Vinny's therapy Thread 3rd sleep Doc

[Vinny V]

Thanks for the information, I will begin working on it.

The nausea was really only this morning..for the most part.

I was given a nasal wisp mask that I'm going to try and see what happens.

It may be a few days for me to get back..I'm heading to my deceased fathers house to clean out and sort his stuff with my siblings..

Thanks

[Pugsy]

Okie Dokie.

Take care and my sympathies to you and your family.

[Vinny V]

When I try the nasal wisp do I have to make any changes to the pressure to account for the smaller mask??

[Pugsy]

No need to make special changes in pressure but don't be surprised to find out you don't need quite as much pressure with a nasal mask as with a full face mask.
Some people find that when using a nasal mask they don't need as high of a minimum pressure....can't guarantee it for you but it happens fairly often.
I think it has to do with the way full face masks tend to pull the jaw back a little with that lower strap and in doing so the airway gets altered a bit and maybe narrowed a bit...and a little more pressure is needed to hold the airway open.
Using a nasal mask doesn't pull the jaw back that much.

[Midwest_non_sleeper]

I'm not sure if anyone has hit on this or not, but the nausea you felt this morning possibly has nothing to do with your apnea therapy. You may actually be coming down with something, Lord knows it's going around right now just about everywhere. Regardless, you're in good hands with Pugsy, she's our resident Den Mother and Jail Matron at the same time.

[Pugsy]

Sorry but I got the impression that the nausea had been on going which is why I mentioned the aerophagia thing....when I had some aerophagia issues I also had some nausea.

So if today is the only time....scratch the aerophagia idea.

[Vinny V]

Sorry but I got the impression that the nausea had been on going which is why I mentioned the aerophagia thing....when I had some aerophagia issues I also had some nausea.

So if today is the only time....scratch the aerophagia idea.

In the beginning I had nausea all the time... This was the first time in over a week I was nauseous,

I already had what was going around...a few weeks ago man...knocked me on my butt for over a week.

[Vinny V]

Okie Dokie.

Take care and my sympathies to you and your family.

Thanks,

While I have some Wi-Fi I found what you said about your events happening during REM interesting..
During my sleep study my AHI was 10.8 but my REM AHI was double that. And I've noticed that the majority of my physical awakenings now Actually waking with a start happen mainly during dreams...And before cpap the first 4-5 hours of sleep i was out like a light, but the second half of the night I would startle awake with a racing heart and pounding head, breathing heavy.. Multiple times...it got to the point once I did my initial 4-5 hours is sleep i would force myself to get up since I would feel like crap but...if I went back to sleep and had any events in the second half of the night I would feel even worse...so foggy I could barely sstring 2 words together

[Pugsy]

I am very familiar with REM dependent OSA myself.
AHI of 12 in non REM during my diagnostic sleep study but rocking and rolling in REM with 53 per hour AHI.

It stands to reason that you also seem to get worse in those wee hours of the morning because that is when we tend to have more REM and it lasts longer in duration.
Google "sleep stages" and look and the normal hypnograms....you can see what I mean.
It's also normal to wake up after REM stage sleep completion...that's normal. Most of the time we won't remember it because we just roll over and go right back to sleep but sometimes we are awake long enough to remember it.

[Vinny V]

First night with new settings..

Feel like I was hit by a truck...

This is also the highest AHI I've had in weeks

It felt very different with the low Min setting got used to the steady pressure of straight cpap

I do not know why there is such a big gap in the flow rate data....

New Settings Night 1.png (60.52 KiB) Viewed 5615 times

[Pugsy]

Did you sleep solidly or have lots of wake ups that you remember?

Did you at anytime take the SD card out of the machine last night?

How many sessions are you seeing? That's below the statistics area on the left.

[Vinny V]

Did you sleep solidly or have lots of wake ups that you remember?

Did you at anytime take the SD card out of the machine last night?

How many sessions are you seeing? That's below the statistics area on the left.

I did not sleep soundly.. Was up alot. Did stop the machine for night snack, a couple bathroom trips.

Did not take card out.

There are 2 main sessions and 2 smaller sessions. Listed on the lower left only one is highlighted yellow, I cannot get all of them to stay yellow

IMG_20190408_095305_hdr.jpg (577.85 KiB) Viewed 5595 times

[Pugsy]

so 4 sessions....don't worry about the yellow thing...only one can be yellow

I don't know what happened to the flow rate. Normally that doesn't happen unless the SD card isn't seated in the machine fully.
If you didn't mess with the SD card at all...shouldn't have happened unless there is a glitch in the software or data files somewhere.
Watch to see if this is a one off fluke or if this happens a lot.

Go back to the minimum of 10 but make the max 14 and add in AFlex at 2 and see how you do.
Your AHI is going to be low....working on comfort and sleeping quality right now.

[Vinny V]

Ok

I added a picture of the section with the sessions.

I will adjust the pressure

I have tried the a flex and c flex before and really did not like it, the dr. Set me up with it 3 weeks into therapy didn't like the way it felt and he said what ever feels better go with it had me trying the different types and settings, liked non of them so he said it was ok to stop..

The nausea was not as bad this morning, I think it is because I have been tightening the straps to combat leaks and it presses the back of my neck hard and my chiropractor told me that any prolonged pressure on the neck area can irritate the vagus [sic] nerve which can make you nauseous.. I have stop the leaking ( for now) with some extra cushioning on the side of the mask that is not against the pillow.

I tried a nasal wisp last night and the venting was so loud I could not sleep ( gave it an hour) then stopped and put my other mask on that's the first short session

[Pugsy]

Okay.....if you already tried the Flex options and didn't like them then don't try it again.

I don't have much else to offer except maybe work on mask selection and comfort and fit to see if it resolves your issues.

If the RERAs are real and related to flow limitations then the machine should be able to deal with them provided you let the machine adjust the pressures per the auto adjusting algorithm...meaning don't tie the machines hands with an 11 cm max when you have a 10 cm minimum. Give the machine some room to do its job.

RERAs may just point to crappy sleep and wake ups or they may point to something going on in the airway.

You do need to learn how to distinguish awake/arousal breathing from asleep breathing. If you aren't asleep when anything is flagged it isn't real.
http://freecpapadvice.com/sleepyhead-free-software