decker12 wrote: ↑Thu Oct 27, 2022 9:11 pm
lynninnj wrote: ↑Thu Oct 27, 2022 4:07 pm
Hopefully soon you will be able to lower your AHI as well.
Out of curiosity, what AHI should I be shooting for? I'm pretty happy with having 33 AHI during my initial sleep study, to being reduced to less than 3 a night with my CPAP machine. Note that my AHI remains under 5 regardless of which mask I wear.
There are a lot of people who swear that you have to get your AHI super low (i.e. consistently below 1) in order to have your xPAP therapy "optimized".
But there's more to optimizing xPAP than achieving super low AHI night after night. Sometimes the work needed to reduce the AHI from 3ish to less than 1 causes more disruption to your sleep than the marginal benefit is worth. (That's certainly true for me.)
At a certain point the question has to become:
What's the overall quality of your sleep? In other words, are you able to get to sleep quickly? Do you have few or no wakes during the night? When you do wake up in the night, do you get back to sleep quickly? And, most important of all,
do you feel rested when you get up in the morning?
For some people (again, I seem to be one of them), the machine will typically score enough events when I am
transitioning to sleep to keep the AHI from consistently being below 1. But these events would likely not be scored on a real in-lab sleep test and I discount them as
sleep-wake-junk or SWJ for short. If I'm feeling rested in the morning, it doesn't really matter if my overnight AHI = 0.5 or if my overnight AHI = 3.5. Once the AHI gets up to 4, I usually do feel it because at that point there is usually a cluster or two of events that did happen when I was mostly likely asleep.
I also make a point of judging how
rested I feel when I wake up
before I look at the data. And I try really hard not to let a "bad" AHI ruin how I feel if I'm actually feeling pretty good when I wake up. Conversely, there have been plenty of days where I've woken up feeling pretty lousy, but the AHI is less than 1. Why? Because typically on those nights I simply did not sleep very well in terms of things that are
not directly related to OSA. Sometimes the problem is as simple as I'm coming down with a head cold. Other times, I spent a lot of time tossing and turning, but the SWJ breathing was not ragged enough to get flagged as OAs, Hs, and CAs. Sometimes my aerophagia is acting up and I kept waking up to turn the machine off and back on in order to give my poor stomach a bit of a break in terms of the pressure. Sometimes it's as simple as I got to bed really late even for me (3:00 AM or later) and still had to force myself to get up before 8:30 AM because of something going on at work or because of an early morning doctor appointment.
With the P10, even though the myAir app doesn't show it (myAir always thinks I have a 5/5 mask seal), I know I definitely have mask leakage especially when I roll over and the thing rolls up along my face and comes out of one nostril. I can hear it, and then of course I have air blowing all over my face until I mentally wake up a bit and fix it.
Two things:
1) The my Air app's 5/5 mask seal score is based on the entire night and heavily weighs whether your median and 95% leak rates are below the Resmed Redline of 24 L/min. It's quite possible that your leaks are much, much smaller than 24 L/min and it also sounds like you tend to wake up and
fix the leak really quickly. So from the
machine's point of view, those leaks are trivial: They're not affecting the efficacy of the xPAP therapy at all because they are either too small or too short to matter. But from
your point of view, those leaks are highly disruptive of your sleep architecture because they're causing mini-wakes every time you try to move around in bed and because you find that you have to tighten the headgear far too tight just to get a seal that might let you roll over in bed.
2) With the P30i mask, you don't wake up to the sound of leaks all night long. That means you are likely getting better quality sleep in terms of sleep continuity. And that could actually mean that you are moving around
less in bed. And the moving around less in bed is what's triggering the back ache.
The problem, of course, is that you want nice continuous sleep that still provides enough movement in bed so that your back isn't sore when you wake up. It could be that if you continue to use the P30i, your brain will eventually "get caught up" on continuous, good quality sleep and then start moving around in bed more frequently so that the back also doesn't get sore every night.
That's why I have to tighten the thing so much, to keep it in place when I switch positions during sleep. I don't consider myself a vain person but waking up with red bands along my cheekbones which persist for hours, like I've been wearing a diving mask, just doesn't look or feel right. But the cream sounds like a good idea.
You are right:
1) You should not have to tighten the headgear on the P10 so tight that you have red bands along your cheekbones that last for hours.
2) It may be worth trying the lanolin cream to get a better seal.
But also note this: If you manage to eliminate those pesky leaks with the P10, your brain just might decide to move around less during the night when you're using the P10 and the backache might become an issue with that mask as well.
I'll also throw this idea out there as well for trying to fix the irritating leaks with the P10: Since the P10 has the hose attached at nose level, the hose typically drapes across your chest, and this can make it more difficult to turn over because you have to "move the hose" at the same time as turning over. If you don't move the hose, the weight of the hose can pull the mask off the nose. There are two potential fixes for this problem:
(1) Hang the hose. Find a way of routing the hose over your head and securing in a way that gives you the freedom to turn over without having the hose pull the mask away from your face. You will need to work this out when you are awake and practice turning over to make sure you don't dislodge the hose from whatever you are hanging it on. You also need just enough slack in the hose between the hanging point and the mask to allow free movement from side to side without the hose sagging onto your face.
(2) Hug the hose while you are sleeping on your side. And then keep hugging it as you turn over in bed. That way the hose moves
with the mask and your body and it's less likely to pull the mask away. In order to do this, you will need to run the hose
under the covers. Again, you may want to practice this technique while awake in order to see whether that helps prevent the nasty leaks that keep waking you up when you try to turn over while wearing the P10.
The idea in both 1) and 2) is to fit the P10 as loose as possible and then experiment with the machine on and while you are awake to see if you can figure out a way of turning over that minimizes the chance that the hose's weight is pulling the mask away from your nose because you're not moving the hose along with the mask when you turn over.
I'll end with this question:
Do you actually feel
rested after a night of fighting the leaks with the P10? Or is it just that while you know your sleep wasn't great, you are glad that there's no backache?
