mouth leaks problem

[stege]

I recently tried mouth taping to reduce major leakage but this caused AHI to jump considerably. Is there a happy medium when it comes to the leakage amount ?

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[Pugsy]

How did you sleep with the mouth taped? Sleep soundly or wake up often?

Do you know if your OSA is particularly worse on your back or in REM?

Were the non taped mouth leaks causing you to wake up often during the night?

[stege]

Three nights of taping and fairly sound sleep although I have woken up at approximately 1:00 am each night . Non taping nights I've also been sleeping quite soundly but without the 1:00 wake up and waking at 4:00 am . OSA is definitely worse when sleeping on my back and have been pretty successful at learning to sleep on one side or the other . I'm sorry but I'm kind of clueless when it comes to REM.

[zonker]

I'm sorry but I'm kind of clueless when it comes to REM.

no apologies necessary. if you don't ask, you don't learn.

rem=dreaming.

so she wants to know if you happen to know if your osa is worse when you dream.

[Pugsy]

Google "sleep stages" and look at the normal hypnograms for when REM sleep stage tends to occur. Your clustering of OAs loosely coincides with the time frame where we might expect REM to be happening.

It's common for OSA to worsen in REM (and when supine) and need more pressure. I have it myself. My OSA is document 5 times worse in REM than non REM sleep stages and it's also when I seem to see the greatest changes in pressure.

Now how this might relate to your taping vs non taping....I don't know that it does unless with taping you get more REM and that's if your OSA is worse in REM.

If the non taped nights caused a lot of wake ups from mouth leaks it wouldn't be impossible for you to simply not getting much REM because of repeated wake ups. If you are sleeping more soundly and getting more REM stage sleep and your OSA is worse in REM....might explain the higher AHI.

See where I am going with this???? This might explain why the AHI is higher when the mouth is taped. It's a maybe....and a logical maybe.

[stege]

Great information , thanks . I had no idea dreaming (REM) had so much influence on OSA . I don't recall dreaming much last night and I woke up twice , once at 1:57 and again at 3:22 . Better AHI than previous taped nights . I do know most of my non taped wake ups are caused by leaks ( mouth flapping) so that was the reason to try tape .Thanks for the explanation Pugsy I'll dig deeper into this today .

[Miss Emerita]

The REM (rapid eye movement) state always includes dreaming as well as those characteristic eye movements and an absence of skeletal muscle tone. REM sleep somehow helps us consolidate memories and retain what we've learned.

We can also dream in other sleep stages:

https://www.jneurosci.org/content/38/43/9175

We fail to remember many of our dreams, so not remembering dreams doesn't mean you're not having them.

At your present settings, you are having an assortment of events associated with restriction in the airway: obstructive apneas, hypopneas, flow limitations, and RERAs (respiratory effort related arousal). I can't help wondering whether you'd do better with a higher minimum, especially since the algorithms of your machine are fairly conservative and don't tend to respond aggressively or rapidly to events. And if you are having REM-related issues, the higher minimum might help you get through REM with fewer problems.

I would defer to Pugsy, of course, but it might be worth thinking about inching you minimum up, .5 at a time, staying at each new minimum for at least a few days.

[stege]

Hi , since last contact I increased pressure slowly with what I think were good results . Ten days ago I went to 13.5 from 13.0 but haven't really noticed much difference . My 30 day avg AHI is 2.9 . At both settings I usually sleep straight through without getting up and if I do wake up I drift off again immediately . Would I be wrong in assuming that this pressure setting could be a "sweet spot" for me ? Would there be any benefit to going back to 13.0 from 13.5 ? I have been tweaking comfort settings of humidification and tube temperature because the dryness of the air here causes sinus congestion but don't know how much effect that has on results .