1 month and waking up

I'm wondering if anyone can give me some insight on what might be going on and what I can do. I'm new at this but have had success. Just when I started sleeping most of the night things changed. I'm waking up multiple times at night which then triggers a bathroom visit. I'm wondering if I'm being woke up by either the pressure increasing or something else. I use a nasal mask and mouth tape. Sometimes when I start to wake I hear myself making noise from my mouth. Not snoring but just a different kind of breathing pattern. I spend a lot of my sleeping time on my back elevated but also spend some time on my side. I'm not very good at reading these OSCAR charts but I know you guys are experts.I've attached 3 of them so you can see the whole OSCAR chart.Any ideas that might help me sleep longer stretches of time and get rested?

Hello, arteach. Two things would help us help you.

First, could you stack the following graphs and put them into one screenshot? We don't need the other graphs for now. Please include the left panel in the screenshot.

Events
Flow rate
Pressure (not mask pressure)
Leaks
Snores
Flow limitations.

To squeeze everything in, you can grab the horizontal gray bars that separate the graphs and move them up a little.

Second, could you post a chart from back when you felt you were doing better? Please format it in the same way as above.

Thanks!

Hopefully I did this all correctly. This is what felt like a great night.Thanks for looking!!

Thanks arteach. I've looked at these charts from every angle I can think of, and I'm not seeing a clear reason why you're getting choppier sleep with the more recent chart. Pressure changes, leaks, flow limitations, AHI -- all of these are either comparable or actually better for the worse night.

So there are a couple of things to try chipping away at. One is getting the leaks under better control. Unless you're waking up with tape that has loosened, your leaking must be from your mask. Have you tried tightening the P10 a little by putting the straps closer together? Have you washed the headgear recently, which can shrink the straps a little? Have you tried each of the sizes for the pillows?

As an experiment, you could try giving yourself a narrower pressure range by raising your minimum to, say, 8, and capping your maximum at, say, 12. If that seems a little better, and it doesn't mess up your nice AHI, you might try narrowing it a little further, preferably by bringing the minimum up.

And then the recent change for the worse may be caused by factors unconnected to your CPAP therapy. Additional stress or changes in your night-time environment are possible culprits. Think carefully about changes that happened around the same time as your fall-off: new medications, or discontinuation of old ones? Change in exercise pattern? Diet? Drink, pot, caffeine? Screen time? Light or heat in the bedroom?

Thanks Miss Emerita!! Last night after reading your suggestions I tried to pay better attention to what was waking me. I woke up about 3 hours after going to sleep doing the weird puffing. I don't know how to explain it but I have my mouth taped, I've been doing this for over a year so I know I'm doing that correctly. I wake up because it's like I'm pursing my lips and blowing a bunch of air out. The sound and feel wake me up. At that point I slap a scrunci band over the area which helps. I feel like I'm bound and gagged! After an hour or 2 I can't take it anymore and end my session and take my gear off and go back to bed. All this up and down awake and sleep is not making for the best of sleep. I wish I could figure out what to do. I'm not a mouth breather but sleeping on my back I have the typical responses to jaw dropping etc.........at least that is what I'm assuming. I'm attaching last nights OSCAR. Thanks for taking time to help!! Any more ideas are welcome.

arteach wrote: ↑

Sat Dec 05, 2020 11:40 am

Thanks Miss Emerita!! Last night after reading your suggestions I tried to pay better attention to what was waking me. I woke up about 3 hours after going to sleep doing the weird puffing. I don't know how to explain it but I have my mouth taped, I've been doing this for over a year so I know I'm doing that correctly. I wake up because it's like I'm pursing my lips and blowing a bunch of air out. The sound and feel wake me up. At that point I slap a scrunci band over the area which helps. I feel like I'm bound and gagged! After an hour or 2 I can't take it anymore and end my session and take my gear off and go back to bed. All this up and down awake and sleep is not making for the best of sleep. I wish I could figure out what to do. I'm not a mouth breather but sleeping on my back I have the typical responses to jaw dropping etc.........at least that is what I'm assuming. I'm attaching last nights OSCAR. Thanks for taking time to help!! Any more ideas are welcome.

Sounds like attempted mouth breathing to me.
Might try a cervical collar and tape or go to a full face mask.

Just an observation and opinion.

Miss Emerita is excellent help.

Hope you find relief.

JPB

Your observation and opinion is important. I agree. The odd thing is I've mouth taped long before I began cpap because of sleeping on back and mouth falling open and having dry mouth. I never did this kind of breathing when I was taped up. Now that I'm on CPAP I've begun this..........makes me think it is at a point where I'm having a lot of air pumped into me. I don't know......I'm way too new at this but trying to be successful.

arteach wrote: ↑

Sat Dec 05, 2020 12:04 pm

Your observation and opinion is important. I agree. The odd thing is I've mouth taped long before I began cpap because of sleeping on back and mouth falling open and having dry mouth. I never did this kind of breathing when I was taped up. Now that I'm on CPAP I've begun this..........makes me think it is at a point where I'm having a lot of air pumped into me. I don't know......I'm way too new at this but trying to be successful.

you may wish to try the firm foam cervical collar that jimbud suggests. this helps keep the jaw up(doesn't do a thing for keeping lips closed) and opens up the airway. once i started using one, my ahi went down a full point.

i also use the scunci method as described by forum friend jay aitchsee. i see you are using a scunci as well. i use two plus then elastic bands. this too has helped lower my ahi.

good luck!

I wonder whether you're experiencing "chipmunk cheeks." Air finds its way into the mouth cavity and builds up, looking for a way out. I don't know why it would crop up all of a sudden; is your median pressure on the rise? That wasn't apparent in the two charts you posted, but you could look at your Overview page in Oscar to see whether there's a trend. If there is, you might want to consider lowering your maximum to the point at which the ballooning goes away.

In any event, something to try would be getting your tongue to help you. Try putting the tip of your tongue behind your upper front teeth. Then position the main part of your tongue up against your upper palate. Finally, give a little suck or swallow to create a bit of suction. You should now be able to open your mouth while breathing entirely through your nose. Practice this during the day, and see if you can get it grooved in deeply enough to help while you are asleep at night.

I vote for chipmunk cheeks developing now for some reason. As to why now? Million dollar question.

I actually have had chipmunk cheeks happen from day 1 and found out about the tongue placement trick from all of you. It's a little tricky but I do do it. Maybe as I fall deep asleep I relax and let it go??? I'll keep trying.

This has worked for Me:

I use a regular headband (sweat terrycloth) around head/mouth.
This will help keep the cheeks from puffing out and restricts air flow out of mouth.(loss of therapy pressure)
I also use a cervical collar for the reasons Zonker explained. (it has the added advantage of holding the headband in place)
For some reason this combination helps me minimize the palatal leakage also. I start the night out with it below mouth (on chin) and only move it up if I notice signs of mouth breathing.
Like Zonker, I also use a 2" elastic band over the headband(with Velcro on the ends for adjustment). Very loose for comfort.

I have developed this combination over 1 1/2 years. Many prototypes. Reason? I wear a full beard and am not going to cut it off.

It is amazing what a determined person will do to make all this work. I marvel.

Maybe some combination will work for you.
I bet it does.

JPB