- Mouth breathing leaks during the first six months defeated the therapeutic effects of the machine
*Tried the conventional approach using several chin straps as recommended by sleep doc, Resmed, and DME. Miserably failed and they were damn uncomfortable especially as was summertime.
*Solution: Soft cervical collar (Walgreen's) as suggested on this forum. Large leaks after this dropped like a rock.
- Sleep doc did nothing to narrow pressures from initial machine setting (4-14 cm H2O)
*Made requests to sleep doc to narrow pressure, which she agreed to do
*However, started to realize APAP was not ideal, but was uncertain what to do
- Wanted to try fixed pressure, but sleep doc was hesitant to recommend
*He offers fee-based consulting service to review OSCAR data so decided to do
*Suggested up titration at a couple fixed pressures and gave me confidence to change machine settings (and get over my fear of the DME cops will come after you)
*Finally settled on fixed pressure of 9 cm H2O.
*He also suggested trying Coverall type over mouth in place of collar. The tape actually caused both AHI and mask leaks to increase. I think the reason the collar works better for me is that there is some nasal congestion during sleep, and partial mouth breathing balances it.
- Awakening after ~6 hours of PAP (~5:00 am) was of initial concern
*Getting out bed at 9:00 am is no big deal since I am retired (although it irks my wife since she is a lark and I'm an owl).
- PAP therapy changed my life
