Ozij, if your suggestion is correct, it seems to lead to a very disturbing conclusion: If I use the Activa with mouth taping, I may be sleeping better (more REM and fewer arousals) thanks to very low leak, which is good. But I am also documented as having more apneas with taping, which is not good, and which, theoretically, is likely to cause arousals and disturb my sleep architecture. More REM is good, but it leads to more apneas, which is bad, and which may lead to less REM .... A vicious cycle indeed!ozij wrote:The index parameters you are focusing on, Velbor, are not the only variables we should consider.
We cannot assume the efficacy indices are direct indicators of quality of sleep.
This study may suggest a different expalanation of your own taping data:
Taping leads to more REM and less arousals. For the majority of us, more apneas occur in REM - assuming your obstructive sleep apnea is just that, we can say that: Taped, you dream more and have more apneas during that time. Untaped you have more arousals, some of which actually make you arise...
I linked to this study also because of the way it discusses various possible explanations of how mouth leaks cause the drop in ventilation - the physics of the lowered hypopharyngeal pressure is beyond me - but not the fact.
If levels of mouth leak were the only issue, then I would expect my results with the UMFF, which theoretically eliminates mouth leak and also gives me an excellent overall leak profile, would be more like that seen with the Activa WITH mouth taping. But this is not the case; the UMFF profile is much more like that of the Activa WITHOUT taping than like the Activa with taping.
The issues involved with pharyngeal pressure variability mentioned in the study conclusion is likely related to the VERY high leaks in the study subjects - in fact, the subjects were selected precisely for their clinically problematic mouth leaks - which exceed the machine specifications for leak compensation. That is not the situation I have documented.
I still have no explanation for the increase in respiratory disturbance indices and time in apnea which I exhibit when I use mouth tape with the Activa mask. The actionable item which I hope readers will take from this thread is: when you elect to use mouth tape (or change masks), there may be unanticipated consequences. These changes may not be trivial, and should not be undertaken unreflectively. Look at your data! The data which our machines provide indeed do not tell the entire story, but the machinery remains the most objective and reliable and available story-teller around.
Blessings, Velbor