CPAP, brain fog, blocked nose, etc....

[Laurent_fr]

Hello Everyone,

First of all, I wish you an happy new year and would like to thank you for the help that you give to people here. I guess it should be very time-consuming, so thank you in advance if you can help me too!

I'm Laurent from France, and I was diagnosed with OSA: moderate/severe with index 30 IAH.

First diagnostic was in the end of 2018, but I made another one recently, because I wouldn't believe or accepting the diagnostic. They gave me a RESMED s10 and Dreamwear Philips, it was very hard to sleep well with! I had no results at all, but I really wasn't involved with the treatment, I would not believe it could takes time to see some results... Now, and after reading so long on this forum, I'm ready to trust the fact it could take weeks or monthes...

So I'm back in the very end of 2020 with the same RESMED S10 (but from another company). It's been almost a complete month I wear my mask (see my avatar) and I still feel very bad + tired, bad mood, depressed, and all that great stuff!! I succeed to keep it more than 6 hours a night and I still can't believe it !!!

I've stopped smoking in 2015, alcohol in mid-2019, Anti-depressant in 2020 (escitalopram - very few dose!). I take an half of mianserin tablet and one pill of melatonin before sleep. I also have big problems with my nose who is really annonying to breath well, I met loads of doctors & co, but still have my problem, absolutely no solution, and I'm sure there's a link with the apnea.

I could write you loads of pages to tell you my life, but I think good screen captures from OScar would be more eloquent, and this brain fog doesn't help we to write in English this morning... I (try to) put the Oscar reports at the end of this post.

Once again, thank you so much for the help you could give to me and this fatigue who makes my life impossible.

HAve a nice day.

Laurent

[zonker]

Hello Everyone,

welcome to the zoo!

I've stopped smoking in 2015, alcohol in mid-2019, Anti-depressant in 2020 (escitalopram - very few dose!).

very good job of taking care of yourself!

I could write you loads of pages to tell you my life, but I think good screen captures from OScar would be more eloquent, and this brain fog doesn't help we to write in English this morning... I (try to) put the Oscar reports at the end of this post.

i can tell you right now that your english is much better than my french.

do you happen to know why you are on a fixed pressure rather than auto adjusting?

also, it can take some time to get the benefits of the machine. you've been on for a month and it may take you longer than that.

now, i will step aside so that the experts can come in and give you their good advice!

good luck.

[Pugsy]

do you happen to know why you are on a fixed pressure rather than auto adjusting?

Probably because a lot of doctors in various parts of Europe either don't understand auto adjusting or buy into the old wives tale that fixed is better.

They also aren't real keen on the patient looking at their data and god forbid changing something themselves because they walk on water.

[albabbie]

Laurent,

The first thing that I see is you have a very high and erratic leak rate (vitesse de fulte). I am not a pro at interpreting OSCAR yet, but that might indicate you are having mouth leak during the night when you sleep. That can cause the CPAP therapy to not be as effective as it could be, as it essentially lowers the effective pressure you are receiving.

I had the same problem when I started. I use Somnifix tape to keep my mouth from opening up during sleep and it has worked well in stopping air leaks.

[Pugsy]

Those times in large leaks could also simply be mask movement leaks. I have had worse than that AND MY MOUTH WAS TAPED SECURELY.....so don't always assume that every big leak is mouth opening leak.
It can just as easily be simply mask movement and a mask fitting problem ...especially when someone is new to cpap therapy and still figuring out all this mask fit stuff.

[Laurent_fr]

Thank you very much for your replies!!

Zonker: the doctor ask for fixed pressure after I complain about extra noise from the machine. She was wondering why they put me on auto pressure, but she seem's to be against that "autopilot mode" for everyone...

Pugsy: Finally, do they understand something in life ...!??
I think we really need more control on setting the machine by ourselves, even if I understand it could be dangerous for health and need a medical surveillance... I met so many doctors in my life, but never met one who really care about me and my problems... That's also why I'm so happy to finally find this great forum.

Albabbie: I think it's really possible that the leaks come from my mouth, last night again I woke up in the middle of the night with the mouth dry as hell!!!! Very nice feeling, I guess you know what I'm talking about!
I will take a look at Somnifix, but I guess it will be not compatible with my beard... So it will be time to make choices now!!

Pugsy: My wife told me that she heard some leaks, but not sure about where it comes... I just know that sometimes I wake up with very very dry mouth!! The main problem is to be aware of what exactly going wrong when you're just awaking....

I think I should give a try to the chinstrap the guy who gave me, but I was a bit scare to put that in addition to the mask!! I have already tried the full face mask too but I was hyperventilating after 15 minutes, I'm a little bit claustrophobic and have problems to breath by nose only...

Do you have recommendations for me ? I'm not sure about the actual mask but I can sleep a long time with it...

Thank you very much for your help!!

[Janknitz]

I think we really need more control on setting the machine by ourselves, even if I understand it could be dangerous for health and need a medical surveillance..

Unless you are in congestive heart failure or have a serious lung disease, the only danger from a CPAP machine is dropping it on your head. You can control your own settings and you are correct that nobody cares more about your health than you do.

You might indeed be mouth breathing if you have a very dry mouth. With a beard, taping can be difficult, but so can a full face mask. Try the chinstrap first, and if that doesn't work there are other suggestions to be made.

Auto-adjusting is NOT auto-pilot except for ignorant doctors who leave the settings wide open thinking it will adjust perfectly every time. With the graphs, we will be able to help you find optimal settings. Having an auto-adjust machine helps dial in those settings and helps to SEE whether a fixed or adjusting pressure is best for your needs and what the best settings are for you. With a fixed pressure machine that's very difficult.

[Laurent_fr]

Thank you Janknitz,

So, I'm totally agree with the fact we should have control on the cpap machine, the only way is to buy it but too expensive for me at this moment... I'm agree that it's difficult to understand graphs with fixed pressure, I will ask to the doctor but can you give me an idea of the pressure setting area please ?? Or what I should ask her more precisely ??

And yes, I'm surely mouth breather at night. I have a chinstrap and I will use it next night, hope it will helps... Cause I'm not very happy with the idea of wearing the full face mask, I have one in the cupboard...

Thank you very much for your help.

[Julie]

The standard (machine default) settings are 4 and 20, but almost no one can breathe at 4 and it's pretty ineffective, so most raise it to e.g. 6 to begin, and then if Oscar thinks it needs to be higher when we see results after a few nights, it can be raised again. No reason to change the max setting until it's required, but that is less likely. Just for the record, which FF mask do you have? Chin straps can be good, but don't keep your lips closed of course.

[Laurent_fr]

Bonjour Julie and thank you,

So I could ask for exemple 6-12 ? or more ?

I really dream about having my own machine where I could chose my own presets, without asking to doctors and co....

I tried the chin strap last night but I quickly removed it because it was warming me and I did not fall asleep... So it was a first test, I will try again next night! Today I'm totally "brainfogged" and I know it will take me very long to post here!!

The full face mask is a "Simplus" from Fisher & Paykel :



Maybe I could succed with another try, it really scares me because I need to take big breaths with mouth sometimes... But maybe it's the solution.
I have a philips dreamwear too, but too noisy with leaks of the mask, I can't sleep anymore with that...

I also remember that the machine at the beginning was not in a fixed pressure, so I put a screen capture when the machine was set from 6 to 14



And I finally put the full graph of my past nights since I'm back to this cpap machine, but I don't know if it's really important for diagnostic.



Thank you all and wish you a nice day.