Fixed my leak, yet feel like I am regressing.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
bigTEXoifVET
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Fixed my leak, yet feel like I am regressing.

Post by bigTEXoifVET » Wed Oct 21, 2020 8:13 pm

ResMed Airsense 10 w/ AirFit N30i

A little background: I went years constantly exhausted, but was finally diagnosed June of 2019, and am treated through the VA (so all my equipment is prescribed to me). My sleep study showed an AHI of 53.2. I was initially put on a full face mask as I had a history of breathing through my mouth. Went through several options always having a high leak rate (Amara full view, then ResMed F30, then the F20 and F20 touch). I normally have a full beard but, have also gone without facial hair with each. Even still I could tell a huge difference then before I started treatment.

Back in June they switched from full face to nasal mask, to see if it would fix the leak issues. According to MyAir it has. I went from never getting above an 80 to regularly getting 95-100. However I feel like I am more tired and harder to wake up than when I had the bad leak. I recently downloaded Sleepyhead with the hopes of finally getting my treatment working correctly. Below is a screen shot from the other night (unfortunately don't have the detailed data from other masks).
Sleepyhead 10-18.JPG
Sleepyhead 10-18.JPG (363.32 KiB) Viewed 985 times

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palerider
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Re: Fixed my leak, yet feel like I am regressing.

Post by palerider » Thu Oct 22, 2020 1:08 am

Unfortunately, sleepyhead is a dead product, get Oscar, (link below)

There's nothing terribly wrong with the night you posted, but it probably could be better.

Please fill out your equipment profile, for future use, and post another couple nights worth of data, in this thread, so we can get a better idea what's going on.

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

mper!?
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Re: Fixed my leak, yet feel like I am regressing.

Post by mper!? » Thu Oct 22, 2020 7:10 am

bigTEXoifVET wrote:
Wed Oct 21, 2020 8:13 pm
ResMed Airsense 10 w/ AirFit N30i

.... went years constantly exhausted...... through the VA (so all my equipment is prescribed to me) ??..... was initially put on a full face mask as I had a history of breathing through my mouth....Even still I could tell a huge difference then before I started treatment.....June they switched from full face to nasal mask, to see if it would fix the leak issues....feel like I am more tired and harder to wake up than when I had the bad leak.

Sleepyhead 10-18.JPG
Hi,
couple of comments:

_ it looks your machine would be Aircuve 10 , rather than Airsense 10, is that correct?...then, the best machine for you, maybe;

_ your leaks look fine, on the nasal mask. However, it appears, taking some risk (I would need to confirm some details on FR curve, TV, in some 10min and 2.0 min-duration windows) you would be breathing by mouth for some 70/80% of the night (as suggested by your spiky FR and respiratory parameters, TV, MV,E:I ratio). These, alone, could eventually account for you not feeling good as used to;

_ then, in my modest opinion, once we confirm your massive mouth breathing, I could suggest you could prioritize two things:

....... go yourself for a some 10-15day new titration, default parameters, as per this Resmed Guide: https://www.resmed.com/us/dam/documents ... er_eng.pdf, either in Mode S or Fixed Pressure on PAP mode. I have a first impression you would not need such high EPAPmin, maybe (which implies in more leak). I think it would worth trying this new titration, if you are allowed to;

...... fix your mouth breathing, maybe by getting back to FFM (at least, for me, this was much easier than anything else);

all the best and good luck
Not a Doctor.
"The goal is to turn data into information, and information into insight (Carly Fiorina)".

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Miss Emerita
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Re: Fixed my leak, yet feel like I am regressing.

Post by Miss Emerita » Thu Oct 22, 2020 9:53 am

By the numbers, you're doing pretty well, and I'm not sure how changing masks could cause you to start feeling more tired, given that your leak rates have actually gone down.

Did you start/stop any medications around the same time? Change your sleep routine? I notice you clocked 7 hours on the night you posted; maybe you need more sleep than that?

Here are some ideas about reducing or eliminating mouth leaks. Many people find that chin straps are actually counterproductive, because they tend to pull the jaw back, which makes it harder to keep the mouth closed.

1. Tongue position. Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night. For some people, this is really all it takes to avoid mouth leaks.

2. Collar. If your jaw tends to drop down during the night, pulling your mouth open, then a soft cervical collar, or a firmer snore collar, can be a big boon. More here:
http://www.apneaboard.com/wiki/index.php...cal_Collar

3. Although chin straps tend to pull the jaw back, which is not helpful, the Knightsbridge Dual Band strap has a design that pulls the jaw straight up, which makes it a possible alternative to a cervical collar.

4. Tape. Some people (including me) rely on tape to keep the lips from opening. (I can't rely entirely on the tongue thing.) When the lips open, all too often that eventually leads to a noisy and disruptive mouth leak. To see whether tape would be feasible for you, I recommend that you invest in a box of Somnifix strips. They are very gentle on the skin but hold very well. Be sure to curl your lips inward per instructions before placing the strip. If these work for you, then you can experiment with lower-cost options.

Note about tape: Some people avoid it, for two reasons. (1) If you suddenly need to vomit in the night, the tape could lead to your aspirating some vomitus, which would be bad. However, you can sacrifice one strip to see for yourself how well you can pull you mouth open in an emergency using only your jaw muscles. (2) If there is a power failure and your machine goes off while you're sleeping, you won't be able to do the natural thing and open your mouth to breathe. As for that, out of an abundance of caution, I've put a circuit alarm in a plug on the same circuit as my machine. It will wake me up immediately if I lose power to the machine.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

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palerider
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Re: Fixed my leak, yet feel like I am regressing.

Post by palerider » Thu Oct 22, 2020 11:52 am

mper!? wrote:
Thu Oct 22, 2020 7:10 am
nonsensical rambling garbage.
Honestly, bigTEXoifVET, it's best if you just ignore anything that mperl!? posts, just click this link and say 'yes'

It'll be better for your peace of mind and understanding as you improve your therapy.

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

bigTEXoifVET
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Re: Fixed my leak, yet feel like I am regressing.

Post by bigTEXoifVET » Thu Oct 22, 2020 10:39 pm

Updated my profile, and my machine is the AirCurve 10 Vauto. Below is a few more nights (now in Oscar 1.20)
Sleepyhead 10-17.JPG
Sleepyhead 10-17.JPG (327.66 KiB) Viewed 889 times
Sleepyhead 10-16.JPG
Sleepyhead 10-16.JPG (335.36 KiB) Viewed 889 times
Sleepyhead 10-15.JPG
Sleepyhead 10-15.JPG (341.51 KiB) Viewed 889 times

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Re: Fixed my leak, yet feel like I am regressing.

Post by palerider » Fri Oct 23, 2020 1:11 am

Thanks for posting those and getting Oscar and filling out your profile.

There's not a whole lot that's concerning in your charts, the AHI could be a little lower, the leaks could be a little better controlled, but as Pugsy likes to say, nothing is screaming "FIX ME!".

Being harder to wake up could possibly be because you're sleeping more soundly without the leaks disturbing your sleep.

Do you wake up with dry mouth often?

When you get a chance, give us answers to the questions Miss Em posed.

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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Re: Fixed my leak, yet feel like I am regressing.

Post by Pugsy » Fri Oct 23, 2020 6:11 am

Yep...nothing on the reports themselves is screaming "fix me and you will feel better".
Yes, a little bit of large leak at times which might be mouth breathing or even mask movement but it's not massive nor is it prolonged to the point it could seriously impact therapy all that much.

Now leaks could be disturbing sleep and if that is happening then we want to work on them. Are the leaks waking you up often?
Are you waking up often for any other reason?

Also don't forget the usual culprits...medication side effects or other health issues.
A lot of stuff out there to mess with our sleep and/or how we feel besides cpap or sleep apnea.

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