New CPAP User Looking for OSCAR Feedback

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sun Dec 05, 2021 8:48 am

Pugsy wrote:
Sun Dec 05, 2021 8:38 am
BatmanMatt wrote:
Sun Dec 05, 2021 8:30 am
I suspect my nose is closing up more than I thought. I’ve woken up with my mouth open and bloating and gas several times. Any tips?
You are using a full face mask...is that correct? So any mouth breathing won't harm therapy effectiveness since the mouth is part of the sealed circuit. Mouth breathing is what we do when we can't breathe through our nose.
So ideally we try to fix the cause of the congestion.

As for bloating and gas...common complaint and it's called aerophagia.
https://www.cpaptalk.com/wiki/index.php/Aerophagia

Is this the first time you have experienced it?
You won't like the usual go to fix for it....increase EPR. :lol:
Full face mask yes. Well if that’s the solution I can start to get used to it.

Maybe I can try some things for the nose first like strips?

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sun Dec 05, 2021 8:58 am

I’ve had gas and bloating a 3-4 times so far.

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Sun Dec 05, 2021 9:27 am

BatmanMatt wrote:
Sun Dec 05, 2021 8:58 am
I’ve had gas and bloating a 3-4 times so far.
That's actually fairly frequent for someone who has only been using cpap for not quite 2 weeks.
Frequent enough that we want to nip it right now or at least start trying to figure out the cause.

You need to monitor closely how high your pressures go on the nights when you have more gas and bloating symptoms.
We never really can know which is the primary culprit....the higher pressures the machine might go to during the night or maybe simply the baseline pressures.
It's very possible that we might need to limit the maximum if that ends up being the biggest culprit.
Can you go ahead and show last night's detailed report? I know it is going to be squirrelly overall but I want to see if your overall pressures happened to go a lot higher last night than the night before where I assume you didn't have aerophagia issues since you didn't mention it????

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zonker
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Re: New CPAP User Looking for OSCAR Feedback

Post by zonker » Sun Dec 05, 2021 12:00 pm

BatmanMatt wrote:
Sun Dec 05, 2021 8:48 am

Maybe I can try some things for the nose first like strips?
may i suggest flonase?
people say i'm self absorbed.
but that's enough about them.
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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Mon Dec 06, 2021 7:15 am

Pugsy wrote:
Sun Dec 05, 2021 9:27 am
BatmanMatt wrote:
Sun Dec 05, 2021 8:58 am
I’ve had gas and bloating a 3-4 times so far.
That's actually fairly frequent for someone who has only been using cpap for not quite 2 weeks.
Frequent enough that we want to nip it right now or at least start trying to figure out the cause.

You need to monitor closely how high your pressures go on the nights when you have more gas and bloating symptoms.
We never really can know which is the primary culprit....the higher pressures the machine might go to during the night or maybe simply the baseline pressures.
It's very possible that we might need to limit the maximum if that ends up being the biggest culprit.
Can you go ahead and show last night's detailed report? I know it is going to be squirrelly overall but I want to see if your overall pressures happened to go a lot higher last night than the night before where I assume you didn't have aerophagia issues since you didn't mention it????
Here are the last two nights. I woke up twice last night for some reason but had a generally OK night, no bloating.

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Mon Dec 06, 2021 7:53 am

You went to 11 cm briefly a few time but didn't stay there very long.

Next time you have some aerophagia lets compare that night to these nights and see if for some reason you stay up around 11 cm for a more prolonged time.

As for now...I have a saying...if it ain't really broke I don't see why I need to go trying to fix it.
These settings are working for YOU and that's what is most important. Yeah the FL graph is still a bit active but not horribly so and trying to fix/improve the FL graph caused more problems than the FLs were apparently causing. Not worth trying to fix.

I would leave things well enough alone for right now. There's no hard fast rule that the pressure graph just HAS to be a bit flatter or more stable....especially when trying to obtain that more stable pressure line creates a problem bigger than whatever it was we were trying to improve upon might be causing a problem.
The FLs....what I call a "maybe problem"....we don't know for sure that they just HAVE to be improved upon...
but we do know that doing what is needed to maybe fix that problem for sure causes a big problem that hugely affects sleep quality and that is the last thing we want to do.

Anything that disturbs sleep is unwanted and that includes little tweaks of the settings to maybe fix something that is only a maybe problem in the first place.

Should you happen to wake during the night and you know the reason just keep a log and see if you can spot the reason and then maybe work on the reason.

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Mon Dec 06, 2021 8:01 am

Just so you can get a visual comparison of FL graphs besides my blatantly boring FL graph...below is a really ugly FL graph.
As you can tell yours is no where near that level of activity. Yours is "boring" compared to that one. :lol:

As for your pressure line activity. My pressure line does quite a bit of that movement sometimes. It's usually related to REM stage sleep where my OSA is worse and I just need more pressure and this is fairly common. I don't know if that's what is causing your increases in pressure but it might. Might also be related to sleeping position....might be related to a little chin tucking positioning as well. As long as you sleep decently and AHI remains this low.....who cares. The machine is able to do it's job and that's all that counts.

Image

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Wed Dec 08, 2021 7:31 am

Thanks for all your help and encouragement. Last night was hard and I woke up to 10.7 pressure near the end. Will keep trying.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Fri Dec 10, 2021 7:46 am

Here are my last three days. It's a blood bath. I don't have a support group and this is hard. I still wake up and think it's because the exhaust from the F10 mask has a definite whooshing noise. Had gas and farting this morning. I want to try a mask with the tube on top of my head or something but the DME lady thinks the F10 is fine and I should just try to get used to it. Simplus, or F30I and maybe Dreamwear. I only get one mask swap.

Anyways, I'm starting to be able to sleep on my side but it's barely working and will leak if I'm not in the exact right position. Might a lot of my issues be tied to my mask? I feel like I should be doing better.

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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Fri Dec 10, 2021 8:44 am

BatmanMatt wrote:
Fri Dec 10, 2021 7:46 am
. I want to try a mask with the tube on top of my head or something but the DME lady thinks the F10 is fine and I should just try to get used to it. Simplus, or F30I and maybe Dreamwear. I only get one mask swap.

Anyways, I'm starting to be able to sleep on my side but it's barely working and will leak if I'm not in the exact right position. Might a lot of my issues be tied to my mask? I feel like I should be doing better.
Well your DME lady isn't the one having problems is she? Does she even use cpap? I bet not.
The "you will get used to it" is advice from a lazy ass person not wanting to work at her job.

I do think that finding the right mask is actually the hardest part of this whole cpap journey.
If we can't sleep well because of any issues with the mask (comfort, noise, whatever) then we have a serious problem because without solid sleep....not much matters does it?

Also...they lie about the "one mask swap" rule. The truth is that all masks come with a 30 day warranty FROM THE MANUFACTURER and has nothing to do with your insurance and everything to do with a lazy DME not wanting to do the paperwork for getting credit from the manufacturers. They could swap out the mask a dozen times and not lose money if they would just do a little paperwork. Yes, your insurance will only pay for one within the allowance period but manufacturers will reimburse the DME when they keep having to try other masks. Used to be (long time ago) the DME had to physically return the unwanted mask but now all they do is fill out paperwork and the unwanted mask goes in the trash.

I am not the person to be giving out advice on which full face mask might be better for people. I have never used one beyond trying it just for grins. The DreamWear FFM I did try and it's not a bad mask and I could use it if I just had to but I simply can't stand any mask that touches the nasal bridge area of my nose. I get immediate nasal congestion from the least little pressure on the nose where my turbinates are. If I can't breathe...I can't sleep.
The main drawback to the DreamWear is sometimes people hear that air flowing through the frame and find that noise annoying and prevents sleep. I didn't have that issue myself with it but I realize that all masks come with a huge YMMV sticker.

For your gas/bloating/aerophagia issues....I propose limiting the maximum and see what happens both in terms of vent noise and the gas issues.
Last night you spent more time up around 11 cm than you did the other nights...lets see if limiting the max helps with the aerophagia issues and doesn't allow too many apnea events to slip by the defenses.

Try reducing the maximum to 9 cm. See what happens.

Is there any way you could sleep and just breathe through your nose so you could use a nasal mask of some sort?
It would sure open up your choices to more masks that have silent venting systems.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Fri Dec 10, 2021 1:15 pm

Pugsy wrote:
Fri Dec 10, 2021 8:44 am
BatmanMatt wrote:
Fri Dec 10, 2021 7:46 am
. I want to try a mask with the tube on top of my head or something but the DME lady thinks the F10 is fine and I should just try to get used to it. Simplus, or F30I and maybe Dreamwear. I only get one mask swap.

Anyways, I'm starting to be able to sleep on my side but it's barely working and will leak if I'm not in the exact right position. Might a lot of my issues be tied to my mask? I feel like I should be doing better.
Well your DME lady isn't the one having problems is she? Does she even use cpap? I bet not.
The "you will get used to it" is advice from a lazy ass person not wanting to work at her job.

I do think that finding the right mask is actually the hardest part of this whole cpap journey.
If we can't sleep well because of any issues with the mask (comfort, noise, whatever) then we have a serious problem because without solid sleep....not much matters does it?

Also...they lie about the "one mask swap" rule. The truth is that all masks come with a 30 day warranty FROM THE MANUFACTURER and has nothing to do with your insurance and everything to do with a lazy DME not wanting to do the paperwork for getting credit from the manufacturers. They could swap out the mask a dozen times and not lose money if they would just do a little paperwork. Yes, your insurance will only pay for one within the allowance period but manufacturers will reimburse the DME when they keep having to try other masks. Used to be (long time ago) the DME had to physically return the unwanted mask but now all they do is fill out paperwork and the unwanted mask goes in the trash.

I am not the person to be giving out advice on which full face mask might be better for people. I have never used one beyond trying it just for grins. The DreamWear FFM I did try and it's not a bad mask and I could use it if I just had to but I simply can't stand any mask that touches the nasal bridge area of my nose. I get immediate nasal congestion from the least little pressure on the nose where my turbinates are. If I can't breathe...I can't sleep.
The main drawback to the DreamWear is sometimes people hear that air flowing through the frame and find that noise annoying and prevents sleep. I didn't have that issue myself with it but I realize that all masks come with a huge YMMV sticker.

For your gas/bloating/aerophagia issues....I propose limiting the maximum and see what happens both in terms of vent noise and the gas issues.
Last night you spent more time up around 11 cm than you did the other nights...lets see if limiting the max helps with the aerophagia issues and doesn't allow too many apnea events to slip by the defenses.

Try reducing the maximum to 9 cm. See what happens.

Is there any way you could sleep and just breathe through your nose so you could use a nasal mask of some sort?
It would sure open up your choices to more masks that have silent venting systems.
Can you tell from my data if I breathe through the mouth? Someone said it’s possible to see on Oscar. I want to try a nasal mask like the P10 and I’m fine with a chin strap. My mouth opens when I’m in deep sleep I guess sometimes? Not because I need to open it.

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Pugsy
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Re: New CPAP User Looking for OSCAR Feedback

Post by Pugsy » Fri Dec 10, 2021 1:57 pm

BatmanMatt wrote:
Fri Dec 10, 2021 1:15 pm
Can you tell from my data if I breathe through the mouth? Someone said it’s possible to see on Oscar.
No, not really. We can make educated guesses but they are still educated.
The machine doesn't/can't tell us what is causing a leak. To the machine a leak is a leak no matter where it comes from.
It can be mask movement leak or mouth opening leak and even if it is mouth opening leak it isn't always massive leak either.

I once woke up and I was mouth breathing. A nice gentle mouth breathing and since I was wide awake I decided to just continue mouth breathing so that I could see what known mouth breathing looked like. Below is the graph from that experiment. About 10 or 15 minutes of awake known mouth breathing and I circled that time in red.
As you can tell it was minimal actual leak and well within the machine's ability to compensate.
Now for the bigger leak at 03:00 to 03:30....dunno what it was from as I slept through it. Probably mask movement leaks though. Some people think that the plateau points to mouth breathing but after seeing my known mouth breathing leaks I don't know that I totally want to go there as an absolute. What I usually suggest is that when we see large leaks that don't wake us up, that we tape our mouths shut at least the one night and see if the leaks totally go away and that answers the question.....mask movement or mouth...and then the person knows what needs to be worked on....keeping the mouth shut or mask fitting. When fixing a problem we first have to identify the problem.

Image

Another example as to why the plateau thing doesn't always reflect mouth breathing.
Sometime back I was trying a new mask and as with all new masks it involves a bit of trial and error getting the fitting of the headgear just right. I was seeing a lot of leaks...and big blocks of leaks...and I was wondering if my mouth was opening a lot or if the fitting was still too loose. So I taped my mouth one night and below is the report from a night with the mouth taped and the tape never came loose. Lots of leak but it was from mask movement. Once I knew exactly what the leak was from I made the necessary tension adjustments with the headgear and that solved the leak problem.

Image

So the moral to this whole thing....we don't always know where a leak is coming from but there are ways to figure it out and address it....if it needs to be addressed.

If you want to try the P10 or similar mask then try it. If leaks do happen and they end up causing a problem....there are ways to deal with it. I sometimes mouth breathe (usually on my back) but never for very long and rarely deep into large leak territory and I sleep through it...so I shrug my shoulders and move on.
Nasal pillows are much easier to get sealed and stay sealed because there is simply less skin to mask area that needs to be kept sealed.

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If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Fri Dec 10, 2021 4:12 pm

Thanks. My DME is nice but very discouraging and inflexible. I swapped for an F30i which should immediately help with my side sleeping. I hope it’s as comfortable as it feels and that it seals.

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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Fri Dec 10, 2021 5:32 pm

Pugsy wrote:
Fri Dec 10, 2021 1:57 pm
BatmanMatt wrote:
Fri Dec 10, 2021 1:15 pm
Can you tell from my data if I breathe through the mouth? Someone said it’s possible to see on Oscar.
No, not really. We can make educated guesses but they are still educated.
The machine doesn't/can't tell us what is causing a leak. To the machine a leak is a leak no matter where it comes from.
It can be mask movement leak or mouth opening leak and even if it is mouth opening leak it isn't always massive leak either.

I once woke up and I was mouth breathing. A nice gentle mouth breathing and since I was wide awake I decided to just continue mouth breathing so that I could see what known mouth breathing looked like. Below is the graph from that experiment. About 10 or 15 minutes of awake known mouth breathing and I circled that time in red.
As you can tell it was minimal actual leak and well within the machine's ability to compensate.
Now for the bigger leak at 03:00 to 03:30....dunno what it was from as I slept through it. Probably mask movement leaks though. Some people think that the plateau points to mouth breathing but after seeing my known mouth breathing leaks I don't know that I totally want to go there as an absolute. What I usually suggest is that when we see large leaks that don't wake us up, that we tape our mouths shut at least the one night and see if the leaks totally go away and that answers the question.....mask movement or mouth...and then the person knows what needs to be worked on....keeping the mouth shut or mask fitting. When fixing a problem we first have to identify the problem.

Image

Another example as to why the plateau thing doesn't always reflect mouth breathing.
Sometime back I was trying a new mask and as with all new masks it involves a bit of trial and error getting the fitting of the headgear just right. I was seeing a lot of leaks...and big blocks of leaks...and I was wondering if my mouth was opening a lot or if the fitting was still too loose. So I taped my mouth one night and below is the report from a night with the mouth taped and the tape never came loose. Lots of leak but it was from mask movement. Once I knew exactly what the leak was from I made the necessary tension adjustments with the headgear and that solved the leak problem.

Image

So the moral to this whole thing....we don't always know where a leak is coming from but there are ways to figure it out and address it....if it needs to be addressed.

If you want to try the P10 or similar mask then try it. If leaks do happen and they end up causing a problem....there are ways to deal with it. I sometimes mouth breathe (usually on my back) but never for very long and rarely deep into large leak territory and I sleep through it...so I shrug my shoulders and move on.
Nasal pillows are much easier to get sealed and stay sealed because there is simply less skin to mask area that needs to be kept sealed.
Thanks. My DME is nice but very discouraging and inflexible. I swapped for an F30i which should immediately help with my side sleeping I hope. I hope it’s as comfortable as it feels and that it seals well. It wont hurt my nose and I can actually read with it on.

_________________
Machine: AirSense 11 Autoset
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Airsense 11 w/ heated tubing
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BatmanMatt
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Re: New CPAP User Looking for OSCAR Feedback

Post by BatmanMatt » Sat Dec 11, 2021 8:18 am

Pugsy wrote:
Fri Dec 10, 2021 1:57 pm
BatmanMatt wrote:
Fri Dec 10, 2021 1:15 pm
Can you tell from my data if I breathe through the mouth? Someone said it’s possible to see on Oscar.
I really liked the F30i. I woke up a lot but I already like it more than the F10. Stays on, I can roll, etc. The underside of my nose is rough though so I need to find some tips there. It doesn't look like flow limit. improved, maybe got worse. Not sure if I should expect better results. Leak rate looks WAY more improved. Any thoughts?

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