Stumped (updated with new sleepy head data)

The climate control hose does not fit just the cpap I tried that last week. I just got up and will be checking and uploading the latest and greatest graphs.

sleepwiggler wrote:The climate control hose does not fit just the cpap I tried that last week.

I can confirm this. The electrical plug thing gets in the way when trying to plug directly to the blower. It won't quite seal.
Now what might be possible is to reverse the ends and put the normal mask end on the blower and use the electric plug end at the mask level.

Pugsy wrote:

sleepwiggler wrote:The climate control hose does not fit just the cpap I tried that last week.

I can confirm this. The electrical plug thing gets in the way when trying to plug directly to the blower. It won't quite seal.
Now what might be possible is to reverse the ends and put the normal mask end on the blower and use the electric plug end at the mask level.

Hi Pugsy,

Tired that as well and no go it is a little to big.
I am posting an update in about 2 minutes would love some more input.

Here is the latest.
I used the mask fit option till I got the green face to remain constant. The mask was snug but not uncomfortable. I am using the large pillow but I am going to order the small when funds are available because I think that may be a better fit and I may not have to get the mask so tight. My WONDERFUL DME would not even consider a Medium. Anyway I did not strap the humidifier down last night but did check for leaks again, nothing. Everything secure on the mask, again sometime In the night I hear a loud hissing and check and one side of my elbow is loose. I just don't know if I doing it or it is popping out. I make sure that I hear a click and no more issues there, Any way here is the graph.

Well I think the leak is mask related some how.
I have zero experience with full face masks or their various parts but if you are just needing maybe to replace the elbow or the cushion (or get a new difference size cushion) you might check out EBay.
Sometimes I have seen cushions and less than half of online retail and still new sealed in the bag

I would make a comment about this report though...was your OSA deemed worse in REM sleep? The pattern of clusters of events correlate with the time frame for REM stage sleep...of course it could be supine sleeping and/or maybe a little bit of both.
During those times where you see the ugly clusters...you need more pressure.
Either by reducing EPR so the drop during exhale isn't so great or increasing the pressure in general
or change it to Auto mode and let the machine increase the pressure as needed for those time frames.
If it were me...I would just change it to auto mode and keep the 15 as minimum and just open max to 20...keep the EPR at 3.
Assuming that this is a typical report and not an extremely rare ugly fluke.

Unless you have bigger problems with more pressure than the events are a problem and this is the best compromise you can come up with.

Pugsy wrote:Well I think the leak is mask related some how.
I have zero experience with full face masks or their various parts but if you are just needing maybe to replace the elbow or the cushion (or get a new difference size cushion) you might check out EBay.
Sometimes I have seen cushions and less than half of online retail and still new sealed in the bag

I would make a comment about this report though...was your OSA deemed worse in REM sleep? The pattern of clusters of events correlate with the time frame for REM stage sleep...of course it could be supine sleeping and/or maybe a little bit of both.
During those times where you see the ugly clusters...you need more pressure.
Either by reducing EPR so the drop during exhale isn't so great or increasing the pressure in general
or change it to Auto mode and let the machine increase the pressure as needed for those time frames.
If it were me...I would just change it to auto mode and keep the 15 as minimum and just open max to 20...keep the EPR at 3.
Assuming that this is a typical report and not an extremely rare ugly fluke.

Unless you have bigger problems with more pressure than the events are a problem and this is the best compromise you can come up with.

Not sure about rem sleep but I do know that I have been having issues during rem sleep as I have been having very vivid angry dreams and yelling and getting quite ugly and acting out the dreams, punching, what I do I the dream I do in my sleep. I had posted about that earlier.

Do some google searching for "sleep stage" and take a look at the normal hypnograms to see when REM normally happens. Generally the first REM sleep stage happens around 90 minutes after sleep onset and as the night goes on the REM stage will come on more frequently and last longer with the most REM occurring in those wee hours of the morning assuming that the sleep architecture allows the normal progression of the stages.

2 things are the most common culprits when we see such marked changes in the reports between some time when nothing much at all happens and the other where we have the ugly clustering
Either REM sleep pressure needs are different because the OSA is worse or the events are just more difficult to prevent....or sleeping on our backs with the same scenario.

I do remember now that you are known to have a lot of physical activity happen during your dreams.
Understand why that might be going on with the physical activity during dreaming is beyond my expertise level but given what is seen on this report and if you have a lot of other reports similar to it with the ugly clustering (whatever the reason) I would try to break up the clusters if it were me. I don't know if breaking up the clusters will make any changes in terms of your dreams or your acting out your dreams but the AHI and the clustering points to sub optimal cpap therapy during those time frame. IMHO worth trying to fix even if you didn't act out your dreams so much.

Remember...we don't have to be in REM sleep to dream. We can actually dream in any of the other sleep stages. We tend to think REM when we talk about dreaming but it can actually happen during the other sleep stages as well.

We could go out on a long skinny limb and come up with all sorts of "maybes" but for me I tend to try to fix what is known to be a potential problem (in this case the clustering of events pointing to sup optimal therapy at least during those time frames) and see if fixing it helps anything else.

Thanks I will look at other data on sleepy head I have about a years worth of data

sleepwiggler wrote:Not sure about rem sleep but I do know that I have been having issues during rem sleep as I have been having very vivid angry dreams and yelling and getting quite ugly and acting out the dreams, punching, what I do I the dream I do in my sleep. I had posted about that earlier.

What you are describing is rem sleep behavior disorder. It may be the cause of mask displacement and excessive leakage.
It may be time for a consult with your sleep doctor, your neurologist, or your primary care physician to see if a cause can be determined. This disorder is also drug related so a close look at side effects of any meds you are taking reveals anything of interest. I take Pramipexole for PLMD and my neurologist took care to ensure that I wasn't having this as a side effect. Fortunately, non of that occurred.

Do your have a copy of your sleep studies? They might make mention of anything like this occurring during the sleep study.

JDS74 wrote:

sleepwiggler wrote:Not sure about rem sleep but I do know that I have been having issues during rem sleep as I have been having very vivid angry dreams and yelling and getting quite ugly and acting out the dreams, punching, what I do I the dream I do in my sleep. I had posted about that earlier.

What you are describing is rem sleep behavior disorder. It may be the cause of mask displacement and excessive leakage.
It may be time for a consult with your sleep doctor, your neurologist, or your primary care physician to see if a cause can be determined. This disorder is also drug related so a close look at side effects of any meds you are taking reveals anything of interest. I take Pramipexole for PLMD and my neurologist took care to ensure that I wasn't having this as a side effect. Fortunately, non of that occurred.

Do your have a copy of your sleep studies? They might make mention of anything like this occurring during the sleep study.

I already take klonopin and requin for rls. I go to my sleep doctor at the end of the month and we will be discussing this.

Have you done the drill re blood ferritin levels, etc., as low values there can contribute to RLS.

JDS74 wrote:Have you done the drill re blood ferritin levels, etc., as low values there can contribute to RLS.

Yes I have all the work there and rechecked and rechecked the last was 6 months ago.

Here is a link to the Mayo Clinic page on REM Sleep Behavior Disorder (RDB) that may provide some insight into what is going on.
Mayo Clinic on REM Sleep Behavior Disorder

That could explain all or most of the leak issues that you are having.
In addition, Requip can cause hallucinations as an adverse side effect. I didn't see anything related with Klonopin.

JDS74 wrote:Here is a link to the Mayo Clinic page on REM Sleep Behavior Disorder (RDB) that may provide some insight into what is going on.
Mayo Clinic on REM Sleep Behavior Disorder

That could explain all or most of the leak issues that you are having.
In addition, Requip can cause hallucinations as an adverse side effect. I didn't see anything related with Klonopin.

Thanks I read the Mayo link last night and national sleep foundation. I have been on Requip for years and I am at the max dose which many state is too much for RlS but it kind of works. I have a long list of things to discuss with my sleep doctor and the amount of meds is one of them

Here is the latest I think I am making progress on the leak.