Using CPAP for years, always tired (oscar analysis?)

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Miss Emerita
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by Miss Emerita » Tue May 30, 2023 11:21 am

Stick with 13.5 a few more nights, then bump it up to 14.5.

I'm also curious: do you like having the ramp on? Your starting ramp pressure of 4 is very low -- for many people, so low as to be uncomfortable. If you like the ramp feature, then keep it, but you might experiment with a higher starting ramp pressure.

It makes sense to me that you'd have more CAs with Flex turned on. The little boost in pressure that you get when you shift from exhalation to inhalation can wash out just enough CO2 to delay your "breathe now" neurochemical signalling. If the delay is 10 seconds or more, that will be scored as a CA. But I don't know why turning Flex off would allow your OAs to increase. Possibly just a coincidence?
Oscar software is available at https://www.sleepfiles.com/OSCAR/

danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Tue May 30, 2023 12:12 pm

Miss Emerita wrote:
Tue May 30, 2023 11:21 am
Stick with 13.5 a few more nights, then bump it up to 14.5.

I'm also curious: do you like having the ramp on? Your starting ramp pressure of 4 is very low -- for many people, so low as to be uncomfortable. If you like the ramp feature, then keep it, but you might experiment with a higher starting ramp pressure.

It makes sense to me that you'd have more CAs with Flex turned on. The little boost in pressure that you get when you shift from exhalation to inhalation can wash out just enough CO2 to delay your "breathe now" neurochemical signalling. If the delay is 10 seconds or more, that will be scored as a CA. But I don't know why turning Flex off would allow your OAs to increase. Possibly just a coincidence?
Thanks for the replies, I'll keep it at 13.5 tonight, then boost to 14.5 tomorrow.
I've never had an issue with the 4 ramp being too low, I can breathe just fine. I like it nice and low when I lay down and settle in.
As for the OAs with Flex off, it's definitely not coincidence. Going back to March, I had a run of OAs with Flex off. The OAs were 19 events, 16 events, 25, 31 events. The next night I had turned Aflex 2 on and got OA: 1 event, 3, 1, 5 events.
I think I'm gonna go back to Aflex 2, Cflex isn't doing me any good.


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Miss Emerita
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by Miss Emerita » Wed May 31, 2023 11:35 am

Yes, ugh. Have you tried the suggestions made earlier about the leaks? As for AHI: I would suggest you make just one change at a time. So try one more night with 13.5, leaving Flex unchanged.

Next time you post a chart, could you turn off the calendar? That way we can see the stuff toward the bottom of the left panel, which includes Flex information, as I recall.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Wed May 31, 2023 6:52 pm

Miss Emerita wrote:
Wed May 31, 2023 11:35 am
Yes, ugh. Have you tried the suggestions made earlier about the leaks? As for AHI: I would suggest you make just one change at a time. So try one more night with 13.5, leaving Flex unchanged.

Next time you post a chart, could you turn off the calendar? That way we can see the stuff toward the bottom of the left panel, which includes Flex information, as I recall.
I reread all the suggestions for leaks and none of them apply for my situation. My pillow is flat, I sleep on my side, that website doesn't sell nasal pillow liners and I looked up videos on how to reduce leaks on an airfit p10 and there aren't any. One thing I will try though is sizing down my nasal pillow from M to S. I also tightened both my straps.
I'll post tomorrow with calendar off, I was looking at previous results and forgot to switch it off. Thanks for your help. :)

danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Thu Jun 01, 2023 7:36 pm

Forgot to post last night's.

https://imgur.com/a/hwe7CuR

Leak was better. Woke up at 3:45am and couldn't get back to sleep. This happens a couple times a month.

danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Fri Jun 02, 2023 6:35 am

Thur night:

https://imgur.com/a/0Ag3Uig

Bumped up to 14.5 minimum

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Pugsy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by Pugsy » Fri Jun 02, 2023 6:38 am

danissleepy wrote:
Fri Jun 02, 2023 6:35 am
Thur night:

https://imgur.com/a/0Ag3Uig

Bumped up to 14.5 minimum
How'd you sleep last night?
Did the leaks wake you up?
What about after the last big leak around 4:15 and on...were you asleep?

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danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Fri Jun 02, 2023 4:02 pm

Pugsy wrote:
Fri Jun 02, 2023 6:38 am
danissleepy wrote:
Fri Jun 02, 2023 6:35 am
Thur night:

https://imgur.com/a/0Ag3Uig

Bumped up to 14.5 minimum
How'd you sleep last night?
Did the leaks wake you up?
What about after the last big leak around 4:15 and on...were you asleep?
Slept fine, minimal wakeups. No leaks woke me up. Been very tired all day. I woke up around 5am and by 10am was really tired. That's pretty standard for me though. Haven't had a restful night of sleep in 25 years at least.

danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Sat Jun 03, 2023 6:04 am

Whoa! One of my lowest AHIs ever. Not sure what happened but hopefully it keeps up. I definitely feel more awake than usual.

https://imgur.com/a/CWwy148

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Miss Emerita
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by Miss Emerita » Sat Jun 03, 2023 11:15 am

It's very good to hear you're feeling more rested today! Stick with these settings and keep working on the leaks. I'll be curious whether the smaller P10 pillows help. If they don't, you may need a mask with a little more structure. (One that I liked was the Aloha, but of course that doesn't mean it'd work for you.)

Fingers crossed you're on a roll here.
Oscar software is available at https://www.sleepfiles.com/OSCAR/

danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Sat Jun 03, 2023 2:19 pm

Miss Emerita wrote:
Sat Jun 03, 2023 11:15 am
It's very good to hear you're feeling more rested today! Stick with these settings and keep working on the leaks. I'll be curious whether the smaller P10 pillows help. If they don't, you may need a mask with a little more structure. (One that I liked was the Aloha, but of course that doesn't mean it'd work for you.)

Fingers crossed you're on a roll here.
Thanks! Really hoping this isn't a fluke but we'll see. :) I'll check out the aloha, I haven't heard of it.

danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Sun Jun 04, 2023 6:11 am

OOF

https://imgur.com/a/11jadep

Dunno what to do with these leaks. I tried a 30i mask and they don't work for me. I have a thick beard that makes it hard to get a good seal. One time I tried it without the beard and the latex or whatever irritated my skin and made me break out really bad. Not to mention trying to sleep with the thing on. It's pretty much the airfit p10 or nothing so I've got to make it work.
Edit: I've not tried the Aloha and it looks like something I could use. Can't really afford it at the moment though.

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Miss Emerita
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by Miss Emerita » Sun Jun 04, 2023 11:18 am

CAs are consistently inconsistent. They may just reflect a lot of arousals from sleep, and it's possible the arousals are connected with the major leakage. Hard to be sure. How are you feeling today?

I'm wondering whether you're having some mouth leaks. If you are, you might check out the Jay/Zonker Scunci method:

viewtopic/t184804/Full-face-mask-option ... lit=scunci

I use a Scunci over my mouth tape and keep it in place with two bobby-pins in back. It's very comfortable and completely eliminates mouth leaks.

For the P10, can you shave a tiny bit right under your nostrils to get a better seal? Or would that lead to the skin irritation?
Oscar software is available at https://www.sleepfiles.com/OSCAR/

danissleepy
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Re: Using CPAP for years, always tired (oscar analysis?)

Post by danissleepy » Mon Jun 05, 2023 8:18 pm

Yesterday felt pretty average. I'll check out that scunci method. I can't imagine having mouth leaks, I'm using that hypafix tape and it seals up super tight. I'm pretty sure the leak is just the seal from the pillow to my nostrils. When I wake up randomly in the night I can feel it leaking out of there. I think whether or not I have leaks just depends on how I shift around in the night and knock the mask pillow askew enough to leak.