TOTAL TIME IN APNEA INCREASED

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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DeeCPAP
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Re: TOTAL TIME IN APNEA INCREASED

Post by DeeCPAP » Mon Jun 12, 2017 10:39 pm

Pugsy wrote:Which mask is simply more comfortable for you and lets you sleep better (assuming leaks don't wake you up which a totally different discussion)?
And then what is the leak rate averaging for that mask.

What is your number one goal? It's gotta be sleep first. Without good solid sleep (which you are having trouble getting for any number of reasons) it really doesn't matter how good or bad your "numbers" are.

If your sleep quality is crap and you feel like crap then it really doesn't matter how good the leak rate is or how low the AHI is or how minimal the time in apnea is.

Pick a mask that you like and is comfortable and you feel you can get the best sleep with and let's see if leaks are bad enough to seriously impact the therapy accuracy.
DeeCPAP wrote:Just a quick question. I changed headgear to a full mask a few weeks ago and Sleepyhead software said:

1) FULL: Total Time in Apnea many days showed 20, others about 10. AHI averaged less than 5. The large leaks are also higher.

2) NASAL: Total time in apnea was about zero to one. AHI less than one. Large leaks were almost zero.


Should I go back to my old mask (I don't really like it) or is my new mask data okay (it's harder to keep the leaks out when I sleep). ?
OR are both masks within normal limits?
I had trouble understanding the above statement.

My suggestion...quit basing what you "should do" on old reports because most of those were reports where the pressure setting was far from optimal.
Start concentrating on the quality of sleep you are getting now and the data you are getting now ...now that you are using the higher minimum pressure.
Those old nights...those are long past gone and done and you can't do a darn thing about them anyway.
Concentrate on the new settings results and whichever mask you personally just like better...then go from there.
It's really not a fair comparison to try to compare old results with new results from the newer more optimal pressure anyway. Apples and oranges.

So again...which mask do you simply like better NOW with the new settings? If the leak rate isn't horribly horrible and you are sleeping better and feeling decent then I think you probably have your answer there. Remember...if you do have a period of time in really, really big leak the accuracy of the data only comes into question for that time in really big leak. The rest of the time the data is accurate anyway.
If the leak rate is horrible with the mask you prefer...let's see what we can do to make the leak less horribly horrible.
You gotta get the sleep first...nothing else matters if you aren't sleeping.
I think I understand, Pugsy. What I was trying to say at the top of this message is the FF mask (the Amera View) showed a lot of obstructive apneas. The Dreamwear SH results were much better during an afternoon nap, sleeping on my side the entire time *and* I was able to keep my mouth closed without having to use tape. At night, the numbers aren't as good, probably because I roll over on my back, BUT I'm now taping my mouth -- the numbers look much better and I'm sleeping more soundly --- as long as I keep my mouth taped. It's a bit scary, but I do need the sleep and will probably cut back using the tape as soon as I can. I'm still amazed at all those long, frequent obstructive apneas in such a short period of time. That kind of thing either cures you or kills you. lol

As an aside, I found that Sleepy Time tea bought at the grocery store allows me to take an afternoon nap! Yay! So, all in all, things are on the upswing and yes, I'm feeling more rested now for the first time in a very long time, thanks to you and several others on the forum. I wish there were a bunch of "hug" icons available.

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWear Nasal CPAP Mask with Headgear
Humidifier: XT Heated Humidifier
Additional Comments: My headgear varies (STILL!)
Resmed S9 with humidifier and in need of the right mask.

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Pugsy
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Location: Missouri, USA

Re: TOTAL TIME IN APNEA INCREASED

Post by Pugsy » Mon Jun 12, 2017 11:15 pm

Should you ever decide to revisit the Amara View you may need even more minimum pressure. I suspect that the major part of your increased apneas with the FFM was simply not only were you probably rolling over onto your back (or there's the REM thing possibility) and needing more pressure for those things but it's quite common for people to need more pressure when using a FFM than when using a nasal mask (assuming leaks aren't compromising things).
It doesn't make much sense to think about it....X amount of pressure that holds the airway open should work no matter what the mask assuming all other things are equal but I think part of the issue with more pressure with FFM is that full face mask change the position of the airway ever so slightly.
That lower strap needed to secure a full face mask tends to pull the chin back a little and possible causes the airway to become a little bit more narrow to start with and then when the apnea events happen the pressure just can't get the airway open well enough.
So just remember that if you decide to ever try the Amara again...from what I have read from people who have documented the change need...maybe around 2 cm more minimum.

It's rarely just one single thing...most often it's a combination of things...like maybe that little bit of airway change and maybe rolling on one's back or maybe more REM sleep some nights than others...or maybe a combination of all these things.

I did some experiments when I first started therapy and determined that sleeping on my back didn't seem to cause any change in pressures.
But REM stage sleep sure did and that wasn't a big surprise because in my diagnostic sleep study my non rem AHI was only around 12 but in REM it was over 50. Supine sleeping vs side sleeping saw no real change in the number of apnea events on the sleep study for me but for a lot of people it can greatly increase the apneas and/or need for more pressure.

Now sometimes we can do things to stay off our backs but we can't do anything about REM so even if I had seen a higher pressure need when on my back and wanted to stay off my back I would still have the higher pressure needs in REM to deal with. I saw no need to worry about position because I was going to use (and need) auto adjusting pressures to deal with the REM stuff.
Besides staying off one's back is easier said than done and I think doing the tennis ball thing is just not an ideal fix...come on...use something to wake you up when you roll onto your back for 6 to 8 weeks in hopes of your waking up every time and getting off your back and "learning to stay on your side"...heck, my sleep is fragile enough without adding pain/torture into the mix.
If someone has an auto adjusting machine...make appropriate settings that will cover all the bases and sleep in whatever position you want if that's what promotes good sleep.

Now if you do wish to try something to stay off your back that might help and isn't painful and unlikely to wake you up due to pain or discomfort you might do what I did when I was experimenting to see if supine slee ping was a factor in my higher pressure needs. I built a wall out of a buckwheat hull pillow so that if I rolled backwards a bit and tried to get on my back I would be stopped by the buckwheat hull pillow. It's a lot more comfortable to lean up against that buckwheat hull pillow than to roll over onto lumpy hard tennis balls. I suggest the buckwheat hull pillow because of the weight...less likely to slide out from underneath you. I tried lots of other things first but they would all slide out from under me and I would end up on my back.
As it turned out once I was totally sure I didn't move off my side and I still saw the pressure changes in pretty much what would have been REM going by normal sleep cycles...I was reasonably certain that REM was my main culprit and since we can't control REM (we need it anyway) I just decided to sleep in whatever position I wanted and let the machine do its job. It was going to have to do the work for REM anyway. I figured that if maybe I ended up on my back and in REM at the same time...the machine could handle it anyway.

About the tape thing...I did it for about 2 months when I was first starting therapy. You get used to it and it's not that big of a deal. It will come off easily if it needs to come off...a big yawn will do it. After about 2 months I started getting a bit lazy and forgetful and would realize that lights were off and the mask and machine was on and I had forgotten to put the tape on and would say "it's one night...I will just go without the tape". After I got to the point where I was more forgetful than not I happened to look at my software reports and the leaks that were probably mouth breathing weren't that bad after all and nothing like I was having when I first started therapy. I seemed to pretty much have learned to keep my mouth shut (my mouth breathing was habit because my nose is pretty much always clear and there's no physical need to mouth breathe)....so I ditched the tape.

Yeah, now I sometimes will wake up mouth breathing but it is rarely prolonged and most of the time I barely go into large leak territory so I don't really worry about it. It's not the prettiest leak line but I am sleeping well and feeling decent so I really don't care if there are a couple of less than perfect leak lines that amount to maybe 30 minutes over the entire night. I could tape again but while the tape wasn't extremely annoying....it was there and sometimes it would wake me up...mainly worrying about it coming loose.

As long as you aren't mouth breathing out of physical necessity (bad nasal congestion) it is possible to learn to keep the mouth shut (at least for the bulk of the night).
I do have a full face mask available should I ever have really bad nasal congestion but in over 8 years I have never had a situation where I couldn't get the nose opened up enough to use a nasal pillow mask and I have had some pretty bad colds and even the flu in those 8 years.

Beware of those afternoon naps...they can make it so you don't sleep so solid at night especially if you end up taking a real long nap or late in the afternoon.

Let's give the new settings some time with the mask that you simply like better and see what happens.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
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DeeCPAP
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Re: TOTAL TIME IN APNEA INCREASED

Post by DeeCPAP » Wed Jun 14, 2017 11:06 pm

Pugsy wrote:Should you ever decide to revisit the Amara View you may need even more minimum pressure. I suspect that the major part of your increased apneas with the FFM was simply not only were you probably rolling over onto your back (or there's the REM thing possibility) and needing more pressure for those things but it's quite common for people to need more pressure when using a FFM than when using a nasal mask (assuming leaks aren't compromising things).
It doesn't make much sense to think about it....X amount of pressure that holds the airway open should work no matter what the mask assuming all other things are equal but I think part of the issue with more pressure with FFM is that full face mask change the position of the airway ever so slightly.
That lower strap needed to secure a full face mask tends to pull the chin back a little and possible causes the airway to become a little bit more narrow to start with and then when the apnea events happen the pressure just can't get the airway open well enough.
So just remember that if you decide to ever try the Amara again...from what I have read from people who have documented the change need...maybe around 2 cm more minimum.

It's rarely just one single thing...most often it's a combination of things...like maybe that little bit of airway change and maybe rolling on one's back or maybe more REM sleep some nights than others...or maybe a combination of all these things. Again, thanks!

I did some experiments when I first started therapy and determined that sleeping on my back didn't seem to cause any change in pressures.
But REM stage sleep sure did and that wasn't a big surprise because in my diagnostic sleep study my non rem AHI was only around 12 but in REM it was over 50. Supine sleeping vs side sleeping saw no real change in the number of apnea events on the sleep study for me but for a lot of people it can greatly increase the apneas and/or need for more pressure.

Now sometimes we can do things to stay off our backs but we can't do anything about REM so even if I had seen a higher pressure need when on my back and wanted to stay off my back I would still have the higher pressure needs in REM to deal with. I saw no need to worry about position because I was going to use (and need) auto adjusting pressures to deal with the REM stuff.
Besides staying off one's back is easier said than done and I think doing the tennis ball thing is just not an ideal fix...come on...use something to wake you up when you roll onto your back for 6 to 8 weeks in hopes of your waking up every time and getting off your back and "learning to stay on your side"...heck, my sleep is fragile enough without adding pain/torture into the mix.
If someone has an auto adjusting machine...make appropriate settings that will cover all the bases and sleep in whatever position you want if that's what promotes good sleep.

Now if you do wish to try something to stay off your back that might help and isn't painful and unlikely to wake you up due to pain or discomfort you might do what I did when I was experimenting to see if supine slee ping was a factor in my higher pressure needs. I built a wall out of a buckwheat hull pillow so that if I rolled backwards a bit and tried to get on my back I would be stopped by the buckwheat hull pillow. It's a lot more comfortable to lean up against that buckwheat hull pillow than to roll over onto lumpy hard tennis balls. I suggest the buckwheat hull pillow because of the weight...less likely to slide out from underneath you. I tried lots of other things first but they would all slide out from under me and I would end up on my back.
As it turned out once I was totally sure I didn't move off my side and I still saw the pressure changes in pretty much what would have been REM going by normal sleep cycles...I was reasonably certain that REM was my main culprit and since we can't control REM (we need it anyway) I just decided to sleep in whatever position I wanted and let the machine do its job. It was going to have to do the work for REM anyway. I figured that if maybe I ended up on my back and in REM at the same time...the machine could handle it anyway.

About the tape thing...I did it for about 2 months when I was first starting therapy. You get used to it and it's not that big of a deal. It will come off easily if it needs to come off...a big yawn will do it. After about 2 months I started getting a bit lazy and forgetful and would realize that lights were off and the mask and machine was on and I had forgotten to put the tape on and would say "it's one night...I will just go without the tape". After I got to the point where I was more forgetful than not I happened to look at my software reports and the leaks that were probably mouth breathing weren't that bad after all and nothing like I was having when I first started therapy. I seemed to pretty much have learned to keep my mouth shut (my mouth breathing was habit because my nose is pretty much always clear and there's no physical need to mouth breathe)....so I ditched the tape.

Yeah, now I sometimes will wake up mouth breathing but it is rarely prolonged and most of the time I barely go into large leak territory so I don't really worry about it. It's not the prettiest leak line but I am sleeping well and feeling decent so I really don't care if there are a couple of less than perfect leak lines that amount to maybe 30 minutes over the entire night. I could tape again but while the tape wasn't extremely annoying....it was there and sometimes it would wake me up...mainly worrying about it coming loose.

As long as you aren't mouth breathing out of physical necessity (bad nasal congestion) it is possible to learn to keep the mouth shut (at least for the bulk of the night).
I do have a full face mask available should I ever have really bad nasal congestion but in over 8 years I have never had a situation where I couldn't get the nose opened up enough to use a nasal pillow mask and I have had some pretty bad colds and even the flu in those 8 years.

Beware of those afternoon naps...they can make it so you don't sleep so solid at night especially if you end up taking a real long nap or late in the afternoon.

Let's give the new settings some time with the mask that you simply like better and see what happens.

It seems to be working MUCH better! No tape on my mouth, just will power, at least for now. The numbers look good! Now I understand why sleep deprivation torture during wartime was banned. It's hell, but it's heaven to recover!!!

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWear Nasal CPAP Mask with Headgear
Humidifier: XT Heated Humidifier
Additional Comments: My headgear varies (STILL!)
Resmed S9 with humidifier and in need of the right mask.

User avatar
DeeCPAP
Posts: 441
Joined: Mon Dec 14, 2015 11:32 pm

Re: TOTAL TIME IN APNEA INCREASED

Post by DeeCPAP » Sat Jun 17, 2017 9:01 am

Pugsy wrote:
It's rarely just one single thing...most often it's a combination of things...like maybe that little bit of airway change and maybe rolling on one's back or maybe more REM sleep some nights than others...or maybe a combination of all these things.

<snip>

About the tape thing...I did it for about 2 months when I was first starting therapy. You get used to it and it's not that big of a deal. It will come off easily if it needs to come off...a big yawn will do it. After about 2 months I started getting a bit lazy and forgetful and would realize that lights were off and the mask and machine was on and I had forgotten to put the tape on and would say "it's one night...I will just go without the tape". After I got to the point where I was more forgetful than not I happened to look at my software reports and the leaks that were probably mouth breathing weren't that bad after all and nothing like I was having when I first started therapy. I seemed to pretty much have learned to keep my mouth shut (my mouth breathing was habit because my nose is pretty much always clear and there's no physical need to mouth breathe)....so I ditched the tape.

Yeah, now I sometimes will wake up mouth breathing but it is rarely prolonged and most of the time I barely go into large leak territory so I don't really worry about it. It's not the prettiest leak line but I am sleeping well and feeling decent so I really don't care if there are a couple of less than perfect leak lines that amount to maybe 30 minutes over the entire night. I could tape again but while the tape wasn't extremely annoying....it was there and sometimes it would wake me up...mainly worrying about it coming loose.

As long as you aren't mouth breathing out of physical necessity (bad nasal congestion) it is possible to learn to keep the mouth shut (at least for the bulk of the night).
I do have a full face mask available should I ever have really bad nasal congestion but in over 8 years I have never had a situation where I couldn't get the nose opened up enough to use a nasal pillow mask and I have had some pretty bad colds and even the flu in those 8 years.

Let's give the new settings some time with the mask that you simply like better and see what happens.
Hi Pugsy -- thought you might be interested in an update. The graphs look better, and used tape on my mouth and the tape stayed on, but last night there were lots of long "open airway" leaks. I assume the frame dislodged. The previous night, I pulled it off my head in the middle of the night -- maybe the 3" headband bothers me -- not sure. However, when I nap for an hour or so, there are no "events" or leaks, etc. Probably I sleep on my side the entire time so there's no problem. I'm thinking the frame may be too lose, but on the whole, things are getting better. Still not sleeping long enough (and the weather's been horrible) so maybe that's why I woke up tired. That's it for now. Thank you *again*!!!

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWear Nasal CPAP Mask with Headgear
Humidifier: XT Heated Humidifier
Additional Comments: My headgear varies (STILL!)
Resmed S9 with humidifier and in need of the right mask.

User avatar
DeeCPAP
Posts: 441
Joined: Mon Dec 14, 2015 11:32 pm

Re: TOTAL TIME IN APNEA INCREASED

Post by DeeCPAP » Tue Jun 27, 2017 4:52 pm

Pugsy wrote:Should you ever decide to revisit the Amara View you may need even more minimum pressure. I suspect that the major part of your increased apneas with the FFM was simply not only were you probably rolling over onto your back (or there's the REM thing possibility) and needing more pressure for those things but it's quite common for people to need more pressure when using a FFM than when using a nasal mask (assuming leaks aren't compromising things).
It doesn't make much sense to think about it....X amount of pressure that holds the airway open should work no matter what the mask assuming all other things are equal but I think part of the issue with more pressure with FFM is that full face mask change the position of the airway ever so slightly.
That lower strap needed to secure a full face mask tends to pull the chin back a little and possible causes the airway to become a little bit more narrow to start with and then when the apnea events happen the pressure just can't get the airway open well enough.
So just remember that if you decide to ever try the Amara again...from what I have read from people who have documented the change need...maybe around 2 cm more minimum.

It's rarely just one single thing...most often it's a combination of things...like maybe that little bit of airway change and maybe rolling on one's back or maybe more REM sleep some nights than others...or maybe a combination of all these things.

I did some experiments when I first started therapy and determined that sleeping on my back didn't seem to cause any change in pressures.
But REM stage sleep sure did and that wasn't a big surprise because in my diagnostic sleep study my non rem AHI was only around 12 but in REM it was over 50. Supine sleeping vs side sleeping saw no real change in the number of apnea events on the sleep study for me but for a lot of people it can greatly increase the apneas and/or need for more pressure.

Now sometimes we can do things to stay off our backs but we can't do anything about REM so even if I had seen a higher pressure need when on my back and wanted to stay off my back I would still have the higher pressure needs in REM to deal with. I saw no need to worry about position because I was going to use (and need) auto adjusting pressures to deal with the REM stuff.
Besides staying off one's back is easier said than done and I think doing the tennis ball thing is just not an ideal fix...come on...use something to wake you up when you roll onto your back for 6 to 8 weeks in hopes of your waking up every time and getting off your back and "learning to stay on your side"...heck, my sleep is fragile enough without adding pain/torture into the mix.
If someone has an auto adjusting machine...make appropriate settings that will cover all the bases and sleep in whatever position you want if that's what promotes good sleep.

Now if you do wish to try something to stay off your back that might help and isn't painful and unlikely to wake you up due to pain or discomfort you might do what I did when I was experimenting to see if supine slee ping was a factor in my higher pressure needs. I built a wall out of a buckwheat hull pillow so that if I rolled backwards a bit and tried to get on my back I would be stopped by the buckwheat hull pillow. It's a lot more comfortable to lean up against that buckwheat hull pillow than to roll over onto lumpy hard tennis balls. I suggest the buckwheat hull pillow because of the weight...less likely to slide out from underneath you. I tried lots of other things first but they would all slide out from under me and I would end up on my back.
As it turned out once I was totally sure I didn't move off my side and I still saw the pressure changes in pretty much what would have been REM going by normal sleep cycles...I was reasonably certain that REM was my main culprit and since we can't control REM (we need it anyway) I just decided to sleep in whatever position I wanted and let the machine do its job. It was going to have to do the work for REM anyway. I figured that if maybe I ended up on my back and in REM at the same time...the machine could handle it anyway.

About the tape thing...I did it for about 2 months when I was first starting therapy. You get used to it and it's not that big of a deal. It will come off easily if it needs to come off...a big yawn will do it. After about 2 months I started getting a bit lazy and forgetful and would realize that lights were off and the mask and machine was on and I had forgotten to put the tape on and would say "it's one night...I will just go without the tape". After I got to the point where I was more forgetful than not I happened to look at my software reports and the leaks that were probably mouth breathing weren't that bad after all and nothing like I was having when I first started therapy. I seemed to pretty much have learned to keep my mouth shut (my mouth breathing was habit because my nose is pretty much always clear and there's no physical need to mouth breathe)....so I ditched the tape.

Yeah, now I sometimes will wake up mouth breathing but it is rarely prolonged and most of the time I barely go into large leak territory so I don't really worry about it. It's not the prettiest leak line but I am sleeping well and feeling decent so I really don't care if there are a couple of less than perfect leak lines that amount to maybe 30 minutes over the entire night. I could tape again but while the tape wasn't extremely annoying....it was there and sometimes it would wake me up...mainly worrying about it coming loose.

As long as you aren't mouth breathing out of physical necessity (bad nasal congestion) it is possible to learn to keep the mouth shut (at least for the bulk of the night).
I do have a full face mask available should I ever have really bad nasal congestion but in over 8 years I have never had a situation where I couldn't get the nose opened up enough to use a nasal pillow mask and I have had some pretty bad colds and even the flu in those 8 years.

Beware of those afternoon naps...they can make it so you don't sleep so solid at night especially if you end up taking a real long nap or late in the afternoon.

Let's give the new settings some time with the mask that you simply like better and see what happens.
Hi Pugsy, I just wanted to report back that the AHI is down quite a bit. Your suggestions to raise the minimum was the best! Also lowerering the leak rate, using a *buckwheat pillow* for my head, seems to keep the Dreamwear frame from moving as much which reduced the leak rate. I may buy another buckwheat pillow for my back, too. I't's only been days, but I'm assuming the numbers will continue to be reasonable. I'm now tackling the hours I sleep like a job, so I'm using Sleepy Time tea for naps. I think I'm on the road to recovery, finally!

Thanks again! You're great!!

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: DreamWear Nasal CPAP Mask with Headgear
Humidifier: XT Heated Humidifier
Additional Comments: My headgear varies (STILL!)
Resmed S9 with humidifier and in need of the right mask.