Paul’s Treatment Thread

[zonker]

ah, many is the night when i would've had 0 ahi, if it weren't for that one pesky central!

[pbrankin]

Hi,

I’m finding myself mouth leaking (using nasal pillows).

This is usually occurring during REM sleep and significantly compromises my treatment (no recorded AHI events but SPO2 drops into low 80’s).

I’ve read about mouth taping and that it can be helpful but, mainstream websites (ie. Not CPAP specific) warn against the practice. (Asphyxiation, emergencies, vomiting etc).

Are they being over cautious do you think?

Last time I used tape (just once), I ended up with chipmunk cheeks. So I’m working on tricking my tongue to sit better to block off the oral cavity.

It’s curious that no AHi events were recorded alongside the SPO2 drops. But I’m guessing that, during a leak, not only is treatment compromised, but so is event detection. Would that be correct?

Many thanks for your time.

Paul.

[zonker]

I’ve read about mouth taping and that it can be helpful but, mainstream websites (ie. Not CPAP specific) warn against the practice. (Asphyxiation, emergencies, vomiting etc).

Are they being over cautious do you think?

yes.

but i don't mouth tape myself. here's what i do instead-

https://www.cpaptalk.com/viewtopic.php? ... s#p1086296

that in conjunction with a firm foam cervical collar controls my leaks.

good luck!

[Pugsy]

It’s curious that no AHi events were recorded alongside the SPO2 drops. But I’m guessing that, during a leak, not only is treatment compromised, but so is event detection. Would that be correct?

It depends on just how big the leak is as to how much it might affect the machine's ability to sense and record some sort of apnea event.
Over 40 L/min...maybe the machine might miss an event but I have had events flagged at 35 L/min so I know it works with that 35 L/min leak.

How long did the desat last and how low did it go? How quickly did you recover?

[pbrankin]

Attached is the OSCAR screen shot.

Actually, there was one apnea event recorded and this did register at the time of the deepest desat. I've included a zoomed in view of this as the last image. Although it captured a 12 second OA, it was immediately followed by a non-captured event that lasted just under 12 seconds. Resulting in disrupted/minimized breathing of about 30 seconds. This at least explains the deep de-sat.

However, either side of these events there were less deep, but more frequent/pre-longed desats that are not aligned to any recorded AHI events.

This period aligns with an extended period of leakage hence my assumption that there may have been AHI events, or at least disrupted breathing, occurring during the leakage (due to lack of airway support), that were not registered in the CPAP machine (Airsense 10).

I've also included a screenshot of the Wellue O2 ring output. Its the same data as that in Oscar just that it highlights what happened from an O2 perspective a little more clearly.

Prior to this O2 instability...O2 was running around 95%.

I'm running at 9cm constant CPAP and I've not had an OA event desat as much as this before in the past 4 weeks of treatment. Hence the thought that the leak contributed to the lack of airway support and prolonged the apnea?

Not a great sleep

Would welcome your thoughts.....


Paul

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[pbrankin]

Hi,

In addition to mouth leaks waking me up, I'm also experiencing the following;

Periods of shallower, faster breathing followed by an increase in pulse, an arousal, and occasionally a desat. These apparently do not qualify as an "event" and yet, they still wake me up.

I've attached an Oscar screenshot.

The period from 00:43:00 to 00:44:30 illustrates a good example.

Is this indicative of a need to increase the treatment pressure?

Would really welcome some help as my sleep is lousy at the moment.

Paul

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[pbrankin]

Can anyone help?

Thanks.

[Pugsy]

We have no way to know if you need more pressure or not from one zoomed in on event.
Why not give it a try and see if it resolves your issue???? Simple experiment.
I forget why you are wanting to use fixed cpap mode but I assume you have your reasons. That's fine I guess. Or maybe if you prefer fixed mode you could change to auto mode with a tight range and see if the machine even wants to go higher and evaluate the impact on your overall sleep quality.

Your zoomed in on section of irregular breathing, etc could simply be related to REM stage sleep cycle and the arousal afterwards was a normal post REM arousal/awakening.

IMHO a 12 second lone OA isn't enough to warrant blaming overall crappy sleep on and shouldn't cause significant desats anyway. Hold your breath for 12 seconds while wearing the pulse ox and wait a couple of minutes and see if the O2 levels change much.
Not all crappy sleep can be blamed on the airway and if you are having crappy sleep quality overall....you also need to investigate other possible culprits unrelated to the airway.