still having issues after titration and several masks

[jcpruitt89]

Hello all,

This my first post. Please bare with me. I read most of the rules I believe. If I make any mistakes let me know and I'll try to correct them. So I've been through the wringer with the cpap stuff for about a year. baseline AHI of 6.xx with an at home sleep study. they started me on phillips dreamstation Apap running 5-20 cmh20 with a nasal pillow. This basically did nothing for me at all. So eventually had a Cpap titration study and it was suggested I run the cpap at a flat 7 cmh20. This again didn't help at all. I then changed pulmonologists and I did another cpap titration study. They found despite my relatively low AHI that I was having a ton of brain arousals. I was told I may have a case of UARS. But they then changed my settings to a flat 13cmh20. This helped but I instantly started having problems with leaking through my mouth. I tried a chin strap but the air still kept getting past my lips and drying my mouth out horribly evening with humidification. I tried mouth taping and my AHI dropped down to a low of 1.3 one night but this scares me and seems impractical. So I tried a full face mask out but I'm still not getting proper therapy with it. I keep getting multiple wake ups and fragmented sleep and I don't feel rested evening after sleep 8+ hours. My ahi's haven't been great with it either, 3-5 usually. this is last nights session with it running 15-20 cmh20. I tried messing with the pressures on my own because of getting desperate. Also I'm running with c-flex off.

[zonker]

Hello all,

welcome to the zoo!

you are very close to posting a graph that the experts need.

try this-

How to order the charts
When you start Oscar and select Daily view, you will see a page with information on the left, and charts on the right.

Each chart has a name displayed on it vertically on the left side of the chart.

Drag the Oscar window to use as much of your screen as you can, so that you can get as much info as possible.

You can move a chart up or down in the order by pointing your mouse pointer in the label part of the chart, left clicking and holding while moving the mouse up or down.

and this-

Suggested Support Order for your charts
Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limit (Only for Resmed machines, not on Respironics)
Below these charts, you can organize the remainder any way you want. We normally don't need, or want, to see those, because they end up scrunching up the charts we do want to see.

good luck!

[jcpruitt89]

thanks!! I tried editing it.. Does that look right now?

[Pugsy]

We don't need the snore graph because they are shown on the Events graph.

See this thread for graph formatting hints and examples.
viewtopic/t158560/How-to-post-images-for-review.html

[zonker]

thanks!! I tried editing it.. Does that look right now?

no as it looks nothing like the example given.

[zonker]

thanks!! I tried editing it.. Does that look right now?

no as it looks nothing like the example given.

eta:

should look like this-

12-11.png (122.65 KiB) Viewed 708 times

[jcpruitt89]

I think I got it this time. fingers crossed. Anybody able to see anything of value in this graph

[Pugsy]

Do you take any medications of any kind? If so, what?

Any other physical or mental health issues going on that might impact sleep?

What are your specific complaints?

[Architect]

Hello friend, certainly can understand your position, sorry this is happening, I was once there. No matter what do not give up hope, from my experience, patience is the key to success.

My main issue was finding the perfect mask, I went through lots of em, once I found a mask that did not leak at all, which was Quattro, my pressures were adjusted to the mask fit, every 2 months by sleep clinic, till my AHI dropped below 1,.

There are many varying issues causing cpap therapy not to work, the key is to discover what is most bothersome to you, for me it was mask fit. I tried it all, even duct tape my mouth shut. Tried large size, med size, etc.....

Wish you well on your journey.....

[jcpruitt89]

Do you take any medications of any kind? If so, what?

Any other physical or mental health issues going on that might impact sleep?

What are your specific complaints?

I use to be on testosterone replacement for about 4-5 years then i got off because of side effects. So I've been recovering from that. So my hormones have been a bit screwed up. I have high BP, and heart palpitations on occasion from the OSA. Taking ace inhibitior, beta blocker, melatonin, and trazodone. Although doctor is trying to take me off trazodone for Lunesta instead. I'm sure my hormones are contributing to it but i can't seem to get my hormones leveled out because of the OSA

[jcpruitt89]

Hello friend, certainly can understand your position, sorry this is happening, I was once there. No matter what do not give up hope, from my experience, patience is the key to success.

My main issue was finding the perfect mask, I went through lots of em, once I found a mask that did not leak at all, which was Quattro, my pressures were adjusted to the mask fit, every 2 months by sleep clinic, till my AHI dropped below 1,.

There are many varying issues causing cpap therapy not to work, the key is to discover what is most bothersome to you, for me it was mask fit. I tried it all, even duct tape my mouth shut. Tried large size, med size, etc.....

Wish you well on your journey.....

Thank you!

So you did titrations for each mask until you found the pressures that worked for you? I think that my nasal mask would have worked if it wasn't for the leaking through my mouth because when I taped my mouth my AHI dropped dramatically. But, i can't tape my mouth every night for rest of my life.

It seems that the full masks require more pressure and the efficacy of them is not as good as the nasal masks. Is yours a full face mask?

[jcpruitt89]

As far as pressure settings go, does anyone have any suggestion where I should go from here. I don't think a flat 13cm h20 that my Dr. suggested for my nasal mask is going to work for my full face mask based on my previous trial and error.

[zonker]

Do you take any medications of any kind? If so, what?

Any other physical or mental health issues going on that might impact sleep?

What are your specific complaints?

I use to be on testosterone replacement for about 4-5 years then i got off because of side effects. So I've been recovering from that. So my hormones have been a bit screwed up. I have high BP, and heart palpitations on occasion from the OSA. Taking ace inhibitior, beta blocker, melatonin, and trazodone. Although doctor is trying to take me off trazodone for Lunesta instead. I'm sure my hormones are contributing to it but i can't seem to get my hormones leveled out because of the OSA

don't forget pugsy's last question" "what are your specific complaints?"

[Architect]

Hello friend, certainly can understand your position, sorry this is happening, I was once there. No matter what do not give up hope, from my experience, patience is the key to success.

My main issue was finding the perfect mask, I went through lots of em, once I found a mask that did not leak at all, which was Quattro, my pressures were adjusted to the mask fit, every 2 months by sleep clinic, till my AHI dropped below 1,.

There are many varying issues causing cpap therapy not to work, the key is to discover what is most bothersome to you, for me it was mask fit. I tried it all, even duct tape my mouth shut. Tried large size, med size, etc.....

Wish you well on your journey.....

Thank you!

So you did titrations for each mask until you found the pressures that worked for you? I think that my nasal mask would have worked if it wasn't for the leaking through my mouth because when I taped my mouth my AHI dropped dramatically. But, i can't tape my mouth every night for rest of my life.

It seems that the full masks require more pressure and the efficacy of them is not as good as the nasal masks. Is yours a full face mask?

Hi Friend, yes sleep clinic adjust pressures with each mask, once I used Quattro with no leaks, my pressure was fined tuned to the mask. My issues were improper mask fit/leaks.... Sleep clinic appt was every 2 months, until issues were resolved, now I visit sleep clinic every 6 months.

Mask is all preferences, nasal mask are comfortable, but not gonna lie to you, I love my Quattro, yes it's large, I look like a Jedi pilot, but over the years, I'm used to wearing, no discomfort from mask at all. Last week I tried a new mask Resmed Airtouch F20, worked flawless, now leaking up a storm. Back to Quattro. Quattro is perfect fit for my face. I believe part of cpap success is no leaks. Regardless of mask, from my experiences. Quattro was the only one that didn't leak.

[jcpruitt89]

Do you take any medications of any kind? If so, what?

Any other physical or mental health issues going on that might impact sleep?

What are your specific complaints?

I use to be on testosterone replacement for about 4-5 years then i got off because of side effects. So I've been recovering from that. So my hormones have been a bit screwed up. I have high BP, and heart palpitations on occasion from the OSA. Taking ace inhibitior, beta blocker, melatonin, and trazodone. Although doctor is trying to take me off trazodone for Lunesta instead. I'm sure my hormones are contributing to it but i can't seem to get my hormones leveled out because of the OSA

don't forget pugsy's last question" "what are your specific complaints?"

My apologies. Ever since the OSA my focus has been dog crap.

My specific complaints are that I'm waking up several times a night from the OSA and it takes me 45-60 minutes to fall back asleep each time. I assume because of a stress response. Even if i do get 8 hours I'm still exhausted. This all has caused me to have excessive fatigue, weakness, sleepiness, headaches, dizziness, muscle loss, gastrointestinal issues, hand tremors and low libido. In additional to that high blood pressure and occasional chest palpitations. Mind you I'm only a 31 year old male not overweight and was fairly in shape before this.