Still Not Sleeping Well

[gimmedarem]

Hey guys, I posted a short while ago about how I wasn't feeling rested despite my data looking solid. Insomnia is definitely a problem. I've always had trouble getting to sleep, but staying asleep had never been a problem. After talking to a member here, I just assumed that I was feeling tired because it had been much more difficult for me to fall asleep than usual because I didn't really remember waking. Fast forward to the last 10 days or so, and I've actually caught myself waking up numerous times throughout the night I'll wake and catch myself snoring and that'll be all she wrote for the next couple of hours. I notice that when I'm initially falling asleep so early on in the night and when I'm it seems like about to hit some really restful sleep I'll wake as well. Can you guys take a peak at my data and maybe point something out that I'm missing.

The first chart is from Friday. I actually slept great this day though I did have trouble falling asleep. The second chart is Saturday and it says I slept better but around 2 I woke and just couldn't fall back asleep. If any of y'all could point me in the direction of what could possibly be going on I'd appreciate it. Thanks so much for your time.

[Pugsy]

Your flagged large leaks are really excessive. So excessive that therapy is likely being affected and there's a good chance that the machine is missing apnea events or snores during the times of large leak.

You need to fix the leak issues first and see if that helps the staying asleep issue.

[Pugsy]

You do need to change SleepyHead so that it is using the correct red line for large leak calculations.

Preferences/CPAP tab and change the 24 L/min red line threshold to something more suitable for a Respironics machine..maybe 80 to 90 L/min for your mask and pressures.
The 24 L/min number is a ResMed number and it won't work for a Respirionics machine.

You still are spending way too much time in large leak though. See the gray LL flagged time over in the Events graph. That's the machine itself flagging the large leak.

[gimmedarem]

You do need to change SleepyHead so that it is using the correct red line for large leak calculations.

Preferences/CPAP tab and change the 24 L/min red line threshold to something more suitable for a Respironics machine..maybe 80 to 90 L/min for your mask and pressures.
The 24 L/min number is a ResMed number and it won't work for a Respirionics machine.

You still are spending way too much time in large leak though. See the gray LL flagged time over in the Events graph. That's the machine itself flagging the large leak.

I changed the calculation. Thanks for your help. I'll look for some tips on reducing the leaks.

[Julie]

Would you like some from forum members?

[gimmedarem]

Would you like some from forum members?

Absolutely! I'm always a bit hesitant to ask for much because I'm nowhere near as knowledgeable as most folks here so I feel a bit like an informational leech. So for sure, any tips you have let me know. It's greatly appreciated.

[Julie]

Ok... do you feel your mask is worn too tight but still leaks (that in fact can make things worse)? Have you e.g. lost or gained even a little weight recently? Have you changed your bed pillows? Wearing (new) face cream that helps mask slide around? Have you ever tried liners from eg. Padacheek.com - they can be quite helpful. Could your headgear just be worn out allowing it to pull the mask around? Any other factors you may not have considered but now see in a new light ?

Don't ever hesitate to ask for help because that's what we're all here for - and one day you may have hints for others.

[gimmedarem]

Ok... do you feel your mask is worn too tight but still leaks (that in fact can make things worse)? Have you e.g. lost or gained even a little weight recently? Have you changed your bed pillows? Wearing (new) face cream that helps mask slide around? Have you ever tried liners from eg. Padacheek.com - they can be quite helpful. Could your headgear just be worn out allowing it to pull the mask around? Any other factors you may not have considered but now see in a new light ?

Don't ever hesitate to ask for help because that's what we're all here for - and one day you may have hints for others.

Thanks Julie.

I keep it fairly snug, but it's still moveable. I have lost and still am in the process of losing weight, 70 lbs so far. No to the bed pillows and face cream. I haven't tried
padacheek but I do make my own liners from old t-shirts. Are padacheeks with the investment? They headgear is new and it isn't worn down so I don't suspect that to be the problem. Nothing off of the top of my head but I'm for sure gonna give it some extra thought.

[LSAT]

Ok... do you feel your mask is worn too tight but still leaks (that in fact can make things worse)? Have you e.g. lost or gained even a little weight recently? Have you changed your bed pillows? Wearing (new) face cream that helps mask slide around? Have you ever tried liners from eg. Padacheek.com - they can be quite helpful. Could your headgear just be worn out allowing it to pull the mask around? Any other factors you may not have considered but now see in a new light ?

Don't ever hesitate to ask for help because that's what we're all here for - and one day you may have hints for others.

Thanks Julie.

I keep it fairly snug, but it's still moveable. I have lost and still am in the process of losing weight, 70 lbs so far. No to the bed pillows and face cream. I haven't tried
padacheek but I do make my own liners from old t-shirts. Are padacheeks with the investment? They headgear is new and it isn't worn down so I don't suspect that to be the problem. Nothing off of the top of my head but I'm for sure gonna give it some extra thought.

Spend some time reviewing these videos..
https://video.search.yahoo.com/search/v ... o&fr=yfp-t

[Pugsy]

Have you lost enough weight that maybe the size of the cushion you need has bee affected in some way?

I don't really have much experience with full face masks so I can't offer much more than general ideas.
Are you still using the Mirage Quattro showing in your profile? If so have you read forum member Janknitz's hints on how to manage it?
It works pretty much with any full face mask that is designed to inflate to seal.
https://maskarrayed.wordpress.com/tamin ... e-quattro/

A little large leak that you sleep through isn't that big of a deal but yours is way more than "a little".
15 to 30 minutes total over the entire night that you sleep through isn't the end of the world but half the night with big gray blocks of large leak is another.

[gimmedarem]

Have you lost enough weight that maybe the size of the cushion you need has bee affected in some way?

I don't really have much experience with full face masks so I can't offer much more than general ideas.
Are you still using the Mirage Quattro showing in your profile? If so have you read forum member Janknitz's hints on how to manage it?
It works pretty much with any full face mask that is designed to inflate to seal.
https://maskarrayed.wordpress.com/tamin ... e-quattro/

A little large leak that you sleep through isn't that big of a deal but yours is way more than "a little".
15 to 30 minutes total over the entire night that you sleep through isn't the end of the world but half the night with big gray blocks of large leak is another.

Update: I feel better than I have, but the grey area is showing up for what is essentially the whole night. Maybe I have a hose leak? I don't feel or hear any air rushing out and when I cleaned it Saturday no water was bubbling, but I bought a new hose just in case.

That could be true. I've had trouble with leaks pretty much since I began treatment with the same model mask that I have now but it never effected me until I started losing the weight, not sure if it's related but it seems possible. I'll check out that video today.

[gimmedarem]

Spend some time reviewing these videos..
https://video.search.yahoo.com/search/v ... o&fr=yfp-t
[/quote]


I watched a lankylefty vid before bed last night, and the mask seemed to be fine before I fell asleep, but obviously something happened because my report said there was a large leak for essentially the entire night.

[Pugsy]

I doubt it is the hose because if it were the hose you wouldn't have the times in no large leak but it hurts nothing to try a new hose.

The problem with extended periods of time in really big large leak like you see on Apr 27 is we don't know for sure that nothing happened apnea wise during those really big leaks or if the machine was just clueless. Now maybe nothing happened but in the face of a leak so big the machine essentially loses auto adjusting function...we just can't be sure.
Look at the flat pressure line from roughly 2 to 6 AM...it shouldn't be totally flat like that. It should still have those spiky saw tooth looking pressure spikes which are the normal test pressure probes that we see on all Respirionics auto adjusting modes. Your machine quit auto adjusting and that's because the leaks were so bad it just didn't know what to do.

If you were sleeping good and saying you were feeling great then I might not be as concerned as much but you aren't saying that.
Leaks of that magnitude can disturb sleep. They can also impact therapy when they are so big the machine loses auto adjusting abilities.

Now maybe your poor sleep is something else. Not everything is related to cpap or sleep apnea but when faced with a known problem on the software report we have to try to fix it to see if it helps with our sleep or not.
A perfectly flat leak line doesn't guarantee that we feel the good numbers but it should at least rule out leaks being a factor so that a person can move on to something else as a potential culprit to be fixed.

[gimmedarem]

I doubt it is the hose because if it were the hose you wouldn't have the times in no large leak but it hurts nothing to try a new hose.

The problem with extended periods of time in really big large leak like you see on Apr 27 is we don't know for sure that nothing happened apnea wise during those really big leaks or if the machine was just clueless. Now maybe nothing happened but in the face of a leak so big the machine essentially loses auto adjusting function...we just can't be sure.
Look at the flat pressure line from roughly 2 to 6 AM...it shouldn't be totally flat like that. It should still have those spiky saw tooth looking pressure spikes which are the normal test pressure probes that we see on all Respirionics auto adjusting modes. Your machine quit auto adjusting and that's because the leaks were so bad it just didn't know what to do.

If you were sleeping good and saying you were feeling great then I might not be as concerned as much but you aren't saying that.
Leaks of that magnitude can disturb sleep. They can also impact therapy when they are so big the machine loses auto adjusting abilities.

Now maybe your poor sleep is something else. Not everything is related to cpap or sleep apnea but when faced with a known problem on the software report we have to try to fix it to see if it helps with our sleep or not.
A perfectly flat leak line doesn't guarantee that we feel the good numbers but it should at least rule out leaks being a factor so that a person can move on to something else as a potential culprit to be fixed.

Gotcha. I read the tutorial you attached and will use the tips tonight. Hopefully I'll get it worked out. I saw the dreamwear is good for side sleepers, so I'll give that a shot if I can't get the leaks under control with the Mirage.

[Pugsy]

You know it's possible that with the weight you have lost that the Quattro simply doesn't want to fit your face optimally.
Might be time to look at one of the newer masks out there.

With the new Respironics DreamWear Full Face mask there's just less surface area touching the skin to need to be kept sealed.
Did you see the video review that Jason did on it?
https://www.youtube.com/watch?v=RUwIa3xnsDQ
Might be worth looking into.