Breathing air and mask types and restless leg

JoRehovot · Post by **JoRehovot** » Wed Sep 11, 2019 9:47 pm

Hi all,
Thanks for creating and using this forum. It's AWESOME!
I am a new (1 yr) CPAP user, and I've been watching the forums most of that time. I have been reading posts and learning, and my sleep is much better than it was before I started, though I am still only able to sleep for 5-6 hrs per night.

I hope to start examining data soon and optimizing my settings, but for now I'm just wondering one thing. I use a full-face mask because of allergies which sometimes block my nose. I have the pressure set at 10-12, which is probably not enough, because I sometimes still wake up feeling breathless, but is the maximum I can use without major leaks, with this mask. If I have it much less than that I get no benefit from it.

I often wake up totally blown up with air. Some days I wake up and do some VERY large burps, which is noisy but effective. Other days I can't get rid of the air and it's painful for the first 1-2 hrs of the day.

I have bought a nasal mask, thinking that when the allergies are less, I'll be able to use it. My question is, is swallowing air much reduced with a nasal mask, if I can manage to use it?

Thanks in advance,
Jo
P.S. I think you have all the info about my machine etc. but not about me. I'm a 58 yr-old woman, living in Israel, originally from England, working in hi-tech. Reason I haven't done the analysis is that I work all day at the computer analysing issues, solving people's problems, then I come home and I've had enough of that, so I've resisted getting into it.

LSAT · Post by **LSAT** » Thu Sep 12, 2019 9:30 am

When you get around to it...Download OSCAR software so you can see how your therapy is doing.
https://www.sleepfiles.com/OSCAR/

JoRehovot · Post by **JoRehovot** » Thu Sep 12, 2019 6:27 pm

Thanks LSAT. That leads me to my second question. I downloaded Sleepyhead last year, though I've hardly used it. Any reason to change to OSCAR?
Thanks,
Jo

Okie bipap · Post by **Okie bipap** » Thu Sep 12, 2019 6:54 pm

Sleepyhead will work for your machine. At this time, it looks like all development work and problem fixes for Sleepyhead have ceased. Oscar is currently being worked by several individuals in a cooperative effort to fix any identified problems. If Sleepyhead works for you and you are satisfied with how it works, then keep using it. At some point in the future you may decide to try Oscar. I have used both and decided to stay with Oscar. I was able to get the same information off of each program, but decided to stay with the newer program simply because it is continually evolving while Sleepyhead is staying right where it is now.

Thumper68 · Post by **Thumper68** » Thu Sep 12, 2019 6:56 pm

Welcome Jo!,
Oscar was forked off of Sleepyhead as Sleepyhead is no longer being supported. Oscar has a team of people working on bugs, updates, and other things. It is easy to import your sleepyhead files into Oscar. I switched to Oscar because it is being supported by people who care about improving it for the end user.

JoRehovot · Post by **JoRehovot** » Tue Sep 24, 2019 11:13 am

Thanks Thumper.
I have now installed Oscar and imported my data from sleepyhead AND organized the screen in the recommended way. Next step is to read more and understand better what I'm looking at. Slowly, slowly.
Jo

JoRehovot · Post by **JoRehovot** » Fri Oct 18, 2019 6:11 am

Hi guys,
So I'm gradually getting this thing set up to work well for me. My basic issue is that I need high pressure. I know this because I still wake up in the night breathless. The machine allows me to sleep for longer, but the maximum time that I manage without sleeping pills is about 4 hrs. With Ambien I can sleep for about 7 hrs, but I don't want to take that too often, or it will stop having any effect. It already doesn't work anything like as well as it did when I first used it.

I am using a full face mask because of nasal congestion, which makes me open my mouth and the max pressure I can use with it is 12, because higher than that I just get leakage.
Following advice from people here (not specifically to me) I just started using a nasal spray, and it's helping, so now I want to try the nose mask.

My question is what max pressure should I start at? The company set it originally at 7 for a nose mask? Should I start there? And then if it's not enough (which it wasn't before), how many nights should I try at each rate before increasing, and by how much at a time should I increase? I saw a video which suggested a week at each pressure and to increase by only 0.1 each time, but that seems extreme, and it could take a year or more to get to the right pressure. What do you guys think?

Thanks in advance!
Jo

JoRehovot · Post by **JoRehovot** » Fri Oct 18, 2019 6:13 am

P.S. Let me know if you need to see a sample night?
Thanks,
Jo

Pugsy · Post by **Pugsy** » Fri Oct 18, 2019 7:22 am

Sample of a recent detailed night report would be really helpful. Let's see exactly what your machine is doing in terms of pressure.
Some people using full face masks have found that they don't need as much pressure with a nasal mask as they do with a full face mask.
Not everyone of course but enough to make it worth mentioning. Maybe you would be one of the lucky ones.
Also leaks are usually easier to control with a nasal mask because there's less skin to mask surface area that needs to be kept sealed so maybe it won't be quite so leaky at the higher pressures.

JoRehovot · Post by **JoRehovot** » Fri Oct 18, 2019 7:47 am

Not at the computer right now, and I won't be until tomorrow night but I can tell you that the machine keeps the pressure close to 12 after the 5 minute ramp up, pretty much all night.
I have EPR set at 2, which has much reduced the air swallowing and bloating.

Thanks,
Jo

Sent from my SM-A505F using Tapatalk

Pugsy · Post by **Pugsy** » Fri Oct 18, 2019 7:57 am

You can always just start with the nasal mask at your current settings and see what happens.
If the machine doesn't need to increase the pressure it won't.
Then after a few nights evaluate the results. I like to have at least 3 to 5 nights at a setting to get an idea what is going on.
That is of course unless the results are horrible for some reason or other then I will change things sooner......like if an increase in pressure causes sudden really bad aerophagia.
If after a few nights you look at the reports and see the machine doesn't want to ever go much above the minimum pressure then you can reduce the minimum a bit and repeat the experiment.

The maximum pressure setting isn't your most critical setting....it's the minimum pressure setting that is your most import setting in terms of holding the airway open.

JoRehovot · Post by **JoRehovot** » Sun Oct 20, 2019 12:26 am

Hi Pugsy,
Thanks for the great response. A bit more info about me. I guess it should go in the signature, but here it is, for now.
I have Restless Leg Syndrome quite badly, since a long time before I was diagnosed with sleep apnea. I take Sifrol (Pramipexole dihydrochloride monohydrate, 0.75mg) for it every night, an hour before I go to sleep. This is effective in calming the symptoms most of the time, but occasionally I go through a phase where it's not enough. When that happens I take Clonazepam (Clonex) on top of the Sifrol, in order to be able to get to sleep. The dose of that varies because the more I take it the less it works.

So last Tuesday night was the last fairly typical night with the full face mask, before I switched to the nasal mask. I took Sifrol as normal, and I used the nasal spray (Avamys - Fluticasone Furoate 27.5 mcg) My legs were restless so I didn't even try to get to sleep until late. Eventually I took 0.75 mg of Clonex and went to bed. Here are the graphs from that:

: 2019-10-20_OscarTues.png (122.4 KiB) Viewed 1401 times

According to the graphs, I pulled the mask off at around 4:20. My notes say that I didn't wake up until 4:45, but I was breathless then, and it took me about an hour to feel like I was breathing normally again, and go back to bed.

Most nights are like that, except that, if I don't need to take Clonex then I usually wake up breathless between 1 and 3, and get back to bed sooner.
Here's a good example of that. I had to go back a bit to find one where I had made notes. This was before I started using the nasal spray so took Clarinase (Antihistamine+decongestant). Woke up breathless at 2:40 - was on my back. Again, at 4.40 still breathless, but on my side. Stayed up then for 30 mins to get my breath back. My guess is that I was awake from 6 am.

: 2019-10-20_Oscar.png (169.3 KiB) Viewed 1401 times

And then here are the graphs from the last 2 nights, since I switched to the nasal mask. I put the minimum pressure back to 7 (max 12) to see what would happen. Not sure if there's enough data for you to comment yet. The first night I wasn't really comfortable with it so I kept waking up and then forcing myself to put it back on after a while.

: 2019-10-20_Oscar_Friday.png (167.93 KiB) Viewed 1401 times

Then yesterday I was really tired and slept a lot during the day (without CPAP) and so last night I couldn't get to sleep until very late, but I was more comfortable and I feel better today
(wanted to add that one too, but evidently there's a limit so I'll create a new post.

JoRehovot · Post by **JoRehovot** » Sun Oct 20, 2019 12:37 am

Here's that last graph:

: 2019-10-20_Sat.png (122.53 KiB) Viewed 1400 times

Since I started with the nasal mask (forgot to say: it's a Resmed Airfit N20) I am still getting woken up breathless, although perhaps a little less so. But the aerophagia is back with a vengeance. I don't want to change settings for a bit, since you suggested sticking with it for 4-5 days, but I'm going to put EPR up to 3 tonight, in the hope of reducing that. It looks like the leak rate is much lower than with the full face mask, so I don't think I'm opening my mouth.

Interested to know what you can tell me, from all this, if anything. It may be that this was the wrong time to make the change, because it's still jewish holiday time, which means that I am not going to bed at the normal time, quite often.
Thanks for the help!!!
Jo

bjhunt01 · Post by **bjhunt01** » Sun Oct 20, 2019 1:11 am

For me whenever I've tried to use a full face mask, since I'm a mouth breather, my mouth falls open and I am sucking in a lot of air through my mouth and burping and f***ing with a big belly the next day. Taping my mouth like crazy and using the Bleep or a nasal mask has helped me. Don't know if that might be what you are doing - swallowing a lot of air?

JoRehovot · Post by **JoRehovot** » Sun Oct 20, 2019 1:16 am

Hi BJ,
That was happening to me as well, but since I turned on EPR, it's MUCH better with the full face mask. Now it's come back with the nasal mask. Hence the plan to increase EPR tonight.
Since my leaks have also gone down with the nasal mask, I don't think I'm opening my mouth, but I want to know what Pugsy thinks about that.
Jo

Breathing air and mask types and restless leg

Breathing air and mask types and restless leg

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