Over a month on CPAP, AHI 20.53

[Uff Da]

You say you 'don't understand', but it's so glaringly obvious that your leaks are huge and need to be dealt with before getting into finer details of other aspects. I wish you had responded to my idea of a soft cervical collar as it has helped so many with similar problems.

Sorry I didn't respond to your comment directly. But in the original post I said, " I'm trying out different chin straps and cervical collars to see if I can get anything to keep my mouth shut and avoid such bad leakage problems."

And in post 3 I said, "So far I've tried one chin strap and a 2.5 inch cervical collar to help. Last night's records are in spite of the cervical collar. I have a 3 inch collar on order, should arrive tomorrow. I don't know if that will work any better. I fear it might actually be too wide."

So yes, I was already wearing a cervical collar on the nights for which I've posted data. I had hoped that the 3 inch one would arrive today as was expected, so I'd be able to report tomorrow if it was wearable and if it did any more good. Unfortunately, I got word today that the shipment has been delayed, so it will be into next week before I can test that out.

And the earliest appointment I could get at the DME to try different masks was next Thursday. So again, I'm on my own to try to do what I can in the meantime.

I plan to get into my scrap bag of cotton fabrics and make a few mask liners I can try out tonight. One step at a time.

[Julie]

So sorry, didn't register those!

[Uff Da]

So sorry, didn't register those!

No problem. There's no way anyone can keep everything someone has said in earlier posts straight when one is typically reading from many people's situations. And once a thread gets several posts long, most of us probably just read the last few posts rather than reading through the whole thing each time, so it is easy to forget what was said earlier or even get people mixed up.

Anyway, I got a few mask liners cut out to try. Tomorrow I'll try to make my own custom fitted chin strap based more or less on the Ultimate Chin Strap design. I'd really like to solve the chin dropping situation to the point that next week I'll have the option to consider the smaller nasal masks, instead of full face only, which seem more prone to leakage.

[TedVPAP]

So sorry, didn't register those!

No problem. There's no way anyone can keep everything someone has said in earlier posts straight when one is typically reading from many people's situations. And once a thread gets several posts long, most of us probably just read the last few posts rather than reading through the whole thing each time, so it is easy to forget what was said earlier or even get people mixed up.

Anyway, I got a few mask liners cut out to try. Tomorrow I'll try to make my own custom fitted chin strap based more or less on the Ultimate Chin Strap design. I'd really like to solve the chin dropping situation to the point that next week I'll have the option to consider the smaller nasal masks, instead of full face only, which seem more prone to leakage.

I love nasal pillows and Ultimate Chin Strap (to control mouth leaking). 8 years of success. Insignificant leaking despite pressure of 18.

[palerider]

To my knowledge I did not go back to sleep after I awoke about 1:10. If that's the case, all but one of my OAs took place while I was awake!

Fact is, without actual monitoring, you don't know if you're awake or asleep... (unless you're laying there reading or something)...

You can drift off and back without even noticing.

Some people will swear up and down that they didn't sleep during their sleep test, yet the EEG shows, clearly, they did. etc.

[Snoregone Conclusion]

To my knowledge I did not go back to sleep after I awoke about 1:10. If that's the case, all but one of my OAs took place while I was awake!

Fact is, without actual monitoring, you don't know if you're awake or asleep... (unless you're laying there reading or something)...

You can drift off and back without even noticing.

Some people will swear up and down that they didn't sleep during their sleep test, yet the EEG shows, clearly, they did. etc.

One way you might have a more solid clue without an EEG is if you're watching a clock: I can't tell you how many times I've laid in that weird state between being sufficiently awake and asleep and thinking "Oh, I'll just close my eyes for a second" and next thing I know, I see more than 30 minutes went by according to the clock: EEK!

[palerider]

To my knowledge I did not go back to sleep after I awoke about 1:10. If that's the case, all but one of my OAs took place while I was awake!

Fact is, without actual monitoring, you don't know if you're awake or asleep... (unless you're laying there reading or something)...

You can drift off and back without even noticing.

Some people will swear up and down that they didn't sleep during their sleep test, yet the EEG shows, clearly, they did. etc.

One way you might have a more solid clue without an EEG is if you're watching a clock:

Though, that's not at all conducive to betterment of sleep.

[Snoregone Conclusion]

To my knowledge I did not go back to sleep after I awoke about 1:10. If that's the case, all but one of my OAs took place while I was awake!

Fact is, without actual monitoring, you don't know if you're awake or asleep... (unless you're laying there reading or something)...

You can drift off and back without even noticing.

Some people will swear up and down that they didn't sleep during their sleep test, yet the EEG shows, clearly, they did. etc.

One way you might have a more solid clue without an EEG is if you're watching a clock:

Though, that's not at all conducive to betterment of sleep.

That's an entirely different thing, I never said it was better, just a way (unfortunate as it is) to have a clue you might have actually slept without being conscious of it (oh, the irony...) because you could perceive the clock's watching you (there I go again, a second time!).

[palerider]

To my knowledge I did not go back to sleep after I awoke about 1:10. If that's the case, all but one of my OAs took place while I was awake!

Fact is, without actual monitoring, you don't know if you're awake or asleep... (unless you're laying there reading or something)...

You can drift off and back without even noticing.

Some people will swear up and down that they didn't sleep during their sleep test, yet the EEG shows, clearly, they did. etc.

One way you might have a more solid clue without an EEG is if you're watching a clock:

Though, that's not at all conducive to betterment of sleep.

I never said it was better,

I didn't allege that you did

[Uff Da]

Fact is, without actual monitoring, you don't know if you're awake or asleep... (unless you're laying there reading or something)...

You can drift off and back without even noticing.

The same thing happened again this morning. After awakening and using the facilities, I went back to bed with the mask on and just lay there another hour-plus, without sleeping. I swear I was nowhere near sleeping! My head was going, going, going! And my Sleepyhead record shows that of the 11 OAs I had last night, 9 of them were during this period when I swear I was awake. During this period I was aware of my pressure going up on my CPAP and looked to verify that it had just increased from 10 (which is where it was the previous time I looked) to 14 (when I looked). My Sleepyhead shows that it topped at 15, which is my maximum at the moment. I lay there a while and after a bit felt the pressure starting to go back down. So please, someone, what's with this OAs when one is awake? (Guess I'll have something more to discuss with my doctor in ten days.)

Of course, all of my "snores" last night were also during this period. But I expect a lot of the grunts and groans associated with pain in the morning get recorded as snores.

[Pugsy]

These machines have zero way to know if you are asleep or not.
All they can do is measure air flow/breathing.
When we are awake or semi awake our breathing is very irregular if compared to asleep breathing. The machine doesn't know anything except that the breathing is irregular and sometimes those irregularities will get flagged as some sort of apnea event because all the machine knows is that the breathing is irregular.
Call them false positives if you wish or call then SWJ Sleep/Wake/Junk if you wish. They don't count in terms of therapy effectiveness evaluation though because awake events don't count.

When you have a known awake time that is a separate session you can turn off the reporting (using SleepyHead) and those events will be removed from the statistics. If there is no separate session about the best you can do is mentally remove the awake flagged events.

To turn a session on or off....look over on the left side where the statistics are and scroll all the way down to the bottom until you see the different sessions and the green/black little bar things. Just click your mouse on the green part and it will turn red and that session will be removed from the graphs and statistics. To turn it back on just click on it again and it will change back to green.

[Uff Da]

Thanks, Pugsy. That should help get the data closer to real OAs. And because I get up so often during the night, I do sometimes have whole sessions like this where I know I didn't get to sleep. It doesn't help much for those many times that I lie if bed awake before I get to sleep and don't really know how long, though. Hopefully, things will get better and I won't be spending as much awake time in bed in the future.

----------------------

Last night I made two changes:
1. Increased the minimum pressure to 10. Doctor's prescription was 8. Anyone see any reason why the increase should NOT be done? The pressure of 10 feels perfectly comfortable to me. Did the increase help to reduce my AHI from the ridiculous levels it has been lately? Too early to tell. I've had flukes with AHI of 5.5 and 7.7 previously, then went right back to numbers in the 20s and 30s again. It will take several days, I suspect, to see if the minimum pressure increase is worth keeping.

2. Tried out a homemade mask liner. That appeared to work for the first session of the night. But after I awoke and had to readjust everything before going back to bed, the Sleepyhead data appears that it worked at first, but after half an hour or so (presumably after I went to sleep), my mask & liner must have shifted so I got a large leak which continued for much of this sleep session. I awoke about 1:47 with part of the mask liner in my mouth. Yuck! I gave up both mask and liner for several hours and slept without them. Toward morning I used another liner and the mask again, but never got back to sleep. I had a number of leaks during this period, but not as much as during the second session. I'd say it is worth trying again.

[Pugsy]

I see no reason to not try the 10 cm minimum but until you can get the SWJ stuff reduced by actually sleeping sounder for prolonged periods of time it's really hard to know what the machine wants to do in terms of pressure.
The false positives are likely causing the machine to increase the pressure so until the false positives are significantly reduced (by you simply sleeping instead of tossing and turning and laying there awake for prolonged periods) it's really hard to figure out what your pressure needs are.

[palerider]

Of course, all of my "snores" last night were also during this period. But I expect a lot of the grunts and groans associated with pain in the morning get recorded as snores.

Snores aren't grunts, or goans ... they're a vibration in the flow pattern.
These are classic snores on the inhalation part of the breath curve:

[Uff Da]

Snores aren't grunts, or goans ... they're a vibration in the flow pattern.
These are classic snores on the inhalation part of the breath curve:

Okay, just trying to understand this. Wouldn't the sounds one is likely to make when one is in pain with every move also cause a vibration in the flow pattern?

And how do I get a chart like that from my so-called snores?

(As an aside, I never thought that some of these details resulting from that bloomin' apnea would turn out to be rather interesting - and fun.) So much to learn yet, though.