Need Help With Sleepy Head Graphs - Humidity

Hi Everyone and thank you for such and amazing resource, just spent hours reading and learning.

Basic Facts
I was diagnosed with severe sleep apnea in 1994 and started using a CPAP in 1998.

My current machine for the past year has been an Airsense 10 although I've been using the SDcard from my last machine which is still showing the old respironics cpap not my new Airsense. I use a Ultra Mirage 11 mask and have done so for 10 years plus I think.

About a year and a half ago I moved to UT and I switched machines from the respironics to the Airsense. The humidity levels in UT are much drier than they were in WA state and I'm finding that even with my humidity level set on 4 I'm blowing through the entire tank of water in about 6 hours. I'm also now using the heated tubing which I wasn't using with my older machine.

In WA I had my humidity levels set at the highest level and that seemed to work well. Recently however I'm feeling like I'm not getting enough moisture and that might now be resulting in my mouth opening and drying out. Could that be possible? If my nasal passage dries out does that increase the chances that my mouth will open during sleep?

Since moving to UT I've become a lot more active loosing over 20lbs and probably in the best shape of my life. My sleep has also improved greatly but recently I'm continuing to wake from dry mouth and was wondering if one of the experts here could look at my SleepHead info and see if there's anything I'm missing that might need to be adjusted. I love my Cpap machine and haven't slept without one it for 20 years, just trying to dial this back in again.

I just downloaded the SleepyHead software from the SDCard and am going to upload some screen shots of the last 3 night. This card contains years of data I think so not sure what you'd like to look at but everything is available even data from old machine v new machine if it makes sense to go back that far. Just let me know.

Many thanks in advance for any help.

From looking at your history, it looks like you did real well with your old machine at 9 min and 15 max...Why did you change to fixed 12?

Having lost the weight (congrats) it's very likely your mask no longer fits as well (I have the same one) and either needs adjusting or changing altogether and may be letting out too much air. The humidity problem could be better if that's looked at.

I also think you need to change your pressure and would advise raising the min., but also wonder why you switched to fixed.

PS get rid of the calendar when posting SH graphs in future.

Welcome to the forum.

Dry mouth....can be caused from lots of things.
Medication side effects, other health issues, not enough hydration or cpap users main concern...mouth breathing.
Mouth breathing...it doesn't take much mouth breathing to dry out the mouth and it doesn't always show up on the leak graphs as a large leak either.
Easiest way to check to see if mouth breathing is the culprit. Tape the mouth closed and see if the dry mouth is still present or not.
Then decide how you want to deal with it.
You went from a very humid area to a very dry area and that alone could cause some hydration issues.
I lived in Las Vegas for 6 years. My nose never did get used to the dry climate and it always felt yucky from the dryness and this was before I ever started cpap therapy. And for me it also did cause a little bit of congestion just from being dry. The nasal mucosa react to being too dry just like they react to anything with an increased histamine response and they swell up we get the typical allergy like symptoms. Get much swelling and congestion and we will mouth breath because the nose is stopped up.

You do show some very brief times in large leak on these reports. They might be from mouth breathing and they might simple be from mask movement. Unless they woke you you when they happen I don't know that I would worry about it because it is really very brief and not going to impact therapy all that much.

And yes...the AirSense 10 will use a lot of water especially if the air is dry. Catch 22 here....your nose probably wants more moisture than you are getting (that setting of 4 isn't a very high setting) but you use up all the water sooner if you increase the humidity levels.

Get one of those little gadgets that measures ambient humidity and stick it in your bedroom next to your cpap machine. Find out exactly what the machine is starting with in terms of humidity. They are cheap enough. I have one and I use the AirSense machine and yes, it will use up most of the water in one night when my ambient humidity is around 40%. If I lived in a drier area...for sure.
I am in southern Missouri and it's not known for being all that dry here...but I still see a lot of water consumption at times even at the setting of 5 on my machine and I learned a long time ago that my nose doesn't like being dry so I most often will use the setting of 6 myself. If my nose is uncomfortable I don't sleep so great and I have to sleep to have any chance of feeling decent during the day.

Get one of those gadgets and check ambient humidity and then consider maybe adding a room humidifier.
Also use lots of something like Simply Saline during the day to help with nasal mucosa hydration in general. I still use it almost daily here in Missouri even with our not so dry humidity.

You might include the leak graph in any future screen shots...
See this thread for format hints.
https://sleep.tnet.com/resources/sleepyhead/shorganize
Leak graph is definitely more important than the pressure graph since you are using fixed pressures.
But if this is all the large leak you have and you are sleeping through it...I wouldn't worry about the leaks myself no matter what the cause.

I don't see a need for a change in pressure at this time...the bulk of your AHI is CA/central and more pressure won't fix centrals.
Some of those central flags I suspect are probably SWJ sleep/wake/junk centrals anyway. Any OAs or hyponeas flagged at the same time I would also suspect as not being real and maybe being post arousal flagging....and if not real we don't need to try to fix them.
I would do more investigation into validity of the event flags before changing pressures. Make sure they are real and need killing before we go trying to kill them.

Read this and watch the videos and you will understand what I mean.
http://freecpapadvice.com/sleepyhead-free-software

My suggestion for right now....deal with the dry mouth and/or humidity issues first and then see what's left over that might need to be dealt with.

Julie wrote: ↑

Mon Oct 08, 2018 6:07 am

I also think you need to change your pressure and would advise raising the min., but also wonder why you switched to fixed.

The minimum of 4 is just the ramp being used. He's on a fixed pressure of 12 once ramp time is over and it's a very short ramp time.

Thanks so much for all of the great feedback and suggestions.

I've been trying to drill down as much as I can into and I have a couple of additional questions if you have time. Also please let me know if you need more graphs/info from Sleepyhead.

I’m heading out to purchase a humidifier for my bedroom and the device you mentioned that measures those levels.

I’ve checked my mask and it seems at this point even though I’ve lost weight the mask is still working well without serious leaks. I didn’t have my machine set to Auto so when removing my mask in the morning I sometimes wait a while before turning off the machine, could that be the large leeks that are showing up?

The thing that seems to be sticking out the most is the pressure setting from my last machine. As I read through your posts it looks like my machine is set to Cpap constant pressure 12, instead of Auto where it adjusts pressure based on a range input depending on episodes I’m having. If that’s right maybe that’s contributing to drying out my nasal passage. By getting blasted at 12 for 8 hours! Is that’s possible?

I’m looking back at the readings from a year or so ago and my old machine and comparing them to the past couple of months and that’s helping too.

Happy to hear any more feedback or comments and again huge thanks to this forum and it’s members for creating such an invaluable resource.

I would definitely change the 'mode' feature on your machine to Apap but start with a lower min. setting and leave the max one high (15-20) as it's not the 'one' that really is therapeutic as such, though can come into that in certain circumstances. See how you do for a few nights and let us know.

Breathing when awake can give false readings on software, so that could also be a factor as you surmise, plus make sure you try out your mask (again) when lying down, and after relaxing as you would when asleep... your muscles etc. change when you do that vs how the mask may feel when sitting up.