Increasing AHI

[Stardustor]

https://imgur.com/a/2LlSUMh

I'm using a ResMed P30i nasal pillow mask. I also use 2" - 3M Micropore tape to keep my lips and mouth closed. Nightly, I'm experiencing significant nasal congestion, especially during the early morning hours.
Upon waking and leaving my bed, I'm often completely blocked with congestion. Within minutes of leaving my bed, my nasal congestion clears....??

When I experience those bouts of congestion during the night, I think that I can relate them to occurrences of Obstructive apneas indicated on my sleep charts. I also believe that, somehow, those congestion episodes during the night(s) are also related to the mask leaks that seem to be happening directly where the nasal pillows are supposed to seal in my nares.
In turn, those leaks are related to dry mouth and subsequent awakening(s). All-in-all, those events are messing up my sleep statistics and messing up my sleep...!!

I'm current;ly using nightly doses of Omnaris, a nasal decongestant. It is only effective for half the night.

Any solutions or suggestions out there...???

Stardustor

[zonker]

https://imgur.com/a/2LlSUMh

um, increasing from what?

you could try raising your minimum as it looks like it wants to go higher and stay there anyway.

one night of data doesn't say too much. is this a typical night with the same sort of events?

[Stardustor]

Thank you for your response/

Lately, it's representative of a typical night. AHI has more typically been in the 2.0 area on my OSCAR charts.

I'm almost certain that my issues are related to nasal congestion, which leads to mask leaks, dry mouth and screwy OSCAR chart readings.
How might I provide additional chart results...?

[zonker]

Thank you for your response/

Lately, it's representative of a typical night. AHI has more typically been in the 2.0 area on my OSCAR charts.

I'm almost certain that my issues are related to nasal congestion, which leads to mask leaks, dry mouth and screwy OSCAR chart readings.
How might I provide additional chart results...?

you can give more than one night's chart, is what i meant. the events on the chart you provided is perfect. i just think we will want to see more than one night.

now we are at the point where we want to wait for someone with a little bit more knowledge to come by to help.

good luck!

[ChicagoGranny]

https://imgur.com/a/2LlSUMh

There are many possible causes of your problem.

If you look at the pressure line during that cluster of obstructive apneas about 5:00, you see it is bumping against the 16.0 maximum you have set. If it were me, I would raise the maximum to 20.0 and see what happens. You can always turn it back if it causes problems.

Are you using the CPAP humidifier? What is the setting? For some people, a humidifier setting that is high will cause congestion. For others, a low humidifier setting causes problems.

What position(s) are you sleeping in during the apnea clusters? Have you changed positions?

[Stardustor]

https://imgur.com/a/ebeAX66

Thank you for looking and commenting. Here's a copy of last night's chart
Today, I've raised the upper pressure limit from 16 to 19. I've also increased the lower pressure limit from 10 to 12. We'll see what happens.

Existing humidity level was 2. I've reduced that to 1. Tube temperature setting remains at 78 degrees.

I may be mistaken, but I still think that my peaks in pressure requirements as interpreted by my APAP machine, can be attributed to nasal congestion....??? Without a word of exaggeration, there have been mornings when I wake getting ready to leave my bed, my nasal passages are totally, 100% blocked, ...plugged. Yet, within minutes, upon standing, my nose begins to clear. Within 5 minutes, ...clear and open.

Let me make it clear, from the beginning, I am not an expert or experienced in reading or interpreting OSCAR charts. Simply yearning for a good night's sleep. Uninterrupted by dry mouth awakenings. Willing to try anything reasonable...
Stardustor

[Pugsy]

What does your flow limitation graph look like from last night?
You can omit the mask pressure graph and let the flow graph move into view.

Nasal congestion can cause a reduction in air flow and cause the machine to want to increase the pressure but more pressure isn't the fix for nasal congestion. If you have much nasal congestion causing the pressure to go up it should show up on the flow limitation graph.

[Pugsy]

You know from the cluster pattern shown of those events my first suspect is REM stage sleep. Sure looks like a typical REM cycle pattern to me. Do you know if your OSA is worse in REM or not? It's fairly common. My own OSA is about 5 times worse in REM and sometimes I need 8 cm more pressure just for REM sleep events.

[Stardustor]

https://imgur.com/a/ODCFmIC

Here's an edited chart depicting a different set of graphs...

Stardustor

[Pugsy]

Your flow limitations aren't that big of an issue. They are minor compared to a lot of people's FLs.
I seriously doubt that nasal congestion is driving your pressure upwards. I think more likely REM related or supine related or a combination of both that simply need more pressure to hold the airway open and prevent the collapse in the first place.
Maybe more minimum still yet but for sure more maximum being available.

Here below is a bad FL graph from nasal congestion. Yours isn't bad at all.
Now your congestion might be bad enough to disturb your sleep but it isn't enough to really impact what the pressure wants to do.

ugly fl graph.JPG

[zonker]

Let me make it clear, from the beginning, I am not an expert or experienced in reading or interpreting OSCAR charts. Simply yearning for a good night's sleep. Uninterrupted by dry mouth awakenings. Willing to try anything reasonable...
Stardustor

now that we have the seasoned veterans in here to help you, i can take a crack at the edges of your problem.

this addresses your dry mouth. it's not a cure for the underlying problem. but it can alleviate the dry mouth in the meantime. i suggest xylimelts. this is a wee disk that fits between tooth and gum. it slowly melts through the night, promoting saliva. it has a slightly tacky side that adheres to the teeth to keep it in place.

they can be found in your local drugstore in the oral health section. i know they are at cvs and riteaid. if you can't find them locally, they are also available at amazon.

btw? i can't read a chart worth beans myself. if i have a problem, i post just like you did and rely on the kindness of strangers.

good luck!

[Stardustor]

https://imgur.com/a/kVv6ryyXylomelts

Here's yet another OSCAR chart from last night. A much, much better night...!! Dry mouth again during the wee hours, 3 a.m. - 6 a.m. I will look up those Xylomelts, Zonker. Thank you for the suggestion...!

I still cannot figure out the leaks, tho....?? Trying to stay sleeping on either side, as opposed to on my back. I've always preferred sleeping on my side.

Stardustor

[Pugsy]

Recheck your latest link please. It won't load for me no matter what I do.

As far as leaks go....2 potential sources....mouth opening or mask movement. That's pretty much it.
If a person has leaks AND dry mouth we assume mouth opening. To know for sure a person has to tape their mouth shut and see what happens and based on what happens they get to come up with a plan to fix it.

To fix a problem a person first has to identify the cause of the problem.

[Dog Slobber]

Recheck your latest link please. It won't load for me no matter what I do.

As far as leaks go....2 potential sources....mouth opening or mask movement. That's pretty much it.
If a person has leaks AND dry mouth we assume mouth opening. To know for sure a person has to tape their mouth shut and see what happens and based on what happens they get to come up with a plan to fix it.

To fix a problem a person first has to identify the cause of the problem.

LankyLefty27 just did a video on Mask and Mouth Leaking, causes, solutions and tips for (possibly) differentiating between Mask and Mouth leaks.

I agree that casual observation of data can suggest either Mask or Mouth leak, not determine.

https://www.youtube.com/watch?v=20uSblAwTkg

[khauser]

Recheck your latest link please. It won't load for me no matter what I do.

As far as leaks go....2 potential sources....mouth opening or mask movement. That's pretty much it.
If a person has leaks AND dry mouth we assume mouth opening. To know for sure a person has to tape their mouth shut and see what happens and based on what happens they get to come up with a plan to fix it.

To fix a problem a person first has to identify the cause of the problem.

OP's link should have been http://imgur.com/a/kVv6ryy (remove the Xylomelts at the end)