Newb needs help. Exhaling issues

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Brad S
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Re: Newb needs help. Exhaling issues

Post by Brad S » Mon Sep 19, 2022 8:44 am

lynninnj wrote:
Mon Sep 19, 2022 8:23 am
Come on, dish! (Hopefully some good news in there.)
LOL Good morning. Update coming shortly.

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Continued

Post by Brad S » Mon Sep 19, 2022 10:37 am

Good morning- Updates and random thoughts
Friday and Saturday nights were a trip to the upside down bizarro world. My brain was all over the place. Saturday I slept- woke up for no apparent reason. Took some Z Quil just before 1:00 and went back to sleep. Last night after waking up I sat in bed waiting for my brain to slow down. Tried again and woke up again with nothing wrong except I just couldn't sleep any more and my mind racing.
Last night, I switched to the F30 mask because of the venting of the Evora mask blowing straight out and making me sleep only on my left side so I don't disturb my wife with cold air blowing on her. I slept good but there was tremendous leaking, which I only vaguely recall. I don't think it was enough to disturb my sleep. I was able to sleep on my right side finally. WOOHOO. I have tried to remember to put a pillow sideways between us if I roll over on my right side, but it is easier just to stay on my left and not worry about it.
What I did feel this morning was very odd. When I woke up before I took the mask off I just laid still and focused on my breathing. I don't know how to explain it other than I know I was getting plenty of cool, fresh air and I had no problem breathing in or out but it felt like I was on the verge of suffocating. Like there was not enough oxygen? I really don't know how to explain it other than that. I have felt this before but never focused on it. I do not feel that way at any other time with the mask off. I am sure it is my stoopit brain but the feeling is real.
After two days of tremendous fog, I do feel significantly better today. So far, the fog is not here right now. That is a great thing and this is the least foggy I have felt so far. This needs to stay!
Except for the leak, from what I can tell, I think my numbers look good, even on the bizarro nights.
I will keep plugging along. I do apologize, I know I probably annoy the crap out of some of you- but this is my thread! :wink: and it helps me to look back and see what was going on and where I am going.
Thanks for still being interested.

Friday
https://sleephq.com/public/938d86d6-539 ... 8c1e4d8937

Image

Saturday
https://sleephq.com/public/646279e7-f3d ... 886cb0ba6e

Image

Sunday
https://sleephq.com/public/b710b5b8-602 ... fbdabb353e

Image

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Re: Newb needs help. Exhaling issues

Post by Brad S » Mon Sep 19, 2022 10:42 am

lynninnj wrote:
Mon Sep 19, 2022 8:23 am
I am learning I can tell the whether I had my chin up or not that my numbers will be crap and I feel like crap on a chin down night.
Good morning-
It sounds like you are getting this all figured out and having some really good results.
Are you doing anything when you sleep to keep your chin up? Are you able to focus enough to do it without assistance?
I know it is all in my head, but I feel reassurance by the collar when I lay down. It has become comfortable and helps me to think I will sleep better.
How was your weekend? Do anything good?

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Re: Newb needs help. Exhaling issues

Post by lynninnj » Mon Sep 19, 2022 10:51 am

Brad S wrote:
Mon Sep 19, 2022 10:42 am
lynninnj wrote:
Mon Sep 19, 2022 8:23 am
I am learning I can tell the whether I had my chin up or not that my numbers will be crap and I feel like crap on a chin down night.
Good morning-
It sounds like you are getting this all figured out and having some really good results.
Are you doing anything when you sleep to keep your chin up? Are you able to focus enough to do it without assistance?
I know it is all in my head, but I feel reassurance by the collar when I lay down. It has become comfortable and helps me to think I will sleep better.
How was your weekend? Do anything good?
I don't normally toss and turn a lot so I am just mindful if I get up and go to the bathroom or roll over to the other side-chin up. Maybe if you do that along with your cervical collar (just a tiny bit) it will help? Are your numbers improving along with your sense of security? Your mental acuity and fatigue levels? I am hoping so. (You really do need to dish more. lol)

Thanks for asking, we had a great weather weekend and the highlight was a 70th birthday party with some really excellent people. The bday gal has sleep apnea and cpap and I keep hoping she will join the board but I didn't want to push. She was having dry mouth a few weeks ago and I was glad that I had been reading this board and asked her to check if her humidifier was on. Turns out it wasn't-she had turned it off in a prior season. I didn't ask her about it any more but we shall see. Either way, it's good to be around good people. Thanks again for asking.

Now dish some more-how are the numbers and how are you feeling?

Edit: and how was your weekend? (sorry got a call midway thru and forgot to ask. Excuse my manners please).

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Re: Newb needs help. Exhaling issues

Post by Brad S » Mon Sep 19, 2022 3:45 pm

lynninnj wrote:
Mon Sep 19, 2022 10:51 am
Are your numbers improving along with your sense of security? Your mental acuity and fatigue levels? I am hoping so. (You really do need to dish more. lol)
I believe they are related. I am not worried about going to bed and waking up in total spaz mode anymore. I am back to being able to lay down and go right to sleep- with some good advice from a friend :D here to make the coffee and check for tickle hairs etc. earlier in the evening. Staying asleep is still a problem but I am working on it.
lynninnj wrote:
Mon Sep 19, 2022 10:51 am
Thanks for asking, we had a great weather weekend and the highlight was a 70th birthday party with some really excellent people. The bday gal has sleep apnea and cpap and I keep hoping she will join the board but I didn't want to push. She was having dry mouth a few weeks ago and I was glad that I had been reading this board and asked her to check if her humidifier was on. Turns out it wasn't-she had turned it off in a prior season. I didn't ask her about it any more but we shall see. Either way, it's good to be around good people. Thanks again for asking.
It is fantastic you are able to give such great advise.
lynninnj wrote:
Mon Sep 19, 2022 10:51 am
Now dish some more-how are the numbers and how are you feeling?
LOLOL See three posts above... I did a lot of dishing.
lynninnj wrote:
Mon Sep 19, 2022 10:51 am
Edit: and how was your weekend? (sorry got a call midway thru and forgot to ask. Excuse my manners please).
How rude! Haha
Weekend turned out good. My son turned 38 two weeks ago and he and his family have had colds off and on. Even though they live right next door, we were finally supposed to get together Saturday to celebrate his birthday and play games but he and my granddaughter got sick again. It is very frustrating, now today my daughter in law is sick, they live right next door and can't see or give the kiddo hugs. Grrr!
Went to Black Hawk yesterday and had a nice day in the casinos. Headed to South Dakota for a four day weekend on Friday before it gets too cold up there to go outside and have fun.
I think that's all I got for today. Hope your day is great.

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Re: Newb needs help. Exhaling issues

Post by lynninnj » Mon Sep 19, 2022 5:00 pm

Well hmmm....the numbers look generally better except for the fact that you weren't actually sleeping. I am glad you feel more clear. Thats probably the sleep high I was alluding to.

Yeah, you need to work on the leaks a bit and it wouldnt surprise me if that is why you lie awake. I sometimes have to fix my mask several times once I lay down. It really is easiest to check for leaks when the hose isn't plugged in yet. Cover the end and blow out thru your nose and see what escapes around your face. Do you also wear a beard or mustache?

I really hope you figure it out and don't get too discouraged if it doesn't all fit together. I know I have a few good ones and a bad one creeps in and it is hard to remember at times that this is normal, it happens, and everything isn't ruined. "Roooned" :)

Best to you and good luck!

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Re: Newb needs help. Exhaling issues

Post by Brad S » Tue Sep 20, 2022 7:21 am

lynninnj wrote:
Mon Sep 19, 2022 5:00 pm
Well hmmm....the numbers look generally better except for the fact that you weren't actually sleeping
Good morning.
I am curious when you look at the charts where you see I was not actually sleeping? What day(s) or times specifically?
I am not being a wise ass, I am asking because I am truly interested in what you see compared to what I remember.
lynninnj wrote:
Mon Sep 19, 2022 5:00 pm
Yeah, you need to work on the leaks a bit and it wouldnt surprise me if that is why you lie awake. I sometimes have to fix my mask several times once I lay down.
What I have found, is that if I fit my mask sitting up and then lay down, the fit is not the same. What I have also discovered is that I spend about 95% of my night on my side and when on my side if I don't have my pillow just right it is pushing on the mask, causing the leaks. I do hope to get back to using the N30 or P10 nasal masks. I found them less likely to move on a pillow but they still did.

Please correct me if I am wrong but looking at the leak chart, there are plenty of times where my leaks are low or minimal. Wouldn't it make sense that it is based on something I am doing at a given time and not fit in general?
lynninnj wrote:
Mon Sep 19, 2022 5:00 pm
I really hope you figure it out and don't get too discouraged if it doesn't all fit together.
and everything isn't ruined. "Roooned" :)
Nope- not roooned at all. I am going to figure this out for sure.
I really do appreciate all of your help and suggestions.
I hope you had a good night and are having a great day.

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Re: Newb needs help. Exhaling issues

Post by robysue1 » Tue Sep 20, 2022 8:03 am

Brad S wrote:
Tue Sep 20, 2022 7:21 am
Good morning.
I am curious when you look at the charts where you see I was not actually sleeping? What day(s) or times specifically?
I am not being a wise ass, I am asking because I am truly interested in what you see compared to what I remember.
Most of us who are pretty sure about so-called wake-sleep-junk and wake breathing are looking specifically at more ragged breathing with larger breaths that are during the times when you are likely to be in the process of falling asleep or waking up---i.e. the 10-15 minutes (or less) right after you turn the machine on or right before you turn the machine off. Normal sleep breathing is much regular and more shallow than normal wake breathing is.

Here's a screenshot of one of the nights you posted, where I've put red squares round the periods that you were likely awake or drifting in/out of sleep before either fully falling asleep or fully waking up:
Image
Brad S wrote:
Tue Sep 20, 2022 7:21 am
What I have found, is that if I fit my mask sitting up and then lay down, the fit is not the same. What I have also discovered is that I spend about 95% of my night on my side and when on my side if I don't have my pillow just right it is pushing on the mask, causing the leaks. I do hope to get back to using the N30 or P10 nasal masks. I found them less likely to move on a pillow but they still did.
Not a surprise at all. Many people will say that the only way you can really fit a full face mask (or any mask) is lying down in your normal sleep position. Many people will add that it's also important to fit the mask at a high enough pressure so that pressure increases don't trigger the leaks.

And the bigger the mask, the more area there is for it to be bonked out of place by a pillow when you move around. Some people find using a special cpap pillow with cutouts to accommodate the mask helps.
Brad S wrote:
Tue Sep 20, 2022 7:21 am
Please correct me if I am wrong but looking at the leak chart, there are plenty of times where my leaks are low or minimal. Wouldn't it make sense that it is based on something I am doing at a given time and not fit in general?
In one sense yes: You may be moving around and that could trigger a leak.

Or the leaks could also be happening when you are deeply asleep and your face fully relaxes and the seal is broken.

On the data you posted for September 18, I suspect the numerous short leaks are probably caused by movement and the mask hitting the pillow and you either being awake enough to notice or in a light enough sleep to notice and you may very well have unconsciously tugged on the mask in just the right place to stop the leak.

But that big hour long leak from roughly 3:40 to 4:40? If I had to guess, I'd say facial relaxation (i.e. fit) is the more likely culprit.

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Re: Newb needs help. Exhaling issues

Post by Brad S » Tue Sep 20, 2022 8:52 am

robysue1 wrote:
Tue Sep 20, 2022 8:03 am
Most of us who are pretty sure about so-called wake-sleep-junk and wake breathing are looking specifically at more ragged breathing with larger breaths that are during the times when you are likely to be in the process of falling asleep or waking up---i.e. the 10-15 minutes (or less) right after you turn the machine on or right before you turn the machine off. Normal sleep breathing is much regular and more shallow than normal wake breathing is.

Or the leaks could also be happening when you are deeply asleep and your face fully relaxes and the seal is broken.

But that big hour long leak from roughly 3:40 to 4:40? If I had to guess, I'd say facial relaxation (i.e. fit) is the more likely culprit.
THANK YOU!
There is so much good information in your reply and it has begun to help me understand about the SWJ on the charts along with so many other things in your reply.
There is just so much information and not enough understanding on my end. It is so weird, before all of this, I just thought we went to sleep. Easy Peasy. Right? NOPE. Not so much. It's like every night, you do the exact same thing or routine that worked the night before and then you roll the sleep dice never knowing what you will get.
A lightbulb came on when you talked about facial relaxation. Seriously? Who would have thunk that your face could possibly relax so much that it could change the seal of the mask? I sure didn't.
Your reply has given me a few more pieces to the puzzle. It seems like this journey is a 1,000 piece puzzle and I am sitting here with only a handful of pieces trying to put it all together and see the completed picture. With the kindness and help from people like yourself, I am slowly figuring it out. I appreciate the patience from all of you with my endless questions and sometimes pointless posts and rambling.
Thank you.

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Re: Newb needs help. Exhaling issues

Post by robysue1 » Tue Sep 20, 2022 9:06 am

Brad S wrote:
Tue Sep 20, 2022 8:52 am
THANK YOU!
There is so much good information in your reply and it has begun to help me understand about the SWJ on the charts along with so many other things in your reply.
You're welcome!
There is just so much information and not enough understanding on my end. It is so weird, before all of this, I just thought we went to sleep. Easy Peasy. Right? NOPE. Not so much. It's like every night, you do the exact same thing or routine that worked the night before and then you roll the sleep dice never knowing what you will get.
Lot's of newbies are where you are right now.

Oddly enough, most people who have dealt with chronic insomnia problems know that every night is a crap shoot.

One thing about PAPing, however, is that it takes out one of the bad dice: Even on a bad night, your CPAP machine is going to prevent a whole bunch of near suffocations. And that's worth something.
A lightbulb came on when you talked about facial relaxation. Seriously? Who would have thunk that your face could possibly relax so much that it could change the seal of the mask? I sure didn't.
The folks at the DMEs who fit the masks are remarkably ignorant about how to properly fit a mask. And they're usually not of any help in fixing a problem with significant leaks.
Your reply has given me a few more pieces to the puzzle. It seems like this journey is a 1,000 piece puzzle and I am sitting here with only a handful of pieces trying to put it all together and see the completed picture.
That's actually a great analogy. And one that far too few new CPAP users who don't discover a place like cpaptalk never understand.
With the kindness and help from people like yourself, I am slowly figuring it out. I appreciate the patience from all of you with my endless questions and sometimes pointless posts and rambling.
We were all once newbies ourselves. And a whole lot of us, including me, had endless questions and lots of woe-is-me posts when we were dealing with significant CPAP adjustment problems of our own.

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Re: Newb needs help. Exhaling issues

Post by lynninnj » Tue Sep 20, 2022 1:18 pm

Robysue- anyone ever tell you that you ooze niceness? :D

You are one of many people here I have found that have a sharp concise nice way of saying things. There are a lot of you here by the way.

Brad when I was saying it’s too bad you lay awake etc I was going by what you said in your post regarding several nights sleep I’m not looking at the charts and saying that. I’m not good enough yet everything the charts like that.

Robysues explainer, if I have this right is that when looking at the chart you want long periods of sleep where you are not as likely to have the sharp spikes in either direction. Hopefully she will correct me if I’m wrong? Like you want it to look more like a hot dogs and a prickly cactus.

On one of the threads it mentioned Ayrs nasal saline gel and Lanisoh. I have both of them on hand but usually mean towards the lanolin/lanisoh. I can see how the gel would be good for the P 10 masks. I feel like the lanolin helps me get a better seal. Last night however may have been the exception for that because I think I put too much on and it wasn’t sealing up and I felt like my eyes and my chin were getting blown on all night.

otherwise doing ok thanks

Hopefully you had a good night sleep.

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Spare me the nitpicking. I have a serious health issue and I came here to learn to manage it by managing my OSA. Move along if you can’t be kind.

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Re: Newb needs help. Exhaling issues

Post by lynninnj » Tue Sep 20, 2022 1:24 pm

Sorry one more thing- I have had leaky nights where I have slept fabulously and some where I sleep like crap.

If the leak is bad enough I spend my time fidgeting trying to get it to sit straight and not Leak.

One thing I do from time to time so that I can more easily recognize that I was awake when I look at my chart as I will pull the mask forward away from my nose and then re-settle it in. I do this while the machine is running so I will see a spike right around that time.

I noticed on my own charts that I think what is happening when I have leaks is that the machines just not doing all that I can do to keep my throat from closing and keep the tissues in place. The chin up definitely helps though.

I hope that helps in someway.

_________________
Machine: AirSense 11 Autoset
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Spare me the nitpicking. I have a serious health issue and I came here to learn to manage it by managing my OSA. Move along if you can’t be kind.

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Re: Newb needs help. Exhaling issues

Post by robysue1 » Tue Sep 20, 2022 2:27 pm

lynninnj wrote:
Tue Sep 20, 2022 1:24 pm
I noticed on my own charts that I think what is happening when I have leaks is that the machines just not doing all that I can do to keep my throat from closing and keep the tissues in place.
It is worth pointing out that part of the auto algorithms is for the machine to avoid increasing the pressure in the presence of a large leak specifically because increasing the pressure is likely to make the leak worse.

Some auto algorithms will also experiment with lowering the pressure a bit to see if that helps to fix the leak by reducing the size of the large leak.

And finally, if a leak is large enough, the machine cannot track your breathing accurately. Hence it cannot identify when you might be snoring, when you might have flow limitations, and when you might be having hypopneas and apneas, all of which will trigger pressure increases to help keep your airway from collapsing in the first place. And that's specifically why we tell people that if you often have leaks that are both large and prolonged, you have to figure out a way to deal with them.

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Re: Newb needs help. Exhaling issues

Post by robysue1 » Tue Sep 20, 2022 4:03 pm

lynninnj wrote:
Tue Sep 20, 2022 1:18 pm
Robysues explainer, if I have this right is that when looking at the chart you want long periods of sleep where you are not as likely to have the sharp spikes in either direction. Hopefully she will correct me if I’m wrong? Like you want it to look more like a hot dogs and a prickly cactus.
Yep. Wake breathing and SWJ breathing can look like spikes or prickly cacti in the flow rate graph, particularly if you have not zoomed in on the flow rate graph to the point where you can see the individual breaths.

In general, what you refer to as sharp spikes (in both directions) are worth investigating if you think you may be dealing with lots of wakeful periods. But it's also important to remember that even people with normal sleep patterns will have some arousals and a few awakenings every night. But if a wake is less than about 5 minutes long, most people won't remember it, and arousals are just going from a deeper stage of sleep to a lighter one and then back to the deeper one and if they're not caused by anything in particular and they're not too numerous, then they're probably not disrupting your sleep all that much. In other words: The critical idea is that unless there are an excessive number of arousals or wakes or the wakeful periods (or the SWJ periods when you can't seem to get all the way to real sleep) are prolonged, you don't really need to worry about them.

So learn to trust your body: If you wake up refreshed and feel ready to face the new day, whatever wakes/arousals you had during the night were not disruptive to your overall sleep and you don't need to worry about "fixing" them.
On one of the threads it mentioned Ayrs nasal saline gel and Lanisoh. I have both of them on hand but usually mean towards the lanolin/lanisoh. I can see how the gel would be good for the P 10 masks. I feel like the lanolin helps me get a better seal. Last night however may have been the exception for that because I think I put too much on and it wasn’t sealing up and I felt like my eyes and my chin were getting blown on all night.
Yep. Too much Lanisoh can make it harder to get the mask to seal. If you've got a tissue or a hanky by the bed, you can just wipe some of the excess off and that usually fixes the problem.

_________________
Machine: DreamStation BiPAP® Auto Machine
Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: Also use a P10 mask
First joined as robysue on September 18, 2010. Forgot my password and the email account I used to sign up was on a machine that has long since died and gone to computer heaven.

Correct number of my posts is 7250 as robysue + whatever I have as robysue1

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Re: Newb needs help. Exhaling issues

Post by lynninnj » Tue Sep 20, 2022 4:17 pm

robysue1 wrote:
Tue Sep 20, 2022 4:03 pm
lynninnj wrote:
Tue Sep 20, 2022 1:18 pm
Robysues explainer, if I have this right is that when looking at the chart you want long periods of sleep where you are not as likely to have the sharp spikes in either direction. Hopefully she will correct me if I’m wrong? Like you want it to look more like a hot dogs and a prickly cactus.
Yep. Wake breathing and SWJ breathing can look like spikes or prickly cacti in the flow rate graph, particularly if you have not zoomed in on the flow rate graph to the point where you can see the individual breaths.

In general, what you refer to as sharp spikes (in both directions) are worth investigating if you think you may be dealing with lots of wakeful periods. But it's also important to remember that even people with normal sleep patterns will have some arousals and a few awakenings every night. But if a wake is less than about 5 minutes long, most people won't remember it, and arousals are just going from a deeper stage of sleep to a lighter one and then back to the deeper one and if they're not caused by anything in particular and they're not too numerous, then they're probably not disrupting your sleep all that much. In other words: The critical idea is that unless there are an excessive number of arousals or wakes or the wakeful periods (or the SWJ periods when you can't seem to get all the way to real sleep) are prolonged, you don't really need to worry about them.

So learn to trust your body: If you wake up refreshed and feel ready to face the new day, whatever wakes/arousals you had during the night were not disruptive to your overall sleep and you don't need to worry about "fixing" them.
On one of the threads it mentioned Ayrs nasal saline gel and Lanisoh. I have both of them on hand but usually mean towards the lanolin/lanisoh. I can see how the gel would be good for the P 10 masks. I feel like the lanolin helps me get a better seal. Last night however may have been the exception for that because I think I put too much on and it wasn’t sealing up and I felt like my eyes and my chin were getting blown on all night.
Yep. Too much Lanisoh can make it harder to get the mask to seal. If you've got a tissue or a hanky by the bed, you can just wipe some of the excess off and that usually fixes the problem.
Thanks RS!

Does anyone know if the lanolin can actually soften the silicone in the long run?

I am wondering if the ise of lanolin is softening the actual structure. I am on my 3rd cushion in about a month. I still have the old ones to revisit since they only got used about 10 days but wondering if lanolin is actually damaging.

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!
Spare me the nitpicking. I have a serious health issue and I came here to learn to manage it by managing my OSA. Move along if you can’t be kind.