WheezyRider's CPAP therapy

Thanks. A boatload of CAs, but not with a CSR pattern. I hope you fall asleep early and easily.

wheezyrider wrote: ↑

Sun Jan 02, 2022 8:34 pm

I know it works. Just not in a straight line.

very well said! and that shows me that you've got this.

I should rename my thread WheezyRider's Rollercoaster Ride! The night of the 2nd probably would have been lower if I could have slept straight through like I did last night. Much of the events are 2nd half. I will focus on fixing the leak. Can I still get air with leaks this bad? One other big thing I noticed - I wake up very gassy and I use a nasal mask. I'm wondering if the air is going down into my stomach when my mouth is open, and is that the source of the leak and not leaking around the nasal pillow?

zonker wrote: ↑

Mon Jan 03, 2022 11:56 am

very well said! and that shows me that you've got this.

When I figured out this didn't work.

Miss Emerita wrote: ↑

Sun Jan 02, 2022 8:45 pm

Thanks. A boatload of CAs, but not with a CSR pattern. I hope you fall asleep early and easily.

Staying asleep would be nice. Do you see anything that would indicate why I wake up? I am not waking with an urge to go to the bathroom, Sometimes I'm just awake long enough where eventually I get up and then hard to go back to sleep. AAARGHHH!

wheezyrider wrote: ↑

Tue Jan 04, 2022 6:37 pm

zonker wrote: ↑

Mon Jan 03, 2022 11:56 am

very well said! and that shows me that you've got this.

When I figured out this didn't work.

"Can I still get air with leaks this bad? One other big thing I noticed - I wake up very gassy and I use a nasal mask. I'm wondering if the air is going down into my stomach when my mouth is open, and is that the source of the leak and not leaking around the nasal pillow?"

Once the leaks go north of 24, the machine will have more and more trouble trying to compensate for the lost pressure. So you will not be getting the pressurized air you're supposed to be getting; also, the machine has trouble telling whether you're having events when the leaks are high.

You are still getting plenty of air into your lungs. Probably you are opening your mouth and breathing through your mouth -- no one can tell for sure whether leaks are from the mouth or the mask, but the "plateau" type leak trace often occurs with mouth leaks.

You are probably having some aerophagia -- getting air into your digestive tract. As far as I know, this wouldn't be connected with the leak rate or mouth breathing, unless you are kind of gulping when you mouth-breathe. Aerophagia is pretty common among PAP users. If it's not painful, try rolling with it for now.

So, is your nose now clear enough to breathe through comfortably? If it is, you have several options for dealing with your leaks. One is the Zonker method; maybe he'll drop by and explain it. Here are some other ideas:

1. Tongue position. 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. For some people, this is really all it takes to avoid mouth leaks.

2. Collar. If your jaw tends to drop down during the night, pulling your mouth open, then a soft cervical collar, or a firmer snore collar, can be a big boon.

3. Although chin straps tend to pull the jaw back, which is not helpful, the Knightsbridge Dual Band strap has a design that pulls the jaw straight up, which makes it a possible alternative to a cervical collar.

4. Tape. Some people (including me) rely on tape to keep the lips from opening. (I can't rely entirely on the tongue thing.) When the lips open, all too often that eventually leads to a noisy and disruptive mouth leak. To see whether tape would be feasible for you, I recommend that you invest in a box of Somnifix strips. They are very gentle on the skin but hold very well. Be sure to curl your lips inward per instructions before placing the strip. If these work for you, then you can experiment with lower-cost options.

Note about tape: Some people avoid it, for two reasons. (1) If you suddenly need to vomit in the night, the tape could lead to your aspirating some vomitus, which would be bad. However, you can sacrifice one strip to see for yourself how well you can pull you mouth open in an emergency using only your jaw muscles. (2) If there is a power failure and your machine goes off while you're sleeping, you won't be able to do the natural thing and open your mouth to breathe. As for that, out of an abundance of caution, I've put a circuit alarm in a plug on the same circuit as my machine. It will wake me up immediately if I lose power to the machine.

Hello there,
first of all, ive intented to make my first post tomorrow introducing myself, but after seeing this thread ive seen a similarity to some of my nights with my APAP (that i have since 20.12.21).
is it possible that you take sleeping aids e.g. z-drugs or benzos?
i had this CSR and also many CAs on nights when i took either zopiclone or temazepam in higher dosages. Dropping zopiclone down from 7,5-10mg to 3,75mg and all the CSR is gone and i only have 1-2 CAs a most nights.
I would have to add that i have heart insufficiency but the CSR still only happened in combination with either zopiclone or Temazepame. Also, Antihistamines like Hoggar night did it to me when i took a full dosage.

ManuR wrote: ↑

Wed Jan 05, 2022 1:54 pm

is it possible that you take sleeping aids e.g. z-drugs or benzos?

Welcome to the party! No I don’t take any sleeping aids. I’ve recently tried Tizanidine, that was prescribed for back spasm, but nothing else that would be considered a sleeping aid. I occasionally take OTC Benadryl, but no issues that I can remember.

Good luck with therapy.

Miss Emerita wrote: ↑

Wed Jan 05, 2022 1:06 pm

Once the leaks go north of 24, the machine will have more and more trouble trying to compensate for the lost pressure. So you will not be getting the pressurized air you're supposed to be getting; also, the machine has trouble telling whether you're having events when the leaks are high.

that makes me think my events are a lot higher.

Miss Emerita wrote: ↑

Wed Jan 05, 2022 1:06 pm

You are probably having some aerophagia -- getting air into your digestive tract. As far as I know, this wouldn't be connected with the leak rate or mouth breathing, unless you are kind of gulping when you mouth-breathe. Aerophagia is pretty common among PAP users. If it's not painful, try rolling with it for now.

When I think about it even happens with my mouth closed. I can't get little burp bubbles form with my mouth closed. There's enough discomfort I will continue to whine about it.

Miss Emerita wrote: ↑

Wed Jan 05, 2022 1:06 pm

So, is your nose now clear enough to breathe through comfortably?

Yes, breathing fine.

Miss Emerita wrote: ↑

Wed Jan 05, 2022 1:06 pm

If it is, you have several options for dealing with your leaks. One is the Zonker method

Here are some other ideas:

1. Tongue position.

2. Collar.

3. the Knightsbridge Dual Band strap has a design that pulls the jaw straight up, which makes it a possible alternative to a cervical collar.

4. Tape. I recommend that you invest in a box of Somnifix strips.
.....Some people avoid it, for two reasons.

1. practicing right now
2. this is the Zonker method, no?
3. will look it up
4. Yikes!!! aspirating, an abundance of caution, if I lose power to the machine.Oh My!

Thanks for the great tips and recommendations!!!!!!!

I started with the EPR off(first hour is no sleep), but I felt like I was fighting to exhale. I could not fall asleep and it felt like I was hyperventilating. I turn EPR back on for the remainder of last night(starting @ 22:30) and even though it took me a while to fall asleep(the higher numbers were while I was trying to fall asleep), I slept until 4:30ish, not great but the past week I have been waking at 1-3 and struggling the rest of the night. I'm miserable. But despite the numbers from last night I feel somewhat rested. Any theories why I have the CSR's and was that the reason I woke up? Would have been nice to sleep longer for once.

Do I need to try a different EPR setting(higher/lower)? Why does it feel like I'm holding my nose when I exhale with EPR off? I might get fewer events with EPR off, but I'm not convinced it's an improvement for my therapy. HELP!!!!!

Thanks in advance for any feedback.

You seem to have very few obstructive events, which makes me wonder whether you could lower your overall pressure settings. Conceivably this could bring your CAs down.

How about leaving EPR at 2, so you don't feel you're struggling to exhale, but using min = 7 and max = 9. Worth an experiment? If your OAs and Hs don't shoot upward, then try reducing EPR to 1 and see how that goes.

Do you have an appointment with your doctor to discuss your CAs?

Miss Emerita wrote: ↑

Sun Jan 09, 2022 12:27 pm

You seem to have very few obstructive events, which makes me wonder whether you could lower your overall pressure settings. Conceivably this could bring your CAs down.

How about leaving EPR at 2, so you don't feel you're struggling to exhale, but using min = 7 and max = 9. Worth an experiment? If your OAs and Hs don't shoot upward, then try reducing EPR to 1 and see how that goes.

Do you have an appointment with your doctor to discuss your CAs?

I had an evaluation by an ENT because my PCP was seeing if there was any physical obstructions and he looked at my throat for just a second and said there wasn't any obstruction. I have a brother who had a surgery for apnea and I thought maybe we had that in common.

Yes I have an appt later this month. I will probably try your changes next weekend. I am just going to try to sleep tonight and don't want to risk a sleepless night and have to go to work tomorrow. Thanks for the recommendations.

Miss Emerita wrote: ↑

Wed Jan 05, 2022 1:06 pm

1. Tongue position. 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. For some people, this is really all it takes to avoid mouth leaks.

I think this is helping eliminate my leaks. The past few nights have been very low leaks. It seems to seal my mouth and prevents it from inflating which was common before. However, my sleeping has been kind of minimal and not related but hard to tell how effective it's been because I have been abruptly waking up after 4 hours of sleep and struggling to fall asleep for the rest of the night. The 4 hours or so is pretty good and I have no idea what's causing me to wake up. I am about a month into a new job, so maybe underlying stress?

Thanks again for that tip. I feel if I could sleep through the night I would wake up to angels singing.

Oh, stress can most definitely do that. I hope it’ll ease soon. Great that you’ve gotten the upper hand with leaks!