Newbie, waking up frequently with BIPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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lenarose
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Re: Newbie, waking up frequently with BIPAP

Post by lenarose » Sat Mar 18, 2023 5:12 pm

Update: After trying to set the Dreamwisp mask (size medium) on my face before sleeping, I discovered that it's almost impossible to put it on my face at full pressure without having leaks. I decided to use the small Dreamwisp mask instead and my awakenings/leaking seemed to be significantly reduced. However, the small Dreamwisp mask has given me a sore on my nose even after using it for two nights, so I don't think this is a sustainable mask solution.

I also tried the Airfit P10 nasal pillows mask (size small) for a night and I didn't seem to have much of an issue with leaking causing awakenings. But, I woke up with a scratchy/dry throat and had more difficulty falling asleep with the nasal pillows due to the sensation that I wasn't getting enough air into my nose. I've ordered the Airfit P30i mask to try out (I prefer the hose on the top) and my questions are:

1. Does a scratchy throat indicate mouth leaking and why did this seem to be more of an issue using the nasal pillows (vs. the Dreamwisp mask)?
2. Is the feeling of being suffocated/not getting enough air with the pillows suggestive that the mask size is too small? I currently only have the small size mask so I would like to know if moving up to the medium nasal pillows would help this sensation.

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robysue1
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Re: Newbie, waking up frequently with BIPAP

Post by robysue1 » Sat Mar 18, 2023 7:19 pm

lenarose wrote:
Sat Mar 18, 2023 5:12 pm
Update: After trying to set the Dreamwisp mask (size medium) on my face before sleeping, I discovered that it's almost impossible to put it on my face at full pressure without having leaks. I decided to use the small Dreamwisp mask instead and my awakenings/leaking seemed to be significantly reduced.
That's at least some good news.
However, the small Dreamwisp mask has given me a sore on my nose even after using it for two nights, so I don't think this is a sustainable mask solution.
But of course, this is the bad news. Is the sore an open sore or just a sore spot? You could try putting some Lanisoh on a sore spot, but I'm not sure I'd try it on an open sore/wound.

Also, a sore on your nose from the mask might indicate you are still over tightening the head gear.

Also, you might want to consider a Dreamwisp mask liner from Padacheek.

I also tried the Airfit P10 nasal pillows mask (size small) for a night and I didn't seem to have much of an issue with leaking causing awakenings. But, I woke up with a scratchy/dry throat and had more difficulty falling asleep with the nasal pillows due to the sensation that I wasn't getting enough air into my nose. I've ordered the Airfit P30i mask to try out (I prefer the hose on the top) and my questions are:

1. Does a scratchy throat indicate mouth leaking and why did this seem to be more of an issue using the nasal pillows (vs. the Dreamwisp mask)?

Maybe, maybe not. Can you post the data? The scratchy throat could just be a coincidence. The leak line for the night would go a long way towards figuring out whether mouth leaking with the P10 is a significant issue or not.

2. Is the feeling of being suffocated/not getting enough air with the pillows suggestive that the mask size is too small? I currently only have the small size mask so I would like to know if moving up to the medium nasal pillows would help this sensation.

Could be. Although usually the sign that the pillows are too small is that too much of them goes inside the nostril and you can get a sore spot where the too small pillows are hitting the inside of the nostril.

One thing that has caused that sensation for me is when one (or both) of the inner pillow cones gets inverted. So check that out.

If the cones aren't inverted and you are still feeling like not enough air is coming in, you might want to just bump the min pressure up by 1 or 2 cm. And, if you are using the ramp, bump the beginning ramp pressure up by 1 or 2 cm as well.
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ozij
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Re: Newbie, waking up frequently with BIPAP

Post by ozij » Sat Mar 18, 2023 10:01 pm

lenarose wrote:
Sat Mar 18, 2023 5:12 pm
1. Does a scratchy throat indicate mouth leaking and why did this seem to be more of an issue using the nasal pillows (vs. the Dreamwisp mask)?
As robysue says - a chart of you leaks might help us tease that out. And the scratchy throat was a coincidence.

Another, possible' explanation for "why did this seem to be more of an issue using the nasal pillows (vs. the Dreamwisp mask)" is that when you managed to sleep with less arousals, you sleep was deeper, and that's when your mouth, or oro-nasal valve relaxed, and mouth leaking (not mask leaking) happened more.

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lenarose
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Re: Newbie, waking up frequently with BIPAP

Post by lenarose » Mon Mar 20, 2023 12:19 pm

Thank you robysue1 and ozij! This is the data from the night I used the nasal pillows: https://imgur.com/a/mkcKyIh
robysue1 wrote:
Sat Mar 18, 2023 7:19 pm
But of course, this is the bad news. Is the sore an open sore or just a sore spot? You could try putting some Lanisoh on a sore spot, but I'm not sure I'd try it on an open sore/wound.
The sore is an open wound. I might try experimenting to see if loosening the headgear helps, but it seems like the small mask might just be a little bit too small for my nose. I will look into the padacheek liner as well. I moved back to the medium Dreamwisp mask to let the sore heal and it seemed like I was able to solve some of the leaking problem by tightening the upper straps of the headgear. However, the headgear now feels almost uncomfortably tight to prevent leaks (even with the bottom straps loosened)
robysue1 wrote:
Sat Mar 18, 2023 7:19 pm

One thing that has caused that sensation for me is when one (or both) of the inner pillow cones gets inverted. So check that out.

If the cones aren't inverted and you are still feeling like not enough air is coming in, you might want to just bump the min pressure up by 1 or 2 cm. And, if you are using the ramp, bump the beginning ramp pressure up by 1 or 2 cm as well.
I will try your suggestions with the nasal pillows; it doesn't seem like the cones have been inverted so I will try bumping up the pressure. I haven't been able to fall asleep with the nasal pillows again because of the sensation of not getting enough air so I will see if this helps.

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lenarose
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Re: Newbie, waking up frequently with BIPAP

Post by lenarose » Mon May 08, 2023 4:16 pm

Update: I have had good luck with the Resmed AirFit P10 medium nasal pillows. I didn't think it would work for me since I am mainly a stomach sleeper, but I have been able to sleep through the night most nights now without leaks waking me up! I am also feeling much better symptom wise. Thank you to everyone who replied in this thread!!

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Re: Newbie, waking up frequently with BIPAP

Post by chunkyfrog » Mon May 08, 2023 5:21 pm

I like your avatar.
(Don't you just hate it when you sneeze while eating licorice?)

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ozij
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Re: Newbie, waking up frequently with BIPAP

Post by ozij » Mon May 08, 2023 9:27 pm

lenarose wrote:
Mon May 08, 2023 4:16 pm
Update: I have had good luck with the Resmed AirFit P10 medium nasal pillows. I didn't think it would work for me since I am mainly a stomach sleeper, but I have been able to sleep through the night most nights now without leaks waking me up! I am also feeling much better symptom wise. Thank you to everyone who replied in this thread!!
And thank you, for coming back to update.
Knowing something helped helps both those of us who make suggestions because we always learn from it, and those who are only lurking and are to shy to ask questions about their own condition!

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lenarose
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Re: Newbie, waking up frequently with BIPAP

Post by lenarose » Tue May 16, 2023 1:03 pm

chunkyfrog wrote:
Mon May 08, 2023 5:21 pm
I like your avatar.
(Don't you just hate it when you sneeze while eating licorice?)
Thank you :D

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lenarose
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Re: Newbie, waking up frequently with BIPAP

Post by lenarose » Tue May 16, 2023 1:14 pm

I have recently noticed that I am still feeling tired during the day and even though I'm feeling relatively better (as compared to before BIPAP) it seems like my sleep quality may still be lacking. I have been waking up more the past week and I'm wondering if I should be concerned about leaks again. I do have some suspicions that I am not sleeping enough and my sleep hygiene may be contributing as well.

I'm posting my data for the past two nights in hopes that someone could look at it and explain the "leak threshold" on the Phillips Dreamstation. Should I be concerned about the time over the leak redline? I don't understand what Phillips considers to be the leak redline and how it compares to a "large leak." Here is the link: https://imgur.com/a/oTOS4pA

Thank you!

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Re: Newbie, waking up frequently with BIPAP

Post by Pugsy » Tue May 16, 2023 3:53 pm

lenarose wrote:
Tue May 16, 2023 1:14 pm
Should I be concerned about the time over the leak redline? I don't understand what Phillips considers to be the leak redline and how it compares to a "large leak.
You are using a ResMed red line leak threshold instead of a Respironics red line threshold.
OSCAR defaults to the ResMed red line in the sand of 24 L/min. Respironics machines won't be using that number because they report leaks differently. You only had a very minor short lived large leak on the May 14 report...see the gray area??? towards the end of the night?
Leaks aren't an issue for you as long as they aren't waking you up. I suspect you barely hit large leak territory for that short period of time.

Either turn off the red line % of time over red line in OSCAR or set your red line number to something more suitable for a Respironics machine.
And before you ask...Respironics doesn't have a static red line...instead it varies with the pressure and mask used but probably somewhere between 80 and 90 L/min is where that red line is when looking at the top leak line number.

Instead just look at the LL line on the events graph...that's large leak and if you have a large leak it will be flagged and easily seen on that graph.

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lenarose
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Re: Newbie, waking up frequently with BIPAP

Post by lenarose » Wed Oct 18, 2023 5:56 pm

Hi everyone,

I wanted to provide an update on my sleep and see if anyone has any input. Although I feel better than before using the BIPAP, I still find that I don't feel totally rested when I wake up and am struggling a bit with sleepiness during the day. I'm wondering if there is any issue with my BIPAP settings that may be causing this. I'm no longer waking up frequently during the night and my AHI is normally between 1-3. I saw my sleep doctor a few months ago and she said that all my numbers look good.

I'm providing a screenshot from a few nights ago that along with last night where I seemed to have a cluster of hypopneas within the period of an hour. My AHI last night was slightly higher than usual. Here is the link: https://imgur.com/a/TUd5Jr3

Is there an issue with my settings that is contributing to the residual sleepiness? Or should I start looking at other potential factors that could be causing the sleepiness?

Thank you!

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lenarose
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Re: Newbie, waking up frequently with BIPAP

Post by lenarose » Wed Jan 10, 2024 2:39 pm

I'm posting again to this thread in hopes someone might be able to explain my pressure graph to me and help me continue to tweak my BIPAP settings. I've still been experiencing what looks like residual hyponeas and RERAs that my PR machine is not flagging (and experiencing daytime sleepiness/brain fog). To fix this, I've been experimenting with increasing the PS and keeping both PS max and PS min the same number, with my current settings of EPAP 11, IPAP 16 and PS of 5.

I'm confused by the pressure graph and statistics on the Oscar report. The red pressure line and the pressure statistics suggests that the pressure is not going beyond 12.4. Is this meaningful? If the "IPAP set" says 16, does that mean the machine is actually reaching 16 on every inhale breath throughout the night? Should I just disregard the red line and the "pressure" numbers in the statistics chart? Also, does it look like I should continue to increase the max IPAP to address what I think are hyponeas and RERAs?

I also wanted to update that I switched from a generic Amazon mouth tape (the kind that looks like an X) to the coverall stretch tape, and it seems to have really helpful with my leak numbers. I didn't know I was having mouth leaks because the tape was still on in the morning, but my leak numbers have gone down drastically.

Here is my chart from last night with a zoomed in version of one section of the night: https://imgur.com/a/mnAPq3A. I've really appreciated everyone's help through this process. If it is better to create a new thread since this one was started quite a while ago, please let me know!