Teeth Clenching & CPAP Newbie

ChicagoGranny wrote: ↑

Thu Jul 26, 2018 11:10 am

clenchingtobreathe wrote: ↑

Thu Jul 26, 2018 9:55 am

Can you explain the CA's which are there every night? They seem to be located around times I know I have been going into or out of sleep. Is it a concern? Also is the AHI determined based on both OAs and CA's? How do I get an AHI of 1.16 when the graph only shows one OA event?

The AHI is the average hourly sum of all the OAs, CAs and Hs. Click on the SH Events tab and take a look at the length of the CAs. You would have something to worry about only if they are very long -> 60+ seconds.

Your AHI is excellent. You are treated well with a low pressure.

clenchingtobreathe wrote: ↑

Thu Jul 26, 2018 9:55 am

Still clenching my teeth, though (ARGH!!)

Why don't you try a teeth protector? A small, cheap, simple one - example - https://www.walmart.com/ip/Universal-Ni ... /394781932

Thanks for that information! It does look like relatively good news, doesn't it?! I have damaged the gums right behind my upper front teeth with my bottom teeth until it burns constantly and I can't even let food stay in my mouth because it burns it more. The top guards always touch the gums that are wounded and I suffer more for it the next day. Trying to get dentists to understand that has been a challenge. The discomfort is almost unbearable and I control it somewhat with a special toothpaste and Ibuprofen 800. I haven't bitten into any food (hamburger, pizza, apples, etc) for a year! I really need a bottom guard that is built up on the back teeth so that my bottom teeth cannot reach the roof of my mouth until it heals. Haven't found anyone yet who can/will make one....but I will...hopefully, sooner than later!! I'm getting TMJ symptoms! After I heal the gums I can go back to one of the myriad of top guards I have bought!

clenchingtobreathe wrote: ↑

Thu Jul 26, 2018 9:55 am

My Sleepyhead read out is starting to look repetitive...so I guess that's a good thing! Can you explain the CA's which are there every night?
They seem to be located around times I know I have been going into or out of sleep. Is it a concern?

Transition apneas. Awake breathing and asleep breathing are different functions, and your breathing can get *very* irregular when switching between them. The term "swj" or "Sleep/Wake Junk" is usually used here on the forum to refer to that 'crud' on the chart, but the clinical term is 'transition apnea'. If you want to know more, google that. but, in effect, ignore them, they don't matter.

clenchingtobreathe wrote: ↑

Thu Jul 26, 2018 9:55 am

Also is the AHI determined based on both OAs and CA's? How do I get an AHI of 1.16 when the graph only shows one OA event?

CA and OA are both apneas, so they're in the Apnea Hypopnea Index. Look at the numbers on the left, cai 1.04, oai, 0.12, = 1.16

I'd recommend bumping your min pressure up to 7, you see how the pressure keeps going down til you get somewhere in the 6's, then you have some event that makes the pressure go back up? better to smooth that out and avoid the events if you can.

Requested & Received my actual sleep test results in the mail today. Interesting.
The pulmonary Dr I'm seeing simply told me that I stopped breathing 9X an hour during the test. The results show I during 439 minutes of recording (only 226 minutes sleeping), I had 31 hypopneas (8.7 index) and only 2 OSA events (0.5 index). Is the combination of indexes where he got the 9?? He didn't explain hypopnea to me at all.

I thought hypopneas were shallow breathing....not "stopped" breathing.

I've also noticed that I've only registered ONE hypopnea on Sleepyhead since I started CPAP use, but OSA's are just down a bit.
Tonight I tape my dadgum mouth shut in hopes of getting any sleep at all. Good grief. My face will have a big rectangular red block across my mouth from my skin reacting to adhesive!!

clenchingtobreathe wrote: ↑

Fri Jul 27, 2018 6:34 pm

I thought hypopneas were shallow breathing....not "stopped" breathing.

You are correct.

A pnea - without breathing

Hypo pnea - low/below normal breathing

The Apnea Hypopnea Index (AHI) includes both apneas and hypopneas. You only stopped breathing twice, according to the numbers you are citing, the 2 Obstructive Sleep Apneas (OSA).

Obstructive apnea...80 to 100% air flow reduction that lasts at least 10 seconds in duration.
Not necessarily a total cessation of breathing because of the airway tissues collapsing and blocking things..you can have a partial blockage.

Hyponea 40 (or 50 depending on brand definition) to 79% air flow reduction that lasts at least 10 seconds in duration.

Don't think that hyponeas are just "shallow breathing" because they aren't. They are flow reductions that just haven't made it to earn the OA flag. They are very important in the grand scheme of things and can cause oxygen level drops if enough reduction in air flow and a long enough duration. If they were just "shallow breathing" they wouldn't be part of the AHI or diagnosis.

Some cpap/apnea definitions.
http://sleepyhead.sourceforge.net/wiki/ ... p/Glossary

and you might want to read this
http://adventures-in-hosehead-land.blog ... -test.html

clenchingtobreathe wrote: ↑

Fri Jul 27, 2018 6:34 pm

I had 31 hypopneas (8.7 index) and only 2 OSA events (0.5 index). Is the combination of indexes where he got the 9??

A = apneas
H = hypopneas
I = hourly index

AHI = apneas + hypopneas divided by number of hours

clenchingtobreathe wrote: ↑

Fri Jul 27, 2018 6:34 pm

Requested & Received my actual sleep test results in the mail today. Interesting.
The pulmonary Dr I'm seeing simply told me that I stopped breathing 9X an hour during the test. The results show I during 439 minutes of recording (only 226 minutes sleeping), I had 31 hypopneas (8.7 index) and only 2 OSA events (0.5 index). Is the combination of indexes where he got the 9??

More likely he, very un Spocklike, just rounded 8.7 up to 9, instead of having to explain how you could stop breathing seven tenths of a time.

clenchingtobreathe wrote: ↑

Fri Jul 27, 2018 6:34 pm

Tonight I tape my dadgum mouth shut in hopes of getting any sleep at all. Good grief. My face will have a big rectangular red block across my mouth from my skin reacting to adhesive!!

here's an alternative to tape, if you'd care to try-

viewtopic.php?f=1&t=112758&st=0&sk=t&sd ... i#p1086296

works wonderfully for me and it may help you.

btw, i just LOVE this thread! it's a prime example of someone coming here for help, receiving it and improving their cpap therapy.

good stuff!!

Pugsy wrote: ↑

Fri Jul 27, 2018 7:02 pm

Obstructive apnea...80 to 100% air flow reduction that lasts at least 10 seconds in duration.
Not necessarily a total cessation of breathing because of the airway tissues collapsing and blocking things..you can have a partial blockage.

Hyponea 40 (or 50 depending on brand definition) to 79% air flow reduction that lasts at least 10 seconds in duration.

Don't think that hyponeas are just "shallow breathing" because they aren't. They are flow reductions that just haven't made it to earn the OA flag. They are very important in the grand scheme of things and can cause oxygen level drops if enough reduction in air flow and a long enough duration. If they were just "shallow breathing" they wouldn't be part of the AHI or diagnosis.

Some cpap/apnea definitions.
http://sleepyhead.sourceforge.net/wiki/ ... p/Glossary

and you might want to read this
http://adventures-in-hosehead-land.blog ... -test.html

Thank you for this! Both resources you posted were really good too!

palerider wrote: ↑

Sat Jul 28, 2018 1:34 pm

clenchingtobreathe wrote: ↑

Fri Jul 27, 2018 6:34 pm

Requested & Received my actual sleep test results in the mail today. Interesting.
The pulmonary Dr I'm seeing simply told me that I stopped breathing 9X an hour during the test. The results show I during 439 minutes of recording (only 226 minutes sleeping), I had 31 hypopneas (8.7 index) and only 2 OSA events (0.5 index). Is the combination of indexes where he got the 9??

More likely he, very un Spocklike, just rounded 8.7 up to 9, instead of having to explain how you could stop breathing seven tenths of a time.

Not to worry about him having to explain something....he hasn't explained anything yet. Without you guys, I'd be much worse off than I am!

zonker wrote: ↑

Sat Jul 28, 2018 4:32 pm

clenchingtobreathe wrote: ↑

Fri Jul 27, 2018 6:34 pm

Tonight I tape my dadgum mouth shut in hopes of getting any sleep at all. Good grief. My face will have a big rectangular red block across my mouth from my skin reacting to adhesive!!

here's an alternative to tape, if you'd care to try-

viewtopic.php?f=1&t=112758&st=0&sk=t&sd ... i#p1086296

works wonderfully for me and it may help you.

btw, i just LOVE this thread! it's a prime example of someone coming here for help, receiving it and improving their cpap therapy.

good stuff!!

I had already noticed the "Scunci" suggestion! Unfortunately, I have a jaw issue that makes me reluctant to use them. I HAVE ordered them, however.....and some special medical tape too. If I can resolve that, the burning of my skin wherever the pillow and headgear straps touch me and general anxiety and sleeplessness over having something attached to my face, I'll be just fine!!
And you are RIGHT about getting help from this forum! I'm still pretty desperate 2 weeks into this (as you can tell from this thread! ), so I'm open to all the help I can get!!

Oh brother. I'm baaaack! Tomorrow I will contact the DME about trying other masks. I am just not able to sleep with this one. I made wonderful covers for the face "straps" out of the hem of an old t-shirt. They slid right on and covered everything that touched my face. Also made a little "slipcover" out of the same thing to cover the pillow part that touched my face. The only part of the silicone left exposed were the nasal prongs...and they wore my poor nostrils out.
Granted, I have been a very sensitive sleeper since I menopaused....everything has to be just right for me to relax and sleep anymore.....so this apnea diagnosis and treatment is a bit of a cruelty joke for me. I am serious sleep deprived after 2 weeks. Even took .25 mg of Xanax last night and STILL had to take the mask off after 6 hours of up and down.

Now that I've whined enough, here's my questions of the morning: On my pressure graph, you can see that the pressure shot up past 10. THAT woke me up after I had JUST fallen asleep. Chart also shows leak at that time. Did the pressure shoot up because my mouth opened? (I won't get my special tape until tomorrow)....or did my mouth blow open because the pressure shot up? That's what it feels like when I wake up. Seeing no apnea events at that time, this is the only thing I can discern.
Also, is there a way to tell from the charts whether I'm asleep or awake?

Thank you everyone for your continued help and patience!

clenchingtobreathe wrote: ↑

Sun Jul 29, 2018 9:58 am

Now that I've whined enough, here's my questions of the morning: On my pressure graph, you can see that the pressure shot up past 10. THAT woke me up after I had JUST fallen asleep. Chart also shows leak at that time. Did the pressure shoot up because my mouth opened? (I won't get my special tape until tomorrow)....

You didn't include the snore and flow limitations graphs, look to them for answers.

palerider wrote: ↑

Sun Jul 29, 2018 12:10 pm

clenchingtobreathe wrote: ↑

Sun Jul 29, 2018 9:58 am

Now that I've whined enough, here's my questions of the morning: On my pressure graph, you can see that the pressure shot up past 10. THAT woke me up after I had JUST fallen asleep. Chart also shows leak at that time. Did the pressure shoot up because my mouth opened? (I won't get my special tape until tomorrow)....

You didn't include the snore and flow limitations graphs, look to them for answers.

Here are those graphs which give me more questions. In trying to learn about flow limitation, someone on the forum said that the auto cpap may "think" an event was going to happen and runs the pressure up.....but the pressure wasn't this high when I was actually experiencing events. I was JUST nodding off when this happened and it woke me with a start because it's hard for me to exhale when the pressure is that high.....I had to turn the machine off so I could breathe.

clenchingtobreathe wrote: ↑

Sun Jul 29, 2018 12:41 pm

Here are those graphs which give me more questions. In trying to learn about flow limitation, someone on the forum said that the auto cpap may "think" an event was going to happen and runs the pressure up.....but the pressure wasn't this high when I was actually experiencing events. I was JUST nodding off when this happened and it woke me with a start because it's hard for me to exhale when the pressure is that high.....I had to turn the machine off so I could breathe.

The ResMed clinical guide gives some good, brief overviews of how the machine sets pressures based on detected events. The "flow limits" are when the machine determines your inspiration is partially obstructed and it will raise pressure in response to help keep your airway open.

To my inexperienced and untrained eye I'd say that on your graphs, the flow limits are why the pressure increases. The machine only increases pressure in response to events like flow limits, snores and obstructive apnea, not mask leaks. The leak is probably in response to the higher pressures causing the mask to leak more and not the leak looking like flow limits.

https://www.respshop.com/manuals/ResMed ... %20her.pdf