Newbie Needing Help w/ Sleepyhead ?

[FoggyBrain24]

Thanks. I have something like this now that I think of it, used to use it for sports.

[Pugsy]

If you have a beard...try to make one of the nasal masks work...
People do wear full face masks with beards but they come with extra challenges for beards.

The taping for one night is to get an idea if the leaks you are seeing are mouth breathing or mask movement.

Then you have some choices on how you want to proceed.

[FoggyBrain24]

Thanks Pugsy. I do like this mask more than the others, so hopefully, I can keep it up.
I am thinking I may be opening my mouth occasionally, but not necessarily mouth breathing (at least with the chin strap / ace bandage).

My thought is to try the medical tape tonight and see how I wake up. I can also use the ace bandage to ensure it's at least a pain to open my mouth.
If it sticks, we know it's not mouth breathing.
If it doesn't stick, have to assume I need to focus on keeping mouth closed, but it seems like the best option is then to continue using chin strap?
What would next step be?

Do most people adjust / eliminate mouth breathing with chin straps or other devices or are those part of their "forever" package?
Anything else I should keep an eye on?

Thanks again for all of your help!

[Pugsy]

When I started therapy I had a long time habit of mouth opening...big leaks that lasted half the night.
I tried all the various options for reminding the mouth to stay shut and I elected to just tape. For me it was less annoying than the other options.
After about 3 months of taping I started getting lazy and "forgetting" to tape up until lights were out and machine was on and I would tell myself "tonight I just won't tape and it won't be a big deal". It got to be where more and more frequently where I would "forget"

Then I really looked at my leak reports and on the nights where I wasn't taping anymore I realized that the big massive prolonged large leaks weren't happening.
I might see a random 15 minute big leak but I slept through it and often just barely kissed large leak territory.
I decided that the taping wasn't needed anymore. So I guess the habit of mouth breathing changed.
It's been 8 years now. I still will occasionally see a leak that is likely mouth breathing (but could be mask movement) and I sometimes will wake with a dry mouth and look to the report and see maybe 5 minutes of probable mouth breathing.

I have decided that random short lived leaks that I sleep through aren't as much of a problem as the annoyance of trying to get a "perfect" leak graph might be to my sleep quality.
Getting good solid sleep has always been my priority...not perfect numbers.
When I see a big leak...and I sleep through it...I shrug my shoulders and move on as long as it is random and not half the night.

[TedVPAP]

When I taped, I covered the lower lip with the upper. Then used a piece running across the lips in the center of my mouth. Then a long piece from check to check covering both lips. When successful the mouth is still leak tight in the morning.

[FoggyBrain24]

Thanks all. I taped my mouth up last night with duct tape (carefully...ha). The tape stayed on all night so I think it's safe to say last night was not mouth breathing. I did use the ace bandage which is a bit tighter than the chin strap.

I had worse leaks than usual. I don't recall waking up to anything, but I did not sleep particularly well. I did try to add a "half-caffeine" coffee back in yesterday (at 1 pm), so I don't know if that could have any role, I've always been a little caffeine sensitive. The pressure seemed to fluctuate a bit more. Overall, not a great night.

Thoughts on what to try next? I feel like I would like to give it another night with just the bandage / chin strap and this mask and see what happens. I feel like this mask has been a lot better, but obviously, the leaks / flows are inconsistent night to night.

https://imgur.com/a/uTG9u

[Pugsy]

You didn't have any large leaks last night despite SleepyHead saying that 7% of the time you did.
There are no large leak flags over in the events graph.
The statistic is wrong because of the threshold in Preferences/CPAP tab isn't quite right. Whatever it is set to is still not an accurate threshold. It's really hard to get an accurate threshold for all pressures because it varies with the pressures.

What is the threshold number set to?

Yes, there were some leak line movement ...so mask movement...but they are well within the machines ability to compensate for and I wouldn't worry about them if I slept through them.

[FoggyBrain24]

Thanks. Threshold is set to 30.0. Remind me, I believe you said I should default to 70.0?

I have 2 instances of SH running, one at work, one at home so I may not have updated both.

I see one large leak for 11 minutes in the event graph.

[Pugsy]

I see one large leak for 11 minutes in the event graph.

Where on the events graph? I can't see any gray areas on the events graph.

Remove the snore graph and the respiration graph and make the other graphs larger including the Events graph so we can see it better.

We don't need the snore graph...we can see your snores on the Events graph easy enough.

[Pugsy]

OH....forgot...yes change the 30 to 70.

[Pugsy]

Just had a thought...the 11 minutes in LL is that from the Events tab?
If so, that's wrong...it's tied to that 30 L/min threshold.

[FoggyBrain24]

https://imgur.com/a/uTG9u

Thanks. Updated to 70.0L. Expanded the 4 graphs that I think you pay most attention to.

My thought for tonight is:

Fit mask properly.
Use ace bandage to keep mouth closed.
Hopefully this will keep the pressure between 9-13 and hopefully lower the leak rate.
Ideally, sleep through the night.

Other than that, I'm not sure I can change much else.

I can inquire with my sleep doc regarding the VS2, but I think I can hold off another day or 2 to hopefully build some consistency.

[Pugsy]

Good plan.

I can see the LL flags now...and I went back to the prior report and damn I could see them there now. WTH??
I know I couldn't see them before.
I still say the same thing...if you sleep through that 11 minutes of LL and you feel like your sleep quality was decent and you feel decent during the day...it's not the end of the world if you hit LL territory briefly..and I would let them slide and not worry about them.

The VS2 thing...I am stumped on that one. If we used Encore it won't even show them...so I don't know how critical it is that we kill them.

I wish you could try a ResMed AutoSet. I think the more aggressive algorithm might enable you to use just a little less pressure to get the job done than you are having to use right now with the Respironics.

[FoggyBrain24]

Thanks. I appreciate all of your time & effort here, you are truly a treasure for us suffering from this disorder.

Out of curiosity, are their any future therapies / technology solutions that excite you in this field?

[Pugsy]

Out of curiosity, are their any future therapies / technology solutions that excite you in this field?

I have no idea what might be in the works.
There is the work on the implants that stimulate the hypoglossal (sp?) nerve but that doesn't excite me at all.
Any of the stuff that uses surgery and removes anything I don't care for.

I know there are people somewhere working on improving things...from the masks to the algorithms to the machines and even not involving cpap use. I just don't follow that sort of stuff and it's probably hard to find anyway.

I have always been the type of person to "let's deal with our problem with what is available right now" and say "let's cross that bridge if/when we come to it". What iffing...doesn't accomplish much. I only have so much energy available and I prefer to expend on things that I can see results with right now...and one of those things is helping people here.
Now I will experiment with stuff if possible and it doesn't cost much money..
Like I tried the Provent thing and realized how difficult it was to do successfully and even if the damn things would stick...at best if it worked people only got about a 50% reduction in the AHI. That's not enough for me but for some people with very mild OSA it might be enough IF (big if) they were lucky enough to be in the group where it worked. And of course any therapy is better than no therapy.
I just have the mind set that if I am going to do something I want to do the best I can with it.