I'm a dentist treating myself! CPAP Results... Advice please?

[nee]

Last night's results after bumping the minimum to 12 cmH2O!

Min: 12 cmH2O
Max: 20 cmH2O
ERP: 2 cmH2O

Cervical collar, mouth tape, mandibular advancement device.

1.16.2020.jpg (668.64 KiB) Viewed 1947 times

As an aside, I referred one of my patients to this website yesterday. She told me about how she had tried her CPAP but felt like she was suffocating, and I told her about how her prescribed minimum pressure was probably too low, and to download OSCAR and get on here for help. She's not computer savvy but her family will be helping her.

[palerider]

I like seeing obstructive apnea's and hypopnea under 1.5, so that's good.

Excellent that you're starting to be able to help patients, too!

[nee]

I like what I'm seeing as well.

I got a hypothetical: If my OSA/OSA clusters are REM-related, could IFL/UARS be keep me from getting into REM sleep, and thus lower incidences of OSA/OSA clusters? I see that I usually have two OSA clusters (possibly coinciding with REM sleep), whereas last night I only had one.

Just my scientific/over-analytical mind at work

[ChicagoGranny]

could IFL/UARS be keep me from getting into REM sleep, and thus lower incidences of OSA/OSA clusters?

That's very speculative.

You have so few OAs, I would hardly call them clusters. Do you want to zoom in on the "cluster" and post the chart for comments?

BTW, if you click on the Events tab, a list of all events drops down. The list shows the time of day and length of each event. If you click on any event, the chart will zoom in to that event.

OSCAR is fun when the results start looking good.

[palerider]

I like what I'm seeing as well.

I got a hypothetical: If my OSA/OSA clusters are REM-related, could IFL/UARS be keep me from getting into REM sleep, and thus lower incidences of OSA/OSA clusters? I see that I usually have two OSA clusters (possibly coinciding with REM sleep), whereas last night I only had one.

Just my scientific/over-analytical mind at work

Alternatively, your higher minimum may have prevented the cluster from starting.

I don't know *why*, but I've seen quite a few people who had nasty clusters, going up to 20cm pressure, that with enough minimum pressure, they stopped getting into those clusters in the first place.

[zonker]

I like what I'm seeing as well.

I got a hypothetical: If my OSA/OSA clusters are REM-related, could IFL/UARS be keep me from getting into REM sleep, and thus lower incidences of OSA/OSA clusters? I see that I usually have two OSA clusters (possibly coinciding with REM sleep), whereas last night I only had one.

Just my scientific/over-analytical mind at work

and newbies complain about nomenclature!

[nee]

Last night's results!

Min: 12 cmH2O
Max: 20 cmH2O
ERP: 2 cmH2O

Cervical collar, mouth tape, mandibular advancement device.

1.16.2020 CPAP.jpg (712.38 KiB) Viewed 1867 times

Woke up midway through the night feeling like I had way too much saliva leaking all over the place, so I took the mouth tape off.

[chunkyfrog]

It is so refreshing to meet a newbie who is more clever than clueless.
Everyday civilians are smart enough to master their phones,
but then forget the other devices in their lives are no more complex.

[Pugsy]

If the clustering of REM related events is very bad and causes awakenings then it wouldn't be impossible for a person to not get as much REM as they need and/or make it look like the number of events is reduced when it was more of a situation where the cause itself was prevented more than the airway was held open better.
Might be especially more of a chance of that happening in the wee hours of the morning where REM comes along more frequently and lasts much longer.

Example....my OSA is much worse in REM like 53 per hour compared to non REM around 12 per hour I think it was.
I didn't make criteria during my diagnostic study initially because even when I hit REM it would cause me to wake up and criteria at the lab I was at was AHI of 15 per hour to have them end the split study and put me on CPAP. I couldn't stay in REM long enough to meet criteria and by the time I did it was way late in the night and there was no time to do the titration part of a split study.
It wouldn't be impossible for the same thing to happen if the pressures weren't preventing the bulk of the REM related events.
One or two events might not cause an arousal but 5 of them in 5 minutes very well could.
If that happens then with not being in REM the chances for apnea events are decreased from lack of REM and not necessarily optimal pressures.
This is why I always try to at least break up any dense clustering of events from any reason....REM or sleep position.

[nee]

Hey all!

So I couldn't use the CPAP for the past 4 days (went on vacation) but I got back to it last night.

Same drill...

Min: 12 cmH2O
Max: 20 cmH2O
EPR: 2 cmH2O

Mandibular advancement device, mouth tape, cervical collar (I woke up this morning with it off, though.)

Woke up in the middle of the night with a really sore throat so I bumped up the humidity from 4 to 5, after which I slept soundly.

1.21.2020 CPAP.jpg (688.99 KiB) Viewed 1801 times

Here's a zoomed in view of my OA's.

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I'm curious about the leak rates coinciding with flow limitation increases. Any ideas?

Feeling kinda crappy this morning and need a lot of coffee. Possibly jet lag, possibly the vast quantity of In n Out I ate an hour before sleeping...heh.

[Pugsy]

So I couldn't use the CPAP for the past 4 days (went on vacation) but I got back to it last night.

And why not? OSA doesn't take a vacation too and not happen just because you go on a vacation. It's not tied to being at home you know.

Your OAs look like SWJ for the most part or at least what little I can see of the flow rate prior to the flagging.

Leak rate and FL....I suspect mask movement leak from a change in position most likely. Maybe the increased FL is when you were on your back...or maybe REM.

[nee]

So I couldn't use the CPAP for the past 4 days (went on vacation) but I got back to it last night.

And why not? OSA doesn't take a vacation too and not happen just because you go on a vacation. It's not tied to being at home you know.

Your OAs look like SWJ for the most part or at least what little I can see of the flow rate prior to the flagging.

Leak rate and FL....I suspect mask movement leak from a change in position most likely. Maybe the increased FL is when you were on your back...or maybe REM.

I know, I know! I feel like I have to ease my (pretty recent) girlfriend into it. I felt pretty good with the mandibular advancement device + mouth tape and Mute nasal dilator. I've been trying to get her to mouth tape as she mouth breathes during sleep, but she was very hesitant until she saw the difference in my sleep between wearing mouth tape and not wearing it. Apparently I spent the first night choking and groaning a lot, and I was nice and quiet on subsequent nights.

I'm going to look into the Bleep mask to reduce leaks. I have an appointment with a sleep specialist on Jan. 28 so I'll be asking for a prescription at that point.

[palerider]

So I couldn't use the CPAP for the past 4 days (went on vacation) but I got back to it last night.

And why not? OSA doesn't take a vacation too and not happen just because you go on a vacation. It's not tied to being at home you know.

Your OAs look like SWJ for the most part or at least what little I can see of the flow rate prior to the flagging.

Leak rate and FL....I suspect mask movement leak from a change in position most likely. Maybe the increased FL is when you were on your back...or maybe REM.

Came here to say that and give the same finger wagging admonishment.

[Jas_williams]

Being a dentis can you not write your own mask prescription or is that not allowed/non ethical ?

[palerider]

Apparently I spent the first night choking and groaning a lot, ...

Which is a good reason to take your cpap on vacation... for the other people's rest