Long Day's Journey Therapy Thread

[babydinosnoreless]

Rodger dodger, got it.

Suspect doesn't appear to be dangerous but be alert. There is a rumor she has pink hair and knows how to put the pressure on...

the pink washed out. So I went back to the hair salon and complained. Its copper now.

[Pugsy]

Any shade of red is notoriously fickle about staying around very long especially when the base color is gray or white.
Been there and done that many times myself.
Hopefully the copper will last longer.

When mine gets screwed up I end up with pink roots....ugly pink roots. Sigh...always something to challenge us to stay beautiful.

[Long day's journey]

It’s great you’re going to take charge of your apnea therapy! You will get excellent advice from the experts on the forum. One small thing to help them—in place of the mask pressure chart could you provide you flow limitations chart?

Thanks for the tip--I've attached the one from last night. Interestingly it went way above 8 for a lot of the night plus there seemed to be only a few RERAs. I did cap it at 12, and woke up in the middle of the night with mask leaks that wouldn't stop (laying on my right side). I'm tired, but not yet zombie-like tired as often happens near the end of the work-week.

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[zoocrewphoto]

Sorry I wasn't more specific about the question--it was whether it's better to stay on apap or to settle on a level (such as 8 or 10, etc.) Maybe it just depends on your circumstances. Thanks for the info!

There are a small number of people who are bothered by pressure changes, and for them, it is best to keep a straight pressure. But for most people, it works much better to set the minimum pressure high enough to prevent most events, and a maximum pressure that allows it to go up as needed. This could be for REM sleep, sleeping on your back, or maybe you need more due to a medication like a muscle relaxer or having some alcohol after dinner.

Also, keep in mind that many doctors consider an ahi of less than 5 to be successfully treated. Unfortunately, that would still be 5 times an hour of being disturbed during sleep. Not good. Many people don't feel really good until they get below an ahi of 2 most nights. You aren't there yet. So, while your doctor may have thought a pressure of 8 was fine (got you below 5), it really isn't totally successful. Once your machine is set well for YOU, your ahi should be below 2 most nights,maybe even below 1. Mine is usually under 1, and rarely ever goes above 1.5. And that is down from a diagnosis of 79+.

[Long day's journey]

I renamed this thread to what I initially should have done. I have another thread out there that I could merge if I knew how discussing recent difficulties: viewtopic.php?f=1&t=178620

Still switching from the pillow mask to the full face mask as I'll wear the pillow initially, wake up after a few hours and it will seem uncomfortable so then will switch to the familiar F20 foam mask. Then that will be uncomfortable after awhile and I'll often take it off also. Continuing the mask quest to find the true one--onwards!

Will have to wait till July before I qualify for a new mask/headgear under my insurance unless I can figure out where else I can get one without a prescription.

I've had something disturbing happen to me a handful of times, including last night. I'll wake up with my FFM on but my mouth is wide open, as if in a silent scream. My mouth is very dry and seems almost locked into place. Swishing water around loosens it up but then I'm wide awake and wondering what the heck happened. Here's the screenshot from last night--it evidently started getting exciting when I put on the FFM.

Thinking I'll try to switch to the pillow full-time and buy some Lansinoh today.

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[Julie]

Have you tried raising your min. pressure by 1-2 cms? 5 is pretty low for most and you might just need more.

[Long day's journey]

Have you tried raising your min. pressure by 1-2 cms? 5 is pretty low for most and you might just need more.

Yes, thanks Julie, palerider suggested 7 also in the other thread and when I modified the settings, I had a similar waking event (mouth wide open, extremely dry mouth, etc.). I wonder if it could be related to the pressure going higher, such as last night? I know that the higher pressure means the machine has detected something and is responding accordingly.

It also doesn't seem comfortable breathing at this higher pressure. Or when I've tried to do a mask fit through the machine, I feel like I'm gasping as it ramps up to the highest pressure. Maybe I'm just a delicate flower.

I looked up my sleep study because the nurse practitioner pointed out that my pes score was high (baseline -3, maximum pull of -15) which "greater negative pressures indicate increased respiratory effort to compensate for upper airway insufficiency during sleep." (I can't pretend to understand this & maybe it has nothing to do with what we're talking about.)

[Dog Slobber]

Yes, thanks Julie, palerider suggested 7 also in the other thread and when I modified the settings, I had a similar waking event (mouth wide open, extremely dry mouth, etc.). I wonder if it could be related to the pressure going higher, such as last night? I know that the higher pressure means the machine has detected something and is responding accordingly.

Your machine is immediately jumping to 6, never falls below 6 and spends a great deal of time well above your minimum. Your minimum setting is not responsible for using lower pressure, and in fact might be the cause of some of the higher peaks.

As palerider suggested, set your pressure to 7 and then we'll see what happens.

[Long day's journey]

Your machine is immediately jumping to 6, never falls below 6 and spends a great deal of time well above your minimum. Your minimum setting is not responsible for using lower pressure, and in fact might be the cause of some of the higher peaks.

As palerider suggested, set your pressure to 7 and then we'll see what happens.

OK, thank you all, I'll give it a longer trial at level 7.

[Miss Emerita]

Was your wake-up after that flurry of OAs? It wouldn't surprise me if those repeated OAs were causing you to open your mouth. I see that your earlier pressure increases were in response to FLs. Do you know whether those pressure changes bother you?

[palerider]

Min 9, max 20.

[Long day's journey]

Was your wake-up after that flurry of OAs? It wouldn't surprise me if those repeated OAs were causing you to open your mouth. I see that your earlier pressure increases were in response to FLs. Do you know whether those pressure changes bother you?

Yes, I was wide awake after those incidents. I'm not sure whether the pressure changes bother me--it does disturb me when I wake up due to leaks. Sorry I can't be more definite!

[Long day's journey]

Min 9, max 20.

I appreciate the advice, but it raises my anxiety level for some reason. I think I'll set the ramp time to 35 minutes so I'm hopefully well asleep before it happens.

[Long day's journey]

I want to thank everyone for their patient advice even when I've seemed somewhat dense or apprehensive. I also appreciate the wealth of information on the Bleep mask that helped with adapting to it. My numbers look pretty good, so I can't complain. (Yet, here I go.). I still wake up around 1 -2 am, and now I've been taking pills consistently to go back to sleep to avoid the daytime zombie phenomenon. I'm toying with the idea of getting an oximeter to rule low O2 levels out.

1) Does getting an oximeter in this case seem like a good idea or a waste of money? I've always been a mouth breather but am trying to switch to breathing through my nose (taping my mouth shut). Still, my jaw is tense at night and I find myself using a retainer.

2) Maybe I should adjust my level to 8, no apap, in case the pressure changes are causing my middle of the night wake-ups? -OR-

3) Leave it alone and don't mess with it (highest AHI in the past few weeks has been 1.5).

Else I'm left with the conclusion that this middle of the night wake-up is more psychological than physiological (anxiety interfering with the ability to fall back asleep).

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[Pugsy]

Do you take any medications of any kind? If so, what?

Do you have other physical or mental health issues that might impact your sleep quality?

Any idea what might be causing the wake ups? Did you have those wake ups prior to going on cpap therapy?

By all means give fixed pressure a try. While I tend to believe that it isn't so much the changing pressures that causes the wake ups for most people (I think it is the apnea events that the pressure is responding to that is the main culprit for most people) there are people who say they simply sleep better with fixed pressures. Hurts nothing to give it a try and at least answer that question.
You will probably need around 9 or 10 cm fixed though ...I am not so sure 8 fixed will be enough but you could try it and see what happens. Some nights 8 might get the job done but there are times you need more and if you used 8 and need more then the airway might try to collapse. So you might have to use more pressure all the time instead of some of the time if you want to go with a fixed pressure.