I need some advice with my sleep apnea situation.

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
cpap2994
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Re: I need some advice with my sleep apnea situation.

Post by cpap2994 » Sun May 14, 2023 7:38 am

Pugsy wrote:
Sun May 14, 2023 7:28 am
A machine that will go higher than 20 cm isn't going to do your aerophagia issues any favors. It is not a magic miracle worker.
Yes it will allow a greater pressure support than your EPR can offer but it's a long shot that will resolve your issues with the aerophagia just because you can use 4 or 5 PS....you are still going to need the higher pressures that cause the belly issues.

How much...if any...nasal congestion did you have last night?
Yesterday nasal congestion wasn't that bad honestly, I'm not sure how to "answer" this question because I do feel I'm breathing currently "a lot" with my nose like the "most" I ever did, but I suffer from Turbinate I think is the name on English all my life, and the "solution" I always got offered for it was to get the surgery but I never did it, just using spray's and antihistamine currently.

Maybe should I get the surgery for this? not sure if this can help to be honest with the current situation.

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Re: I need some advice with my sleep apnea situation.

Post by Pugsy » Sun May 14, 2023 7:49 am

What is your humidifier's humidity setting?

Where are you located?

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Rubicon
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Re: I need some advice with my sleep apnea situation.

Post by Rubicon » Sun May 14, 2023 8:19 am

Can you elevate the head of the bed?

How much/when do you have caffeine?

Do you smoke?

What time is your last meal vs what time do you go to bed?

A SleepHQ file might be helpful to see how a BiPAP might help.
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Rubicon
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Re: I need some advice with my sleep apnea situation.

Post by Rubicon » Sun May 14, 2023 8:35 am

Ever see a GI guy to see if you have an incompetent LES?
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Rubicon
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Re: I need some advice with my sleep apnea situation.

Post by Rubicon » Sun May 14, 2023 8:42 am

Rubicon wrote:
Sun May 14, 2023 8:19 am
A SleepHQ file might be helpful to see how a BiPAP might help.
Include this one:

Image
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cpap2994
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Re: I need some advice with my sleep apnea situation.

Post by cpap2994 » Sun May 14, 2023 9:35 am

Pugsy wrote:
Sun May 14, 2023 7:49 am
What is your humidifier's humidity setting?

Where are you located?
The humidity level is 4, and Portugal.

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cpap2994
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Re: I need some advice with my sleep apnea situation.

Post by cpap2994 » Sun May 14, 2023 9:44 am

Rubicon wrote:
Sun May 14, 2023 8:19 am
Can you elevate the head of the bed?

How much/when do you have caffeine?

Do you smoke?

What time is your last meal vs what time do you go to bed?

A SleepHQ file might be helpful to see how a BiPAP might help.
I can try doing it.

I drink 2 times a day, I'm drinking ( https://www.dolce-gusto.pt/capsulas-caf ... no-intenso ) this one (2 capsules a day)/ I drink one as soon as I wake up and the other over the day not a specific time usually when I feel like I'm falling asleep, but at least 6-8 hours before I'm going to sleep.

No I never smoke.

between 4 up to 6 hours prior the time I go to bed. I don't have a specific time for dinner but it's at least 4 hours prior.

I will look for that program to post the results here in the upcoming hours.

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Re: I need some advice with my sleep apnea situation.

Post by Pugsy » Sun May 14, 2023 10:10 am

No good, quick and easy options here.

You got really bad aerophagia when the max pressure was 10 and you were maxed out and sleeping on your back...is that correct?

You get bad aerophagia still yet on your side with the max at 20 and the machine maxed out at 20 even when on your side?
Is that correct? That last 2 hour segment would be acceptable if the belly issues weren't a big problem.
It appears that side sleeping along with letting the machine try to deal with airway issues does seem to at least reduce the AHI. If AHI was all we worried about we could accept that but we have to factor in how we sleep and feel and just how much the aerophagia issues mess with our results.

Your doctor is an incompetent ass with being okay waiting 6 months of essentially not even minimal improvement of the AHI at sub optimal pressures....ludicrous .......finding a non incompetent ass isn't always easy or quick.

All I know to offer for right now....try again with the 20 max setting and side sleeping so we can get more of a feel for how well (or not) it works than the 2 hour segment offers.

In terms of how much does the physical nasal issues contribute to things here as in FLs or pressure needs or therapy...that's an unknown at this time. Right now there's no way to know just how much of an impact your nasal issues might be having on the sleep disordered breathing problem. I am sure there is some impact going on but how big of a part it might play is unknown and we just don't know how much improvement or not would come from nasal surgery.
In general though anything we do to help our breathing all the time will also help nighttime breathing in some fashion.

At some point in the next few days lets try the Mirage FX nasal mask you have in your possession. Sooner than later most likely. Lets rule in or out using a nasal mask as an option that may or may not result in lower pressure needs...but worth at least trying.

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cpap2994
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Re: I need some advice with my sleep apnea situation.

Post by cpap2994 » Sun May 14, 2023 10:29 am

Rubicon wrote:
Sun May 14, 2023 8:35 am
Ever see a GI guy to see if you have an incompetent LES?
I haven't

Here is the link for the Sleephq

May 10: https://sleephq.com/public/a8f99900-c31 ... 748db8e165
May 11: https://sleephq.com/public/3666cf0c-d81 ... 519d0c9368
May 12: https://sleephq.com/public/305ada5e-dcf ... b34dcccd0c
May 13: https://sleephq.com/public/82dc3540-60e ... 4035473a90

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cpap2994
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Re: I need some advice with my sleep apnea situation.

Post by cpap2994 » Sun May 14, 2023 10:46 am

Pugsy wrote:
Sun May 14, 2023 10:10 am
No good, quick and easy options here.

You got really bad aerophagia when the max pressure was 10 and you were maxed out and sleeping on your back...is that correct?

You get bad aerophagia still yet on your side with the max at 20 and the machine maxed out at 20 even when on your side?
Is that correct? That last 2 hour segment would be acceptable if the belly issues weren't a big problem.
It appears that side sleeping along with letting the machine try to deal with airway issues does seem to at least reduce the AHI. If AHI was all we worried about we could accept that but we have to factor in how we sleep and feel and just how much the aerophagia issues mess with our results.

Your doctor is an incompetent ass with being okay waiting 6 months of essentially not even minimal improvement of the AHI at sub optimal pressures....ludicrous .......finding a non incompetent ass isn't always easy or quick.

All I know to offer for right now....try again with the 20 max setting and side sleeping so we can get more of a feel for how well (or not) it works than the 2 hour segment offers.

In terms of how much does the physical nasal issues contribute to things here as in FLs or pressure needs or therapy...that's an unknown at this time. Right now there's no way to know just how much of an impact your nasal issues might be having on the sleep disordered breathing problem. I am sure there is some impact going on but how big of a part it might play is unknown and we just don't know how much improvement or not would come from nasal surgery.
In general though anything we do to help our breathing all the time will also help nighttime breathing in some fashion.

At some point in the next few days lets try the Mirage FX nasal mask you have in your possession. Sooner than later most likely. Lets rule in or out using a nasal mask as an option that may or may not result in lower pressure needs...but worth at least trying.
When I was using min 4 max 10 I didn't had problems with aerophagia but AHI was always 75+ for the whole month.

Today sleeping on my side with the max at 20 I did have aerophagia, there was a pain on my right side, and I relieve this after farting a lot was something that lasted for less than 30 minutes, now I feel "okay" like don't really feel uncomfortable or nothing, is just when I wake up, for the first hour max. I don't mind "waking up" like that if I'm not having AHI's (seems like I had in those 2 hours like 4 or less) and if is not dangerous.

I will try again tonight with the max at 20 and will try to get a consult with a different Dr. here aren't many specialist so usually for at least 2 weeks they don't have a free space for a consult but tomorrow I will call everyone to see.
I read somewhere that using a neck foam brace can help when sleeping too but not sure if that can be something, I can try to order one from amazon ?

And okay in a few day's we try with the nasal mask to see if there is difference.

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Julie
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Re: I need some advice with my sleep apnea situation.

Post by Julie » Sun May 14, 2023 10:51 am

Were you on your side when snoring so much last night? I would have thought you were sleeping on your back from the results. i would really ask the 'nose' doctor (ENT) about the surgery because it is quite common, pretty safe, and would help a lot I believe - whatever else might be a problem, that seems like a very big one.

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Re: I need some advice with my sleep apnea situation.

Post by Pugsy » Sun May 14, 2023 11:00 am

cpap2994 wrote:
Sun May 14, 2023 10:46 am
I read somewhere that using a neck foam brace can help when sleeping too but not sure if that can be something, I can try to order one from amazon ?
Using a soft cervical collar is something you can try and yes, you can probably get one from Amazon.
Will it reduce the pressure needs????? Dunno but it isn't expensive to at least try. It might and it might not but I am always for trying anything that "might" improve things.

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Re: I need some advice with my sleep apnea situation.

Post by Pugsy » Sun May 14, 2023 11:07 am

Julie wrote:
Sun May 14, 2023 10:51 am
Were you on your side when snoring so much last night? I would have thought you were sleeping on your back from the results. i would really ask the 'nose' doctor (ENT) about the surgery because it is quite common, pretty safe, and would help a lot I believe - whatever else might be a problem, that seems like a very big one.
First segment with horrible AHI and snoring was with the max pressure setting way too low. I don't think it mattered what position he was in.

Last 2 hour and halfway decent segment last night was on his side with max pressure hitting 20 cm for the bulk of the night.
Flow limitations and snores were still active but a lot less so than the segment with pressure settings way too low.
It's obvious more pressure is needed but with just about any pressure this person has some significant aerophagia issues so for now reducing the AHI is probably the most important goal if we are looking at AHI, FLs, or snores.
And hope to not make the aerophagia worse which is likely going to be difficult chore.

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Rubicon
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Re: I need some advice with my sleep apnea situation.

Post by Rubicon » Sun May 14, 2023 11:58 am

I think you should get a camera and do some all-night monitoring. IMO you need plain 20.0 EPR 3.0 cmH2O (which is really like 17 cmH2O). That said, there are a couple brief areas where slightly lower pressure maintains airway so that might be a good rock to turn over.

Consider cervical collar?
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
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Rubicon
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Re: I need some advice with my sleep apnea situation.

Post by Rubicon » Sun May 14, 2023 12:07 pm

This is area where pressure drops to ~17.5 (or 14.5 for all you EPR aficionados) and airway cannot be maintained (AKA the Jason Premise - APAP is bad cause it needs events to work).

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Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.