Coleman's Oscar Review request

[coleman3]

Not sure why, but my trend the last three days has moved the wrong direction. I seem to be having a lot of large leaks, due to my mouth being open.

I am still at a minimum pressure of 6 and EPR of 2, would it be a good idea to bump up to pressure of 7 and EPR of 3 and give that a try?

Also, Oscar flagged a "cheyne stokes respiration" for 24 minutes, and upon googling that I felt a little freaked out. Is that a common issue?

Thanks again for your time and help!!

[Miss Emerita]

It's a shame that all periodic breathing is labeled "Cheyne-Stokes" breathing. CS is a small subset of periodic breathing, and it has a distinctive flow rate. If you zoom in on about 6 or 7 minutes in the CS-flagged segment, someplace where there are a lot of CA flags, we can take a look to confirm that you should have no worries.

Periodic breathing occurs when one CA sets off another. You breathe more deeply, washing out a bit of CO2 and delaying your next breath by a little. Then after the pause, you do some recovery breathing, which is deeper and again washes out a bit of CO2. Rinse and repeat. These periods of unstable breathing will correct themselves, and you will probably have fewer and fewer episodes as time goes by.

CAs are "consistently inconsistent," as some people put it. So my advice is to stick to your current settings for a few more days and see how things go.

About the large leaks: do you think you'd be willing to give tape a try? Although it's a bit pricey, you might buy a box of Somnifix strips. They're very gentle on the skin. If you get along well with tape, you can switch to something cheaper down the road.

[coleman3]

Thank you for the information about periodic breathing, I won't worry about that for now!

I am not opposed to mouth tape, I did try it for a couple of nights last week. The only issue I had was my mouth would still fill with air, and I think I was swallowing it and had quite an upset stomach in the morning. But maybe now that I am a little more used to the CPAP, along with the chin strap, I can give the tape a try again and see if it helps.

Hoping to get a good night tonight! Thanks again

[coleman3]

After a couple nights with the chin strap and mouth tape, which did help when used together. I got my Phillips Dreamware full face mask yesterday. I had the best AHI yet, and was able to stay asleep almost the entire night.

Hoping for another good night tonight!

[Miss Emerita]

Excellent news -- thanks for letting us know!

[coleman3]

Excellent news -- thanks for letting us know!

The FFM was going well for a few days, but the past two nights were not great. I had a 3 night long work trip, so 3 nights in hotels. 2 of the nights were ok, the last night my AHI was 4.9.

It seems looking at my sleep data that there are more OA events the past 3-4 nights than I was having previously. I did increase my pressure as you recommended to a minimum of 7, and with an EPR of 3. I have been sleeping through the night better, not waking up at 2-3 AM for an hour has been great!

https://sleephq.com/account/teams/vWdQdZ/shareables

[Miss Emerita]

Well, travel is always unpredictable. I've had amazingly good nights in hotels and amazingly bad ones. I'm glad that on the whole you're doing well.

For some reason the link isn't working; it just takes me to a request that I sign in.

[coleman3]

Well, travel is always unpredictable. I've had amazingly good nights in hotels and amazingly bad ones. I'm glad that on the whole you're doing well.

For some reason the link isn't working; it just takes me to a request that I sign in.

https://sleephq.com/public/teams/share_ ... c92d186064

I think that is the better link there.. unfortunately I travel weekly for work! hopefully I can get used to using the CPAP in the hotel and at home!

[Miss Emerita]

Yes, that link works; thanks.

I'm not convinced you're fully asleep during all those OAs; many of them are preceded by what looks like arousal breathing. Be that as it may, I have two thoughts about what you might try.

First, there's some clustering of OAs, which suggests you may be tucking your chin down toward your chest. This is a bit like putting a kink in a hose. Chin-tucking in turn may be a function of using hotel pillows. Do your best to use a relatively flat and firm pillow. You might also try tucking a second pillow under your chin to keep your head and neck well aligned. Some people benefit from using a soft cervical collar.

Second, you may need a slightly higher minimum pressure. If you feel like experimenting, see how you do with a min of 8.