Encore data from first night with mouth taped

Spottymaldoon · Post by **Spottymaldoon** » Mon Jan 28, 2008 1:09 pm

I taped my mouth for the first time last night - I had been seeing high leakage flows on my Encore reports and had been waking up with a really dry mouth.

Certainly I seem to have stopped the mouth-leakage, judging by the Encore results, but I still found myself 'off-color' in the morning.

I'd be most grateful if some kindly and knowledgeable soul would take a look at the data and give me a general opinion/advice

It's in JPEG form at http://www.richardleveson.com/encore

Thanks,
Spotty

6PtStar · Post by **6PtStar** » Mon Jan 28, 2008 1:42 pm

Looks like it confirmed the fact that you are a mouth breather. I really don't have an answer as to why your AHI went up except it is just one night. I know when I first started taping the anxiety of taping sent my up a bit. Continue for a week and look at it. Once you get the leaks under control you can start looking at other things to get your AHI down a bit although yours is not all that bad.

I am not quite sure what you mean by"off-color". If you mean a bit flushed in the color of your face and hands you might be a candate for an overnight oximetry check with a pulse oximeter.

Jerry

Guest · Post by **Guest** » Mon Jan 28, 2008 4:30 pm

Looks like it confirmed the fact that you are a mouth breather. I really don't have an answer as to why your AHI went up except it is just one night. I know when I first started taping the anxiety of taping sent my up a bit. Continue for a week and look at it. Once you get the leaks under control you can start looking at other things to get your AHI down a bit although yours is not all that bad.

I am not quite sure what you mean by"off-color"

Thanks Jerry, I shall keep on for a while as you suggest. No, 'off color' just means a fair bit less than tip-top!
Cheers,
Spotty

JeffH · Post by **JeffH** » Mon Jan 28, 2008 4:36 pm

I'd be interested to see a night on straight CPAP at a pressure of 8 and then see what your AHI looks like. Taping seemed to help, and I've ALWAYS gotten lower AHI's running straight CPAP.

JeffH

rested gal · Post by **rested gal** » Mon Jan 28, 2008 6:04 pm

WTG, Spotty!

Your before/after taping leak lines look just like my before/after taping.

If it were me, I think I'd set the machine at 8 - 15. Bringing that lower pressure up would probably lower the AHI considerably.

Spottymaldoon · Post by **Spottymaldoon** » Tue Jan 29, 2008 7:53 am

JeffH I did what you suggested and set my machine to 8.0 and CPAP with mouth taped. I posted the result -

http://www.richardleveson.com/encore see 28JAN08

Very interesting! Only one apnea for the whole night but lots of hypopneas.

Rested, thanks for the suggestion - I may try that tonight

Wulfman · Post by **Wulfman** » Tue Jan 29, 2008 3:52 pm

Spottymaldoon wrote:JeffH I did what you suggested and set my machine to 8.0 and CPAP with mouth taped. I posted the result -

http://www.richardleveson.com/encore see 28JAN08

Very interesting! Only one apnea for the whole night but lots of hypopneas.

Rested, thanks for the suggestion - I may try that tonight

Looks much better.
I'd give it a few more nights and then try going another cm higher in CPAP mode.

Den

Spottymaldoon · Post by **Spottymaldoon** » Wed Jan 30, 2008 7:24 am

Thanks. Last night my Encore reported a "subscript out of range error" and all the data for the night was lost. Shall hope this is just the result of an occasional quirk - I notice that there may be an issue with the card interfaces, possibly grease on the contacts, as reading problems are quite frequent.

Spotty

Spottymaldoon · Post by **Spottymaldoon** » Thu Jan 31, 2008 9:29 am

Got the data from 29th Jan and posted at

http://www.richardleveson.com/encore

I set the machine to APAP and the range at 8.0 - 14.0 mouth taped.

Not as good as previous night with most apneas clustered in the first hour (14) and the final hour (5)

I woke from this short night feeling pretty exhausted and with an unusual amount of arrhythmias (PVCs) - wondered if the power had gone off and I had not woken up. With my setup it is very hard to breathe with no pressure to the mask - I believe I shall try to adapt the relief valve on my full-face mask to work on my nose mask before taping my mouth again. There is no point in developing a phobia, however irrational!

Then I'll do more nights with 8.0 CPAP

Thanks for your advice Wulf and Rested.

Cheers,
Spotty

rested gal · Post by **rested gal** » Thu Jan 31, 2008 10:30 am

I'm not a doctor. But having looked at your data reports through Jan 29, I'd set the machine for either of these ways...if it were me:

auto 10 - 20 (or 10 - 16)
The important thing, given the data so far, is to set the minimum pressure at 10, imho.

or

cpap at 10 or 11 or 12

I'd use whatever C-flex level felt best.

I'd also keep taping.

Wulfman · Post by **Wulfman** » Thu Jan 31, 2008 2:59 pm

Spotty,

What position(s) do you sleep in at night?
I'm trying to make sense of the clusters of apneas that are showing up......
You seem to have periods of the night when you don't have events, regardless what the pressure......but then there's that first 45 minutes.....

I think I'd try a little higher pressures.....preferrably in CPAP mode.

Den

roster · Post by **roster** » Thu Jan 31, 2008 7:32 pm

Spotty's highest leak rate before or after taping looks to be around 60/65. The machine should be able to easily maintain the set pressure at this leak rate and still detect apneas and hypopneas.

Spottymaldoon · Post by **Spottymaldoon** » Fri Feb 01, 2008 8:54 am

First of all, I am very grateful to Wulf, Rested and Rooster for taking the trouble to look at my data and respond. Thank you, folks!

Wulf, I tend to move a lot in my bed and change sides or to sleep on my back - I truly don't know if there is any pattern to this to correspond with those apnea clusters. I sort of 'know' that, for me, there are peak apnea periods roughly within the first and the last hours of sleep.

I have no idea what happened in 29th. Jan - that's the worst apnea I ever recorded. I also woke up feeling pretty rough.

Last night I used CPAP at 9.0 with taped mouth and it was a pretty fair night (I woke numerous times) and I feel good this morning. This followed Wulf's advice. Wulf, have you any idea why CPAP works better for you than APAP? Rested's advice to use APAP is very logical and I only tried her suggestion once, but I will give it another go soon. Meantime I'll gather more data in the CPAP 9.0 mode.

Data at http://www.richardleveson.com/encore

Last night I ran the oximeter (my bedside looking more like an intensive care unit every day!) and if there are any interesting results I shall post them alongside the Encore data.

Rooster, it is comforting to know that the machine can register apneas even if there is a high flow rate due to leakage. Hopefully it will also have enough reserve delivery pressure to counteract them too?

Thanks,
Spotty

JeffH · Post by **JeffH** » Fri Feb 01, 2008 9:25 am

Spotty, watch setting the machine too high. I noticed that at 14, you were having non-responses. From what I understand those are centrals and are a direct result of having your pressure too high. If you do run on apap, narrow the range. Having said that, changing what you do every night is not a good way to see what is going on. You really need to set it up one way and LEAVE it that way for at least a week. Patience my friend, patience.

JeffH

Wulfman · Post by **Wulfman** » Fri Feb 01, 2008 9:53 am

Spottymaldoon wrote:First of all, I am very grateful to Wulf, Rested and Rooster for taking the trouble to look at my data and respond. Thank you, folks!

Wulf, I tend to move a lot in my bed and change sides or to sleep on my back - I truly don't know if there is any pattern to this to correspond with those apnea clusters. I sort of 'know' that, for me, there are peak apnea periods roughly within the first and the last hours of sleep.

I have no idea what happened in 29th. Jan - that's the worst apnea I ever recorded. I also woke up feeling pretty rough.

Last night I used CPAP at 9.0 with taped mouth and it was a pretty fair night (I woke numerous times) and I feel good this morning. This followed Wulf's advice. Wulf, have you any idea why CPAP works better for you than APAP? Rested's advice to use APAP is very logical and I only tried her suggestion once, but I will give it another go soon. Meantime I'll gather more data in the CPAP 9.0 mode.

Data at http://www.richardleveson.com/encore

Last night I ran the oximeter (my bedside looking more like an intensive care unit every day!) and if there are any interesting results I shall post them alongside the Encore data.

Rooster, it is comforting to know that the machine can register apneas even if there is a high flow rate due to leakage. Hopefully it will also have enough reserve delivery pressure to counteract them too?

Thanks,
Spotty

Yes, I do!
There are a number of variables that determine the pressure changes in an Auto/APAP. Pressure changes for SOME of us, disturb our sleep. When a person/machine gets into a leak/AHI events/snore/pressure change situation, it can feed on itself and the pressure goes every which way.....as it was doing in your previous charts.

In my opinion, the functions of an Auto should be to zero in on one's best single pressure OR to use it in a very narrow range. In the case of the latter, an argument could be made that by the time you get that range so narrow......you might as well just pick a set pressure.

Another thing that single pressure does is give you a scenario of "all things being equal". That makes it easier to pinpoint problems that show up in the data. With APAPs, you can get a "chain-reaction collision".

I'd leave the pressure setting where it is for about a week and see what things look like. Looks good from last night. The leak line's a little "ragged", but I've had nights like that, too.

Den

Mask

Additional Comments: Equipment isn't correct, S9 ASV w/H5i