Tape vs. chin strap

I decided to tape my mouth shut last night instead of using a chin strap. The tape loosened during the night in one spot. I would feel like a bubble of air would come up into my mouth once in a while and then it would escape out of the loosened part of the tape. I thought maybe that wouldn't be much of a big deal. I was surprised by my Sleepyhead graph, though. I have never seen the apap go to the highest value and just stick there the entire night, and there's more clear airways than I'm used to seeing. Does anyone have a theory as to why this happened? I also see that there was more leaking out my mouth than I realized.
Here is the night before, with a chin strap. Pretty typical looking:


Here is last night with no chin strap and tape:

Are you using the Auto for Her mode or the plain old Auto mode? It makes a difference. The Auto for Her mode will reset the min pressure setting for the current session under certain circumstances, and it's possible that the cluster of events between 0:00 and 0:40 met the criteria for resetting the minimum pressure setting for the night.

How are the eyes this morning?

Hi Robysue, I'm using Auto for Her. That's interesting, that it reset the minimum. That's never happened before. I can't imagine what it could have been about the tape/no chinstrap arrangement that could have caused that cluster. I am interested to see that even at a straight 10 all night the flow limitation graph never seems to look different. I could be wrong but I feel like maybe I slept better at the steady pressure rather than having fluctuations.

The other thing I did differently was I wore the silicone eyeeco goggles. This is the first time I have tried them with the Pico mask, and I was pleasantly surprised to see that I could fit them underneath the forehead piece (this was not possible with the Mirage FX for Her). I also was able to loosen them slightly so they didn't dig into my face. I only put a little ointment in my eyes, and I was pleased to find my eyes looking better this morning than they have in some time. Still a little swollen, but better, which surprises me given that I had more pressure last night than ever before. My next experiment will be to wear the goggles again tonight and just put drops in. I don't know if I'll do chin strap or tape. I feel hopeful that this could mean that I might be able to tolerate the higher pressures. I had tried the goggles once before, but that was with the AirFit N10 for Her which leaks all over the place. Maybe goggles + Pico might be my personal magic combo. If only I could keep my mouth shut.

AMK wrote:Hi Robysue, I'm using Auto for Her. That's interesting, that it reset the minimum. That's never happened before.

The Resmed pages at http://www.resmed.com/us/en/healthcare- ... ology.html include this description of the Auto for Her algorithm:

Resmed wrote:Research has shown that women with OSA have more upper airway resistance and flow limitation than the general OSA population, which is why the AutoSet for Her algorithm has been designed to be more sensitive to flow limitation.

In addition, the algorithm provides more subtle changes in therapy pressure to minimize sleep disturbance. The AutoSet for Her algorithm also automatically adjusts the minimum AutoSet pressure if multiple apneas are occurring below a certain threshold.

So that cluster of OAs at the beginning of the night is what caused the your machine to reset the min pressure from 7 to 10cm. None of your other nights had clusters of events that started when the pressure was in the 7-8 cm range.

Resmed also has a picture of how the "For Her" algorithm responds differently than the regular AutoSet algorithm in a test breathing pattern:

So the "For Her" algorithm responds more quickly to even very modest flow limitations than the ordinary AutoSet algorithm, but it also apparently responds more quickly to normal airflow being reestablished since the For Her algorithm quits increasing the pressure sooner than the regular algorithm does in this picture.

I can't imagine what it could have been about the tape/no chinstrap arrangement that could have caused that cluster. I am interested to see that even at a straight 10 all night the flow limitation graph never seems to look different.

I doubt the tape instead of the chinstrap had anything to do with the cluster. As pugsy puts it, perhaps the aliens paid you a visit. In other words, sometimes stuff just happens and we don't always know why. And why is ther no change in the flow limitation graph? Well, if those flow limitations are clinically significant, then 10cm might not be enough to take care of them. But the question is whether they're really clinically significant and if they are, whether increasing the pressure to the point of finally flattening out the flow limitation line is worth the risk to your eyeballs. (My eyeballs say forget about the flow limitations and take care of your own eyeballs---preserving your eyes is more important than fixing the flow limitations at this point.)

I could be wrong but I feel like maybe I slept better at the steady pressure rather than having fluctuations.

There are plenty of people who find fluctuating pressures disturbing to their sleep. The most vocal supporter of Fixed CPAP on the board is Wulfman (aka Den), who regularly tells folks who are having trouble with APAP to try fixed CPAP for a few nights to see whether they sleep better without fluctuating pressures.

The other thing I did differently was I wore the silicone eyeeco goggles. This is the first time I have tried them with the Pico mask, and I was pleasantly surprised to see that I could fit them underneath the forehead piece (this was not possible with the Mirage FX for Her). I also was able to loosen them slightly so they didn't dig into my face. I only put a little ointment in my eyes, and I was pleased to find my eyes looking better this morning than they have in some time. Still a little swollen, but better, which surprises me given that I had more pressure last night than ever before.

You might have had better eye protection last night. Or it could be that your eyeballs particularly don't like the fluctuations in pressure and find a constant pressure easier to deal with.

My next experiment will be to wear the goggles again tonight and just put drops in. I don't know if I'll do chin strap or tape. I feel hopeful that this could mean that I might be able to tolerate the higher pressures. I had tried the goggles once before, but that was with the AirFit N10 for Her which leaks all over the place. Maybe goggles + Pico might be my personal magic combo. If only I could keep my mouth shut.

It's good to see you are making progress on figuring out how to protect your eyes. Let's hope the experiments with the goggles continue to go well.