annual appointment questions

Tomorrow I have a follow up with Neurologist/Sleep Doctor. It'll be a year on cpap in September. I'm not sure what to discuss. I'm definitely sleeping longer than pre cpap. I still have occasional insomnia when I wake in the middle of the night, but the awake times are shorter maybe 30 minutes as appose to hours. I'm still struggling with masks but have narrowed it down to 3. My AHI is looking good always below 2. What baffles me though is I still have daytime sleepiness, to the point where I often HAVE to take a short nap to get through the day. I go to the gym 3 times a week faithfully and walk every day, yet I haven't lost a pound. I'm drinking plenty of water and eat tons of vegetables from our own garden. Sure I do love to snack, always have, but I've decreased the calories there too. I'd love to increase the exercise even more but I just don't have the stamina. I am extremely active with my family. I also have lots of arthritis pain in my back, knees and hand. I swore it just had to be my thyroid preventing me from losing weight, but endocrinologist says its testing fine.

Do you know what your pressure settings are? Maybe your minimum pressure should be raised. I find I feel better if I adjust my minimum pressure a little higher than what the machine wants to auto me to.

Do you have software and look at your own data?

Yes I have the software. Originally I was on auto settings 8-18. After many months I switched it myself to 11, and have kept it there for a few months now. Do you think raising it will cause more leaks?

trytryagain wrote:Yes I have the software. Originally I was on auto settings 8-18. After many months I switched it myself to 11, and have kept it there for a few months now. Do you think raising it will cause more leaks?

If it were me, I'd experiment with a higher minimum pressure. I wouldn't just accept the pressure the auto machine chooses. I feel a lot better at 13, even though my auto machine is happy with 10. If it didn't work better, I'd drop the pressure back down.

Yes, it might leak more. If so, fix it. If a higher pressure gives better therapy, you should use it, even if you have to deal with more leaks.

I'm playing with min and max settings right now. I'm 2 weeks into an APAP after 2 years on fixed pressure CPAP. I'm finding that the sleep study was probably right on my 9cm prescribed pressure, although the Intellipap likes to raise pressures from time to time if I let it adjust the range. I've found that generally I average 9.4cm and max out around 10.5cm to 11cm with short times at the high numbers. My hypopnea index rises linearly with pressure. Apnea index might occasionally record 1 or no apnea occurrences at 9cm set statically and none if I let the firmware adjust itself.

Typical for me might be AHI around 4 to 5 if I set it for 9 min and 9 max. If I let it range from 8 or 9 up to 13, my AHI might be 16.5 . In both cases, AI=0 and HI=the reported AHI, telling me that all my events are hypopneas and they increase with pressure.

I'm using a nasal pillow mask and sometimes have lip flutter. I use a chin strap and that helps. I have a short beard and tend to lose seal with any mask that covers my nose and mouth. The beard also precludes taping the lips. I've tried Polygrip tape and that tends to turn to gum after a few hours. Still searching for the right combination of mask, pressure, and lip leak cures.

DaveLP wrote:The beard also precludes taping the lips. I've tried Polygrip tape and that tends to turn to gum after a few hours. Still searching for the right combination of mask, pressure, and lip leak cures.

Placement of the tongue is the key to preventing mouth air leaks and mouth breathing. Perhaps you could make a "Do It Yourself" thingy from boil'n'bite mouthguards.

This link is to a long discussion about frequenseeker's "DIY" (Do It Yourself) mouthguard:

Topic started by frequenseeker Dec 01 2004 subject: mouth leak solution, cheap DIY oral appliance
http://www.talkaboutsleep.com/message-b ... php?t=4750

Picture of snork1's creation:
viewtopic.php?t=3265

Pictures of a one piece design by freelans:
http://www.talkaboutsleep.com/message-b ... 1242#71242