New large leaks after 18 months of normal leaks... (w/ chinstrap)

[palerider]

though would love any insights from reading the Oscar tea leaves (or a pointer on where I can learn to do so!)

Your min pressure should be more like 8.4, it's too low for you.

This was suggested by palerider almost a week ago - you haven't done it.

Hasn't done anything I suggested...

While I am grateful for your free advice, the snark really isn't necessary.

Bless your heart, there's need to get bitchy, I'm happy to try and help other people instead.
have a nice day.

[vintage]

Your min pressure should be more like 8.4, it's too low for you.

This was suggested by palerider almost a week ago - you haven't done it.

Hasn't done anything I suggested...

While I am grateful for your free advice, the snark really isn't necessary.

Bless your heart, there's need to get bitchy, I'm happy to try and help other people instead.
have a nice day.

Not sure how else to interpret an eye roll other than as snarky, mate.

[lynninnj]

Quick update: used a strip of 1" Medvance Soft Silicone Tape over my mouth. It's easy to peel without ripping my face, but doesn't prevent leaks for me. So threw a strip of 2" 3M Micropore Surgical tape over it to hold it down. Put a chinstrap on for good measure.

Results were great with respect to both mouth leak and AHIs:



Feel pretty awesome this morning despite being asleep for less than 7 hours (according to my sleep tracker)!

I *think (and have asked specifically) that the data point used to help determine the minimum setting is somewhere around the "med" pressure number. I think* this should be based on several days/weeks worth of data and not just one day, though I am glad you are doing better.

If you look at your chart, the "med" number is 10 something if I recall (I cant see it while quoting). You start out real low and you have to keep having events for it to raise up. By starting up higher, you may be preventing a few of those events simply because it needs a higher pressure to keep things open. See how it goes way up precipitiously? By setting lower pressure higher, it shouldn't have to climb so much. And then it won't drop down so low either after a few events. At the same time, the leaks will cause it to raise up as well in the pressure and that can further worsen leaks if it pushes your mouth open. But getting the low end set up seems the most important thing here.

I am a newbie here and I appreciate anyone willing to correct me if I am wrong. But this is what everyone here has been trying to teach me and maybe if by speaking newbie that helps you then that is a good thing.

I respectfully accept I may have no clue what I am talking about, but this is what I have gathered so far. Hopefully we all get the kinder gentler explainers moving forward. (although this is a very important consideration and waiting to up your low setting may be your major problem that needs to be fixed first before anything else can be fixed.)

[lynninnj]

Quick update: used a strip of 1" Medvance Soft Silicone Tape over my mouth. It's easy to peel without ripping my face, but doesn't prevent leaks for me. So threw a strip of 2" 3M Micropore Surgical tape over it to hold it down. Put a chinstrap on for good measure.

Results were great with respect to both mouth leak and AHIs:



Feel pretty awesome this morning despite being asleep for less than 7 hours (according to my sleep tracker)!

I *think (and have asked specifically) that the data point used to help determine the minimum setting is somewhere around the "med" pressure number. I think* this should be based on several days/weeks worth of data and not just one day, though I am glad you are doing better.

If you look at your chart, the "med" number is 10 something if I recall (I cant see it while quoting). You start out real low and you have to keep having disturbance for it to raise up. By starting up higher, you may be preventing a few of those events simply because it needs a higher pressure to keep things open. See how it goes way up precipitiously? By setting lower pressure higher, it shouldn't have to climb so much. And then it won't drop down so low either after a few events. At the same time, the leaks will cause it to raise up as well in the pressure and that can further worsen leaks if it pushes your mouth open. But getting the low end set up seems the most important thing here.

I am a newbie here and I appreciate anyone willing to correct me if I am wrong. But this is what everyone here has been trying to teach me and maybe if by speaking newbie that helps you then that is a good thing.

I respectfully accept I may have no clue what I am talking about, but this is what I have gathered so far. Hopefully we all get the kinder gentler explainers moving forward. (although this is a very important consideration and waiting to up your low setting may be your major problem that needs to be fixed first before anything else can be fixed.)

Edit: there are a lot of nuances to reading these and I still have a lot to learn. I don't want anyone to think I think I am some sort of expert. I am not, and I don't pretend to be. i just see a lot of leaking going on and that is also driving up your numbers including the "med" pressure.

Second Edit: Would someone here comment on whether the EPR being off may be increasing pressure spikes and potentially leakage?

[zonker]

vintage?

the link is broken on your dropbox files and we can't see your previous oscar charts.

maybe try imgur.com? it's free and very, very solid.

I took palerider's advice and have used Imgur for the latest images. Initial couple of post's images are broken. If you want to see them I'll replace the dropbox hosted images with Imgur ones but I didn't think it was necessary.

What do you think?

no, unless ozij wants to see it.

[vintage]

Quick update: used a strip of 1" Medvance Soft Silicone Tape over my mouth. It's easy to peel without ripping my face, but doesn't prevent leaks for me. So threw a strip of 2" 3M Micropore Surgical tape over it to hold it down. Put a chinstrap on for good measure.

Results were great with respect to both mouth leak and AHIs:



Feel pretty awesome this morning despite being asleep for less than 7 hours (according to my sleep tracker)!

I *think (and have asked specifically) that the data point used to help determine the minimum setting is somewhere around the "med" pressure number. I think* this should be based on several days/weeks worth of data and not just one day, though I am glad you are doing better.

If you look at your chart, the "med" number is 10 something if I recall (I cant see it while quoting). You start out real low and you have to keep having events for it to raise up. By starting up higher, you may be preventing a few of those events simply because it needs a higher pressure to keep things open. See how it goes way up precipitiously? By setting lower pressure higher, it shouldn't have to climb so much. And then it won't drop down so low either after a few events. At the same time, the leaks will cause it to raise up as well in the pressure and that can further worsen leaks if it pushes your mouth open. But getting the low end set up seems the most important thing here.

I am a newbie here and I appreciate anyone willing to correct me if I am wrong. But this is what everyone here has been trying to teach me and maybe if by speaking newbie that helps you then that is a good thing.

I respectfully accept I may have no clue what I am talking about, but this is what I have gathered so far. Hopefully we all get the kinder gentler explainers moving forward. (although this is a very important consideration and waiting to up your low setting may be your major problem that needs to be fixed first before anything else can be fixed.)

Thanks lynninnj. Goal #1 was reduce the leaks which (touch wood) seems solved with mouth tape.

Goal #2 is to deal with changing min/max. Last night I had basically no leaks and med was at 10.4. I've been advised to raise med to 8.4 which I'll likely do tonight if ambitious or tomorrow if I want another night to see if my current mouth tape approach works.

All that said my AHIs are super low (1.14 last night, generally under 3). What should I realistically aim for? Under 1? Seems like this may be micro-optimization at this point. Still going to give it a go but not sure I should focus too much on it. Should I?

[vintage]

Second Edit: Would someone here comment on whether the EPR being off may be increasing pressure spikes and potentially leakage?

I'm also a noob and had no idea what EPR is. Feels like I'd be a lot more comfortable with this ON. I'll give it a go tonight. Thanks for calling my attention to it!

[ozij]

Quick update: used a strip of 1" Medvance Soft Silicone Tape over my mouth. It's easy to peel without ripping my face, but doesn't prevent leaks for me. So threw a strip of 2" 3M Micropore Surgical tape over it to hold it down. Put a chinstrap on for good measure.

Results were great with respect to both mouth leak and AHIs:

Great idea, to put micropore on top of the other tape!

Feel pretty awesome this morning despite being asleep for less than 7 hours (according to my sleep tracker)!

That is a the best reason of all to leave things as they are.

[vintage]

Quick update: used a strip of 1" Medvance Soft Silicone Tape over my mouth. It's easy to peel without ripping my face, but doesn't prevent leaks for me. So threw a strip of 2" 3M Micropore Surgical tape over it to hold it down. Put a chinstrap on for good measure.

Results were great with respect to both mouth leak and AHIs:

Great idea, to put micropore on top of the other tape!

Thanks, stole it from someone here =)

Feel pretty awesome this morning despite being asleep for less than 7 hours (according to my sleep tracker)!

That is a the best reason of all to leave things as they are.
[/quote]

Agreed. Still worth experimenting with a few things but after the mouth leak issue nothing seems pressing. Maybe I can optimize some more but they seem like micro-optimizations right now.

[zonker]

All that said my AHIs are super low (1.14 last night, generally under 3). What should I realistically aim for? Under 1? Seems like this may be micro-optimization at this point. Still going to give it a go but not sure I should focus too much on it. Should I?

that's the million dollar question, innit? "how low can you go?" to quote the limbo song. my theory(which i stole from jnk) is to go as low as you can while still holding the airway open. that is, after all, the whole point of therapy.

it's fairly comical for me to be saying this and i still can't get used to it. i spent almost seven years "chasing zero" while plaintively protesting i wasn't. then i finally gave up. i found that those nights i spent at an ahi of zero WERE NOT THE BEST NIGHTS OF SLEEP. sorry i didn't mean to shout, but it's true.

now that i've given that up and starting chasing comfort, i'm much better off. i sleep better because i'm taking care to have more exercise, more and better supplements, less wine and coffee. i sleep more soundly because i can be more comfortable.

around here on the forum, many of us think it's best if your ahi is around 1. but that is purely subjective. it's YOUR therapy and yours to do with as you wish.

personally, i think you've got this. continue to tweak when you feel like it. (who am *I* to tell you otherwise?) you'll get used to this, the newness will wear off and you'll soon find yourself right where you want and need to be.

[lynninnj]

All that said my AHIs are super low (1.14 last night, generally under 3). What should I realistically aim for? Under 1? Seems like this may be micro-optimization at this point. Still going to give it a go but not sure I should focus too much on it. Should I?

that's the million dollar question, innit? "how low can you go?" to quote the limbo song. my theory(which i stole from jnk) is to go as low as you can while still holding the airway open. that is, after all, the whole point of therapy.

it's fairly comical for me to be saying this and i still can't get used to it. i spent almost seven years "chasing zero" while plaintively protesting i wasn't. then i finally gave up. i found that those nights i spent at an ahi of zero WERE NOT THE BEST NIGHTS OF SLEEP. sorry i didn't mean to shout, but it's true.

now that i've given that up and starting chasing comfort, i'm much better off. i sleep better because i'm taking care to have more exercise, more and better supplements, less wine and coffee. i sleep more soundly because i can be more comfortable.

around here on the forum, many of us think it's best if your ahi is around 1. but that is purely subjective. it's YOUR therapy and yours to do with as you wish.

personally, i think you've got this. continue to tweak when you feel like it. (who am *I* to tell you otherwise?) you'll get used to this, the newness will wear off and you'll soon find yourself right where you want and need to be.

You make some very good points Zonker. I found myself being perturbed getting two point something. I would wake in the morning and it kind of upset me. But the last few nights of near 1, I felt markedly improved. But I won't complain at the two point something even though I know I want to see it get better.

[vintage]

All that said my AHIs are super low (1.14 last night, generally under 3). What should I realistically aim for? Under 1? Seems like this may be micro-optimization at this point. Still going to give it a go but not sure I should focus too much on it. Should I?

that's the million dollar question, innit? "how low can you go?" to quote the limbo song. my theory(which i stole from jnk) is to go as low as you can while still holding the airway open. that is, after all, the whole point of therapy.

it's fairly comical for me to be saying this and i still can't get used to it. i spent almost seven years "chasing zero" while plaintively protesting i wasn't. then i finally gave up. i found that those nights i spent at an ahi of zero WERE NOT THE BEST NIGHTS OF SLEEP. sorry i didn't mean to shout, but it's true.

now that i've given that up and starting chasing comfort, i'm much better off. i sleep better because i'm taking care to have more exercise, more and better supplements, less wine and coffee. i sleep more soundly because i can be more comfortable.

around here on the forum, many of us think it's best if your ahi is around 1. but that is purely subjective. it's YOUR therapy and yours to do with as you wish.

personally, i think you've got this. continue to tweak when you feel like it. (who am *I* to tell you otherwise?) you'll get used to this, the newness will wear off and you'll soon find yourself right where you want and need to be.

Thanks zonker. It's a little baffling to me that an AHI of 1-2 can still result in feeling destroyed the next day, migraines, etc. Esp since (as I understand it) the threshold is an AHI of 5 to be diagnosed with OSA.

I'd be slightly tempted to go back to no CPAP since I was right around 5 in my sleep study. But I'm less tempted because I have zero desire to go back to exhaustion at noon and a migraine if I didn't nap!

My take is that the numbers are helpful to raise and diagnose issues, but (as you say) the real indicator of how well therapy is going is how you're feeling.

Related - the mouth taping is really paying off. Last night I took mix/max to 7/13 and turned on EPR. Here's the chart:



Median pressure was 10.76. Would you suggest potentially increasing min to, say, 10?

[lynninnj]

All that said my AHIs are super low (1.14 last night, generally under 3). What should I realistically aim for? Under 1? Seems like this may be micro-optimization at this point. Still going to give it a go but not sure I should focus too much on it. Should I?

that's the million dollar question, innit? "how low can you go?" to quote the limbo song. my theory(which i stole from jnk) is to go as low as you can while still holding the airway open. that is, after all, the whole point of therapy.

it's fairly comical for me to be saying this and i still can't get used to it. i spent almost seven years "chasing zero" while plaintively protesting i wasn't. then i finally gave up. i found that those nights i spent at an ahi of zero WERE NOT THE BEST NIGHTS OF SLEEP. sorry i didn't mean to shout, but it's true.

now that i've given that up and starting chasing comfort, i'm much better off. i sleep better because i'm taking care to have more exercise, more and better supplements, less wine and coffee. i sleep more soundly because i can be more comfortable.

around here on the forum, many of us think it's best if your ahi is around 1. but that is purely subjective. it's YOUR therapy and yours to do with as you wish.

personally, i think you've got this. continue to tweak when you feel like it. (who am *I* to tell you otherwise?) you'll get used to this, the newness will wear off and you'll soon find yourself right where you want and need to be.

Thanks zonker. It's a little baffling to me that an AHI of 1-2 can still result in feeling destroyed the next day, migraines, etc. Esp since (as I understand it) the threshold is an AHI of 5 to be diagnosed with OSA.

I'd be slightly tempted to go back to no CPAP since I was right around 5 in my sleep study. But I'm less tempted because I have zero desire to go back to exhaustion at noon and a migraine if I didn't nap!

My take is that the numbers are helpful to raise and diagnose issues, but (as you say) the real indicator of how well therapy is going is how you're feeling.

Related - the mouth taping is really paying off. Last night I took mix/max to 7/13 and turned on EPR. Here's the chart:



Median pressure was 10.76. Would you suggest potentially increasing min to, say, 10?

Curious-how do you feel?
Do you feel like the EPR made sleeping more comfy?

I always do the math at the end of the morning and smile when I’ve had 10 or fewer events. You’re right at 10.

I also look at my time in apnea and I feel like regardless of what the numbers say for AHI the less time I spend in apnea the better I feel. It seems to correlate for me anyway.

Have a wonderful will rest the day! Sorry I can’t answer your other question

[vintage]

Curious-how do you feel?
Do you feel like the EPR made sleeping more comfy?

I always do the math at the end of the morning and smile when I’ve had 10 or fewer events. You’re right at 10.

I also look at my time in apnea and I feel like regardless of what the numbers say for AHI the less time I spend in apnea the better I feel. It seems to correlate for me anyway.

Have a wonderful will rest the day! Sorry I can’t answer your other question

Feeling pretty good! Still didn't sleep long enough (exercised and ate late, and thus went to bed too late). But not dragging an hour after getting up like I was two weeks ago with the huge leaks.

AHI vs. time in apnea - ah, interesting, the medical establishment focuses on AHI but time in apnea seems like it could be a reasonable way to measure things. I need to bone up on reading my oscar data a little more. Thanks for the tip =)

[lynninnj]

I don’t know if any of the research suggests what I say is true. I have just been paying closer attention to time spent in apnea. In theory they should be roughly equal-its just a personal thing.

Think about it- an apnea is 10 seconds or more. So ten apneas like you had last night will be a minimum of 1 minute and 40 seconds.

It’s just a personal thought and no reading supports that. Sorry.