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palerider · Post by **palerider** » Sat Mar 07, 2020 1:34 am

souldrifter wrote: ↑
Fri Mar 06, 2020 11:50 pm

palerider wrote: ↑
Fri Mar 06, 2020 11:36 pm

souldrifter wrote: ↑
Fri Mar 06, 2020 10:30 pm
When you say 6 or 7, I'm assuming you mean the max pressure. I don't believe I can change that on my end, I think that has to be done by the company that issued my machine, so I'm not sure how I'm going to make changes easily. I'll figure it out.

And yes, I will definitely stay in this thread for all things related, especially in the beginning

Thanks!
He means *MIN* pressure, max should (probably) be at 20, it just works better that way for most people.

And yes, you can easily change things on your end, all you need to do is get the clinical manual, https://www.respshop.com/manuals/ResMed ... %20her.pdf
Ahhh I see. That's what I was missing. Appreciate it!

Yup, providers *LIE* outright all the time about patients ability to make changes, from little lies to big, malicious ones. It's pretty dreadful. Some even say "It's ILLEGAL" (It's not) in order to scare patients.

PatOnCPAP · Post by **PatOnCPAP** » Sat Mar 07, 2020 2:06 am

Okie bipap wrote: ↑
Fri Mar 06, 2020 3:42 pm
Welcome to the forum. If you are able to do so, I highly recommend you see an ENT about the deviated septum. I had mine repaired over 20 years ago and it made a big difference in my ability to breathe both with and without the machine. Prior to the surgery, I could never breathe through both sides of my nose at the same time, and had frequent sinus infections. Since then, I have had very few sinus infections.

+1 on this advice. It wont replace the need for CPAP but it will help. Anything that is causing a flow limitation that can be fixed, should be I feel. Do your homework on a good ENT tho. I had to have 2 septoplastys done. The first one only helped with the terrible post nasal drip I was having. The second one involved a special bone grafting technique and opened my breathing up much better.

PatOnCPAP · Post by **PatOnCPAP** » Sat Mar 07, 2020 2:10 am

I even wonder how accurate these sleep studies are when it comes to Centrals? After all our CPAP machines mark any sort of arousal or deep sigh as a Central. Couldn't the same thing be occurring in these studies?

Jas_williams · Post by **Jas_williams** » Sat Mar 07, 2020 4:13 am

PatOnCPAP wrote: ↑
Sat Mar 07, 2020 2:10 am
I even wonder how accurate these sleep studies are when it comes to Centrals? After all our CPAP machines mark any sort of arousal or deep sigh as a Central. Couldn't the same thing be occurring in these studies?

That is not correct an event needs to be over 10 seconds long to be scored do you often sigh for over 10 seconds and the machines are pretty good at deciding if the events are obstructive or central they just don’t know if your asleep or not

palerider · Post by **palerider** » Sat Mar 07, 2020 12:26 pm

PatOnCPAP wrote: ↑
Sat Mar 07, 2020 2:10 am
After all our CPAP machines mark any sort of arousal or deep sigh as a Central.

No, no they don't. You have to be not breathing for at least ten seconds for the machine to mark an apnea, central, OR obstructive.

palerider · Post by **palerider** » Sat Mar 07, 2020 12:29 pm

Jas_williams wrote: ↑
Sat Mar 07, 2020 4:13 am

PatOnCPAP wrote: ↑
Sat Mar 07, 2020 2:10 am
I even wonder how accurate these sleep studies are when it comes to Centrals? After all our CPAP machines mark any sort of arousal or deep sigh as a Central. Couldn't the same thing be occurring in these studies?
That is not correct an event needs to be over 10 seconds long to be scored do you often sigh for over 10 seconds and the machines are pretty good at deciding if the events are obstructive or central they just don’t know if your asleep or not

Sighs involve air movement, so even a 10+ long sigh wouldn't be flagged as an apnea...

zonker · Post by **zonker** » Sat Mar 07, 2020 12:35 pm

souldrifter wrote: ↑
Fri Mar 06, 2020 10:30 pm

When you say 6 or 7, I'm assuming you mean the max pressure. I don't believe I can change that on my end, I think that has to be done by the company that issued my machine, so I'm not sure how I'm going to make changes easily. I'll figure it out.

And yes, I will definitely stay in this thread for all things related, especially in the beginning

Thanks!

ooops. my reply was knocked aside by palerider, that rude so 'n' so!

and he answered as i would. just to expand, though. some doctors will push back on you making your own changes. just remind them politely but firmly that it is YOUR therapy and you can make adjustments as you see fit.

good luck!

Dog Slobber · Post by **Dog Slobber** » Sat Mar 07, 2020 12:41 pm

PatOnCPAP wrote: ↑
Sat Mar 07, 2020 2:10 am
I even wonder how accurate these sleep studies are when it comes to Centrals? After all our CPAP machines mark any sort of arousal or deep sigh as a Central. Couldn't the same thing be occurring in these studies?

ooops. my reply was knocked aside by zonker, that rude so 'n' so!

The problem with sleep studies is not the accuracy of measuring events, both centrals or obstructive. The problem is; it is not very representative of your typical sleep.
Different bed, different pillow, different routine, different hours, wired up, and it's just one small snapshot of an activity that is varies night to night and hour to hour.

zonker · Post by **zonker** » Sat Mar 07, 2020 12:43 pm

Dog Slobber wrote: ↑
Sat Mar 07, 2020 12:41 pm

PatOnCPAP wrote: ↑
Sat Mar 07, 2020 2:10 am
I even wonder how accurate these sleep studies are when it comes to Centrals? After all our CPAP machines mark any sort of arousal or deep sigh as a Central. Couldn't the same thing be occurring in these studies?
ooops. my reply was knocked aside by zonker, that rude so 'n' so!

The problem with sleep studies is not the accuracy of measuring events, both centrals or obstructive. The problem is; it is not very representative of your typical sleep.
Different bed, different pillow, different routine, different hours, wired up, and it's just one small snapshot of an activity that is varies night to night and hour to hour.

dueling responses!

shall we tag team against palerider and jnk...?

palerider · Post by **palerider** » Sat Mar 07, 2020 1:01 pm

zonker wrote: ↑
Sat Mar 07, 2020 12:35 pm
just remind them politely but firmly that it is YOUR therapy and you can make adjustments as you see fit.

As well, that you don't work for them, it's the other way around.

zonker · Post by **zonker** » Sat Mar 07, 2020 1:02 pm

palerider wrote: ↑
Sat Mar 07, 2020 1:01 pm

zonker wrote: ↑
Sat Mar 07, 2020 12:35 pm
just remind them politely but firmly that it is YOUR therapy and you can make adjustments as you see fit.
As well, that you don't work for them,it's the other way around.

true, dat.

this is also why i don't use self service check out lines at the grocery store.

souldrifter · Post by **souldrifter** » Sat Mar 07, 2020 1:02 pm

Ht538 wrote: ↑
Fri Mar 06, 2020 10:50 am
I am a bit older than you but also have ADD and messed about with stimulant meds and am working on CPAP now to see if there’s anything that will help me with fatigue/brain fog. I would say to keep pursuing the CPAP. Like you I am relatively young, thin, don’t snore, and was told that I didn’t need a sleep study, that “something else” was driving my fatigue. “Luckily” I got a sleep study finally because the military was afraid of narcolepsy. I don’t have narcolepsy, but do have mild OSA. The links between OSA and cognitive function are well established and it’s also known that poor sleep can exacerbate ADD issues.

That said, even if OSA isn’t causing your fatigue/brain fog, it’s something to be dealt with for a host of other health reasons. It sounds like you are owing very proactive in self care and doing the basic stuff docs already recommend, so that is awesome by you!

https://www.additudemag.com/adhd-sleep- ... -symptoms/

https://www.sleepfoundation.org/articles/adhd-and-sleep

The only thing I might also suggest is taking to your psychiatrist about the ADD and related meds. They can really mess with your sleep, sometimes good and sometimes not so much. And if you don’t have a psychiatrist, ask your primary doc to refer you. Head meds need to be handled by someone who has experience with them and NOT a gp. Ideally you could find either a sleep doc or psychiatrist that have some experience in dealing with ADD And sleep issues. However, I have been incredibly disappointed by the fact that most of these folks work very much in silos.

Also recognize, ADD also come with a host of co-morbid issues like anxiety/depression that also mess with your sleep. In fact many folks with ADD don’t set enough REM sleep as you describe.

In some circles, ADD is considered to be a sleep related issue and many ADDers also have insomnia/circadian thrum etc issues. In fact, ADD is considered an arousal disorder. I have an issue with fatigue, to the point that they thought I was narcoleptic, but was really my brain checking out because something wasn’t keeping me focused or “aroused”. Check out the articles below for a little more detail. It’s also worth noting that there is some evidence/theory that many folks with ADD might actually be misdiagnosed, and they instead have sleep apnea or other sleep issues.

https://www.sleepfoundation.org/articles/adhd-and-Sleep
https://www.additudemag.com/adhd-sleep- ... -symptoms/

Thanks for sharing, very insightful. Now that I've been thinking about it, I'm not surprised that there's a correlation.

souldrifter · Post by **souldrifter** » Sat Mar 07, 2020 1:12 pm

Dog Slobber wrote: ↑
Sat Mar 07, 2020 12:41 pm

PatOnCPAP wrote: ↑
Sat Mar 07, 2020 2:10 am
I even wonder how accurate these sleep studies are when it comes to Centrals? After all our CPAP machines mark any sort of arousal or deep sigh as a Central. Couldn't the same thing be occurring in these studies?
ooops. my reply was knocked aside by zonker, that rude so 'n' so!

The problem with sleep studies is not the accuracy of measuring events, both centrals or obstructive. The problem is; it is not very representative of your typical sleep.
Different bed, different pillow, different routine, different hours, wired up, and it's just one small snapshot of an activity that is varies night to night and hour to hour.

Interesting point, I think I read somewhere that being in a new/foreign sleeping environment can cause apneas. Might be wrong about that but I wouldn't be surprised.

souldrifter · Post by **souldrifter** » Sat Mar 07, 2020 1:15 pm

zonker wrote: ↑
Sat Mar 07, 2020 1:02 pm

palerider wrote: ↑
Sat Mar 07, 2020 1:01 pm

zonker wrote: ↑
Sat Mar 07, 2020 12:35 pm
just remind them politely but firmly that it is YOUR therapy and you can make adjustments as you see fit.
As well, that you don't work for them,it's the other way around.
true, dat.

this is also why i don't use self service check out lines at the grocery store.

souldrifter · Post by **souldrifter** » Sat Mar 07, 2020 1:48 pm

Night 1

Night 1 is in the books. The nasal mask had a good fit overall and was comfortable with a great seal. I decided to use micropore tape to tape my mouth to prevent leaks and it went well at first. The first hour using my machine I was watching tv propped up on a wedge pillow. I started out using the fixed prescribed pressure setting of 4 and noticed it was a bit hard to breathe as suggested on this thread so I bumped it up to 6 min - 20 max AutoSet, so far so good.

After turning off the tv when I attempted to go to sleep, I removed the wedge pillow and used my regular pillow. I laid awake for a while and at some point, I noticed that the air pressure felt a bit high. I looked over and saw that it was at ~11. I messed around with the settings again and decided to leave it at 6 fixed, which felt fine, and then bumped it down to 5 fixed. I'm assuming that I was more comfortable in the lower settings only because I'm not used to breathing through my nose that much.

The main issue I was having was that my jaw was getting really sore with the tape over my mouth. I'm assuming that this was because it was essentially locked into a position it's not used to with no support. When I took off the tape, I noticed I was having trouble keeping my mouth shut as I stopped thinking about it. At this point, it was around 3 AM and I made the decision to take it off for the night so that I could get some sleep.

I'm a bit disappointed that I took the mask off after only ~4 hours. I'm beginning to think it was definitely wishful thinking to go with the nasal mask rather than the full face mask, and I should probably put the nasal mask on hold until I become more comfortable breathing through my nose without the machine. I ordered a snoring strap to help support my jaw that should arrive tomorrow so I'm not giving up on it, but I'm anticipating that I likely will trade it in for the full face setup on Wednesday (soonest I can do it). I'm not sure how useful the OSCAR data will be since I"m pretty sure I didn't sleep but I can post that tomorrow when my SD reader comes in.

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