Please help me with my sleep reports

[Claudiu]

Hello all!

I'm 40 and have been using the CPAP for 10 years. There is no specialist monitoring my data. At first there was one, who set my pressure 4-19, but it's been 7 years since I manage it myself and changed it to see the best one for me. It's difficult to find a good specialist in my country, especially in my town. All was good until November when i had a weird bronchitis and had to take two types of antibiotics. I don't know what happened since then, but I can't sleep. Although AHI is not too high (under5), I'm always tired and I get up during the night, all sweat and I feel that I don't reach deep sleep. I don't know it it's related to the cold, but my lung xray was ok, and so was the spirometry.

Can you please check my SleepHQ reports? I use a nasal Philips Dreamware mask and Air Sense 10 machine. Even when I had a low leak rate I had bad sleep...I don't know what to do anymore...

https://sleephq.com/public/87319a2a-59f ... adf13f8449

https://sleephq.com/public/537d725f-244 ... cb5616f055

https://sleephq.com/public/4868b09c-650 ... 1e2f7b6c5e

https://sleephq.com/public/a75dd8b9-f15 ... bf10c5267f

https://sleephq.com/public/f42157e6-e3c ... a5797e19e3

https://sleephq.com/public/3c36aeca-410 ... ff36ba9958

https://sleephq.com/public/f120d7b5-ad9 ... 222f84f8ef - here I tried a single pressure

Thank you and have a good sleep!

[Miss Emerita]

Welcome! I'm so sorry I missed seeing your post last week. I spot-checked your hypopneas and CAs, and almost all of them clearly arise from arousal breathing. I'll explain more about that below.

You also have a lot of flow limitations. Is your nose stuffy?

Do you have any reports from the time before the bronchitis?

Arousal breathing reflects a change from a deeper sleep stage to a lighter one or a wake-up. Arousal breathing tends to be deep and irregular-looking. By taking those deep breaths, we set ourselves up for CAs or Hs afterwards. (There are two possible mechanisms that might be at work; let me know if you're interested in knowing something about them.) The problem isn't the CAs and Hs, at least at the rates you're seeing them; instead the problem is the arousals.

So why are you sleeping more poorly after your bout of bronchitis? I don't know the answer. I'm curious to see an earlier report and to learn about nose stuffiness; maybe we'll have a few clues from that additional information.

[vandownbytheriver]

I'm 40 and have been using the CPAP for 10 years. There is no specialist monitoring my data. At first there was one, who set my pressure 4-19, but it's been 7 years since I manage it myself and changed it to see the best one for me.

Setting your pressure to 4-19cm was not doing anything... the machine comes with 4-20cm anyway. You have been professionally neglected. Welcome to the zoo.

It looks like you need more than 7cm but you have a serious leaking problem. It's either mask leaks or mouth leaks.... could be some of both. Do you wake with dry mouth? That's mouth leaking. Do you wake hearing and feeling air around your nose? That's pillows mask leaking.

To get your therapy working you need to cure those leaks. First, check your Mask Fit by setting a decent high pressure (say 12cm) and running Mask Fit from the Settings Menu. Tighten/adjust whatever it takes (I'm not a pillows user) to get the mask leaks tamed at 12cm... experiment with laying down in bed, rolling over, all your normal positions.

Next is the mouth leaking... I didn't mouth-leak until I hit my 60's... that I know of. If you have a bed partner this will become apparent to them, air is blowing out your mouth. I'm guessing most of your leaking is via the mouth, huge leaks like that are hard to come by otherwise, and those climbing leak graphs are indicative of this.

The solution for many is tape. I'm using superhuman pressures, 17/21, so I have to tape like a package to Antarctica. I use Cover Roll Stretch Tape, 2" wide, known by other names in other countries. I tape my top lip over my bottom lip vertically, then a horizontal piece across. Licking from the inside is the way to release this tape, it's strong enough that peeling will hurt.

[Claudiu]

Thank you for taking time to reply!
I tried these days to tape my mouth but unfortunatelly the hypopneas wake me up all sweat and asphyxiated...
i researched and the solutions apppaarently is high pressure, but it's not working for me...The same with lower pressure...
I had some days off and I could sleep more to compesate somehow, but I'm terriffied as I start working tomorrow. These days it was relaxing, I took nice walks in the evening with no good results. I'm really desperate...Shall I see a cardiologist? maybe Neuro?

https://sleephq.com/public/584d85ac-198 ... 1642e4ad36 (my mouth was taped first hours)

https://sleephq.com/public/705913da-f6d ... 0102e15902

https://sleephq.com/public/b15d4ca5-987 ... 18a9dca77f (this was my mouth taped)