New (UARS) -- lots of questions

[slowriter]

Does lowering the IPAP + EPAP reduce the suffocating feeling? The pressure didn't look like it exceeded 15cm in the graphs, so I'm not sure that lowering the IPAP max would help.

I'm not really sure what's causing that. Sometimes that happens if the pressure is too low, but that's clearly not it.

Can you check what the pressure is when you feel that? Or does it happen all night long?

I was more recommending reducing those pressure settings to address the aerophagia.

[zan]

Does lowering the IPAP + EPAP reduce the suffocating feeling? The pressure didn't look like it exceeded 15cm in the graphs, so I'm not sure that lowering the IPAP max would help.

I'm not really sure what's causing that. Sometimes that happens if the pressure is too low, but that's clearly not it.

Can you check what the pressure is when you feel that? Or does it happen all night long?

The suffocating feeling seems to start only after I initially fall asleep, after which I start waking up feeling suffocated. It looks like my pressure was steadily decreasing last night, so maybe my pressure was getting too low...?? I think I'll try the lower settings tonight and see if it reduces the aerophagia and/or worsens the suffocation.

[slowriter]

Do you have ramp on?

If yes, turn it off.

[zan]

Do you have ramp on?

If yes, turn it off.

Ramp is / was off from day 1.
....

Last night was tons better than the night before, but still with plenty of room for improvement.

Settings: MaxIPAP 15, MinEPAP 6.4, PS 5, changed Trigger from Very High -> Med because I felt like it was doing too much to breathe for me

Subjectively: Still had a bit of aerophagia, but not as constant or intense as Tuesday night. Instead, I spent about half - two thirds of the night with the back/top of my throat feeling very dry despite never opening my mouth and having the humidity at max level... weird. Sleeping at 6-7 EPAP was so much more comfortable and natural for me, although I still fully woke up at least four or five times to check my mask and drifted in and out of consciousness for most of the night (I can attribute this to newbie syndrome, I think). Other than the aerophagia (which although mild was still present, and I almost wonder if it was more a remnant of the night before?) and the severely dry throat I would have labeled last night a resounding success. I kept the mask on for a full nine hours!

OSCAR data: Looks like my events were entirely CAs (I'm ignoring the large leaks, as many of those were from taking a brief break from the mask). I have noticed that I pause breathing a lot even when I'm lying down awake. I'm not super concerned about the CAs right now, I'd rather focus on comfort and staying asleep with the mask on all night.

[slowriter]

I'm not super concerned about the CAs right now, I'd rather focus on comfort and staying asleep with the mask on all night.

Good.

Since you have no reported OA or H events at this min EPAP, it doesn't look like you need any more.

You might try trigger at high to see if that has any impact on your reported CAs.

Otherwise, right: focus on the above.

And realize it can take time.

[zan]

I'm not super concerned about the CAs right now, I'd rather focus on comfort and staying asleep with the mask on all night.

Good.

Since you have no reported OA or H events at this min EPAP, it doesn't look like you need any more.

You might try trigger at high to see if that has any impact on your reported CAs.

Otherwise, right: focus on the above.

And realize it can take time.

Thanks for the reassurance. Any idea what I can do about the dry throat? I think it has to do with air slipping past my tongue and into my mouth at night. Tonight I can try taping my mouth just to make sure it's not opening, but I highly doubt it since every time I awoke and felt the dryness my lips were shut tight. My friend recommended gargling warm salt water but that only seems like temporary relief. Any thoughts?

[slowriter]

Thanks for the reassurance. Any idea what I can do about the dry throat? I think it has to do with air slipping past my tongue and into my mouth at night. Tonight I can try taping my mouth just to make sure it's not opening, but I highly doubt it since every time I awoke and felt the dryness my lips were shut tight. My friend recommended gargling warm salt water but that only seems like temporary relief. Any thoughts?

I didn't comment because I assumed you're using the mask that's in your profile, which is a FFM, and so different than what I use.

But if you're using the P10 (which you earlier mentioned), then a) update your profile, and b) the problem is almost definitely mouth leaks, and one solution is indeed taping your mouth shut.

And if that was the problem, you probably don't want to max the humidity setting.

[zan]

Thanks for the reassurance. Any idea what I can do about the dry throat? I think it has to do with air slipping past my tongue and into my mouth at night. Tonight I can try taping my mouth just to make sure it's not opening, but I highly doubt it since every time I awoke and felt the dryness my lips were shut tight. My friend recommended gargling warm salt water but that only seems like temporary relief. Any thoughts?

I didn't comment because I assumed you're using the mask that's in your profile, which is a FFM, and so different than what I use.

But if you're using the P10 (which you earlier mentioned), then a) update your profile, and b) the problem is almost definitely mouth leaks, and one solution is indeed taping your mouth shut.

And if that was the problem, you probably don't want to max the humidity setting.

I'm using an N20 mask as I don't have all the parts of the P10s to use them -- my profile is up to date, at least as it appears to me. I'll try taping tonight.

[slowriter]

Maybe search the forum for threads that discuss this issue in the context of the N20? I really don't know.

[zan]

Do you think the dryness might have anything to do with the fact that I disabled the heated hose feature?

[slowriter]

Do you think the dryness might have anything to do with the fact that I disabled the heated hose feature?

No idea.

But why would you turn it off?

[zan]

Do you think the dryness might have anything to do with the fact that I disabled the heated hose feature?

No idea.

But why would you turn it off?

Just wasn't interested in trying it, at least not yet. I can try it tonight.

[slowriter]

Do you think the dryness might have anything to do with the fact that I disabled the heated hose feature?

No idea.

But why would you turn it off?

Just wasn't interested in trying it, at least not yet. I can try it tonight.

I can't see any reason not to use it. The default temp is substantially lower than body temp, so it's not like it feels warm or anything.

[slowriter]

I need to make a correction.

For some reason, I had in my mind that the N20 is a FFM.

Of course, it's not.

So then your impulse you needed to deal with mouth leak was of course correct. That should solve your problem

[zan]

Another 9+ hour night on the machine, I was really exhausted after the previous night's constant awakenings so I crashed at 9pm and slept until 7:30. Didn't actually fall asleep until about 11 though, and there's a gap at 10:30 - 10:45pm where I stood up to walk around and take 75mg Trazodone.

Settings: MaxIPAP 15, MinEPAP 6, PS 5, 68deg F on the hose as per slowriter's suggestion to start using it. I lowered the EPAP a little because I wanted to maximize comfort, and I think it did help with reducing aerophagia. I tried taping my mouth but the tape (the adhesive part of a band-aid) came off in the middle of the night because I had taken it off just before 11pm to take my meds, which weakened the adhesive.

Subjectively: I had very little aerophagia, which was great. Some dryness in my mouth and throat when I woke up so I'll try mouth taping again tonight and take my meds before putting the tape on. The EPAP setting was pretty low and I'll definitely be raising it in the future to treat UARS, but for now I think I've hit the sweet spot in terms of comfort because I was nearly able to forget I had the mask on while I was falling asleep last night. My plan is to spend another 2 - 4 days at these settings, or however long it takes to feel normal to wear the mask, and then slowly raise the EPAP and maxIPAP until I start to feel a difference in my sleep quality. Right now, I feel like I've gotten a nice long round of sleep in (which I did) but I don't feel like it was restorative. I woke up maybe one or two times in the night, for one I briefly got out of bed because I remembered that I needed to top up my pet's water bowl (and it was so urgent I couldn't wait until the morning, I guess).

OSCAR: My leak rates look crazy toward the end of the night. I really like to bury my face into my pillows / blankets when I sleep, which sadly isn't totally compatible with the N20. Maybe for my birthday, or next summer when I have a job and can buy it myself, I'll look into the Bleep or N30i. Because of the massive leaks I'm not sure whether the CAs are legitimate measurements or not, but I guess it's not so important right now because I'm still in the stage of getting used to the machine. Overall, it was another good early night on PAP and I'll report back in a few days when I start upping the pressure again, or if there's anything else I need help with.