mostly hypopneas and no large leaks reported.

Have narrowed it down to this after trying a FFM with a much higher pressure and also APAP mode.

I fall asleep quickly and stay asleep until I get to that ~6 hour mark.

Looking for ideas on how to get it to ~8 hours.

Is there something else I should be looking at in the data to try and understand why I am waking up?

Thanks,

Since you're using straight pressure, it wouldn't be pressure increases.
So, then you look for leaks, apnea or other events (or clusters) or other things that sort of "jump out at you" (or look suspicious) just before awakening.

Other things like needing to go to the bathroom.......my bladder has a limit of about 4 - 6 hours.


Den

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[Krelvin]

So I have just been taking it off the mask and sleeping the last 2 hours without it until I get up. I feel pretty awake at 5am, but am then pretty tired when I go to get up at 7am.

You have been reinforcing the issue by taking your mask off and sleeping without it. Your body is used to doing that since that is what you do every morning.

Instead, you take the mask off, get up, go to the bathroom whatever and then re-prep back to sleep like you do at night. Don't sleep without your mask.

[ChicagoGranny]

Is there something else I should be looking at in the data to try and understand why I am waking up?

Sleep is not all about CPAP and data.

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Practice total abstinence of caffeine including sources like chocolate
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Optimize emotional stress in your life
- Use CPAP software to make sure your therapy is optimized

Instead, you take the mask off, get up, go to the bathroom whatever and then re-prep back to sleep like you do at night. Don't sleep without your mask.

+1

[Therapist]

I fall asleep quickly and stay asleep until I get to that ~6 hour mark.

Looking for ideas on how to get it to ~8 hours.

If you have been going to bed at 11 and waking at 5, start going to bed at 1 and see if you sleep until 7. Try this for a while and if you are getting very sleepy in the evening, switch bedtime to midnight and see what happens.

Many people do very well with 7 hours of sleep, so you may not be able to get to 8.

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Practice total abstinence of caffeine including sources like chocolate
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Optimize emotional stress in your life
- Use CPAP software to make sure your therapy is optimized

Perfect Granny!

[donewithbeingtired]

OK thanks. I do all the sleep hygiene stuff you listed....except caffeine. I drink coffee in the morning and then nothing after 11am, but maybe I need to let that go.

Again I have no issue falling asleep, I am tired by 1030 or so and am out within minutes of getting into bed. Also the events I have are spread out through the night....a single hypopnea here and there...about 1 an hour average. They are not concentrated around the 5am wake up time.

I will endeavor to keep the mask on for full sleep time and see if I can work up to it.

--T