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MNsleeper
Unread post  Post subject: Questions  |  Posted: Wed Jun 13, 2018 12:22 pm

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I am newly diagnosed and am slowly getting used to my CPAP. I use it as much as I can but am not seeing any benefits so far. I wasn’t ever really bad though, I have never felt exhausted during the day and I do work odd hours and haven’t had to miss work because of tiredness. I usually sleep a few hours with my machine then wake up and go back to sleep again with it so about 5-7 hours a night. This is about the same as before I had it so I thought I would do a little experiment.
Last night I didn’t use my machine and setup a camera to record me and used the snore lab app on my phone. I slept from about 10:30-4 with it and looked at the data today. I moved around a little bit but didn’t snore once and didn’t appear to have any issues at at. I didn’t even open my mouth which I thought I have been doing with both my nasal and full face masks. I know this isn’t scientific at all, I have no readings on o2 levels or a purging else but is this something I should bring to my doctor? Do people with sleep apnea have it every night or just sometimes?


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LSAT
Unread post  Post subject: Re: Questions  |  Posted: Wed Jun 13, 2018 2:42 pm

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Location: WI
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What was your original sleep test diagnosis?


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Wed Jun 13, 2018 2:45 pm

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First study showed mild apnea. Ahi of 11. Second one showed moderate with ahi of 22. Almost all events happened while I was on my back.
I did notice in the second study that the chest straps were much looser than the first study. I’m not an expert but aren’t those supposed to be snug to measure breathing rates?


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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Wed Jun 13, 2018 2:46 pm
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I don't know how much truth there is to the "hold over effect" but from what I read the holdover effect is where the airway doesn't collapse as much or as bad for a few nights after a person stops cpap but after 4 nights or so the airway forgets it ever stayed open and the OSA returns in full force. That's what I have heard anyway and why I have seen some places advice discontinuing cpap for a few days prior to a repeat diagnostic sleep study.

So did you maybe not have much going on because nothing happened because of the holdover effect? Dunno...maybe.
What position did you sleep in? Is your OSA maybe worse in one position than another and you didn't sleep in the worse position last night?

Hey Jason...what are your thoughts on the hold over effect? Any truth to it? What I heard from a couple of other sleep techs was..."maybe"


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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Wed Jun 13, 2018 2:48 pm
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The chest or abdominal belt isn't for breathing rate. It's just to measure effort to help distinguish central apnea vs obstructive apnea stuff.
They don't have to be very snug to measure effort to breathe.
With an obstructive apnea you will try to breathe and there will be effort.
With a central apnea you just don't breathe and there is no movement of the chest or diaphragm.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Wed Jun 13, 2018 3:56 pm

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Interesting and thanks for the reply!
I mostly slept on my back which is where the majority of issues surfaced.
It was pretty strange/cool seeing myself sleep.
I am still wondering why I am waking up after about 2 or 3 hours on CPAP. I posted my sleepyhead data in another thread but don’t know if I posted it correctly.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 5:43 am

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Here is a snapshot of some data from last night. I know that I woke up at about 12:55. I don't see any events flagged but in the details it shows apneas and hypopneas. I am still trying to understand what all this data is really showing me.
I started the night with my FFM but since I haven't shaved in awhile it was leaking so I switched right away to my nasal mask for the night.

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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 7:43 am
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Looks like you inadvertently turned off the event flags.
Look down at the bottom of the graphs where you see "Flags" and a little arrow. Click on the arrow to expand the menu and anything you see that is red/black click on it to change it to green/black.

Restart SleepyHead and see if the Event graph now shows proper events.

If it doesn't and everything is green/black....create a new user profile in SleepyHead and import again and see if it shows up in the new profile.

We don't need all those graphs. You can get all that is needed in one image and then if anyone wants additional then they will ask.

Need the AHI stuff on the left and the statistics...hide the calendar and turn off the pie chart (Preferences/Appearance tab remove check mark).
On the right the graphs...
Events
Flow rate
Pressure
Leak
that's all we need. Those other graphs aren't really needed.

Here's an example of a Respironics report.
Image


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 8:32 am

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Thanks! How is this? I broke it down to the segments of the night that I used the mask. I usually keep it on but last night I took it off for awhile in the middle of the night.

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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 9:46 am
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Pretty darn good looking report.
Leaks are NOT a problem unless they are waking you up. No where near being a problem either. Really very minimal.
Your leak line is better than mine.

I see no reason the change anything unless you are having problems sleeping or whatever and the we talk about the whatever it is and try to figure out the problem and then the solution.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 10:23 am

Joined: Sat Jun 02, 2018 11:41 am
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Thanks, glad I could get the report right!
I didn’t used to wake up this much but now it is every two or three hours. I do still feel ok during the day though and I woke up without the machine the other night so maybe it is just what my body is used to now.
My big question is if it is possible to stop using CPAP. I will lose that to my doctor and maybe try an oral appliance or body positioning. I am getting us d to it a little bit really miss just being able to go to sleep without a mask.


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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 10:49 am
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So how long have you been on cpap?
Do you have a copy of your sleep study results? If so, what was your AHI and oxygen levels? If you don't have copy of the report...get one.

Depending on your diagnostic results you might be a candidate for one of the alternative therapies for sleep apnea.
Some sleep doctors do that sort of thing and some don't so you would just need to check with your doctor in that regard.

I don't really prefer wearing the mask either but in my case my OSA was so severe that there wasn't any other viable alternative and after about 3 months or so it sort of grew on me in the sense that it wasn't nearly as annoying.

For the first 3 months I was waking often just from my brain waking me up to point out the fact "hey dude, do you know there is a alien on your nose blowing air up your nose"...I wasn't having any problems really...it was just the brain taking some time to adjust to the new normal for sleeping. So some of your increase in wake ups could just be the brain wanting to alert you to the alien stuck on your face.

Now after 9 years...it's second nature and while I would still prefer not to have to use it I have come to terms with the necessity of it because if I don't use it then bad things happen to my body that are worse than the slight annoyance of using the mask and machine.

Those oral devices...not without potential issues there also. Nothing is a free ride here. Your bite can change....you can have TMJ pain flare ups...sometimes they work decently and sometimes they don't work at all. They don't work well for severe sleep apnea either. Just can't reduce the events well enough.
There is no easy solution. Everything comes with some pros and cons.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 11:46 am

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Yes, I have both reports—done about a month apart. The only reason I even thought that I had an issue was I got really sick with Mono and wasn’t sleeping at all. My tonsils were very enlarged (the doctor who finally diagnosed me with mono said she had never seen bigger as they were practically touching which is why whenever I would fall asleep my airway would close and wake me up). The results of the first study were AHI=11, RDI=15, lowest O2 was 92% for NREM and 93% during REM. Total apnea’s and hypopneas were 53, RERAs were 19 and the longest was 31 seconds. It also states that my restricted AHI was 3 per hour.

I decided to do another study instead of going right on CPAP because I was still a little sick during the first one. The second one was worse though.
AHI=18
RDI=22
Lowest O2= 87% (but that was only momentary and only 1 time)
Total apnea’s and hypopneas=93
RERAs=22
Longest apnea was 32 seconds
Restricted AHI was 7 per hour

I had a total of 144 arousals in my first study and 178 in my second.

Thats about all the data I think you wanted, anything else that would help just let me know!

I have also tried doing some tongue and neck exercises which I think might be helping (tiger yawn, lick the ceiling, etc.). Since almost all my AHI came in the supine position from my jaw falling back I have also tried wearing a cercical collar a few nights. I feel that helps with dry mouth and keeping my mouth closed and isn’t too uncomfortable.

I will try the full mask tonight after shaving and see what happens!

Thanks again for all the information—a whole world of knowledge is coming into light about this disorder! My career depends on it so you can see why I am so concerned, not to mention my long term health!


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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 12:08 pm
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Your OSA is much milder than mine...my AHI was 53 and desats to the low 70s.

How long have you been on cpap?

I know when you joined here but that doesn't tell me how long you have been using it. If you just started cpap not long before you found this forum...please give it some time and let your body and brain get adjusted to this before you do anything else.

It took me over 3 months just for my brain to quit waking me up because there was something weird on my face blowing air up my nose and I really had no issues of any sort with the mask or leaks. It was just the brain not being happy about something being different than normal.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 12:13 pm

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Sorry, the one piece of info I didn’t include!
It’s only been about three weeks so far. I have used it every night except one where I did my little experiment of filming myself. Hopefully I will get more and more used to it and be able to stay asleep longer. My record is about four hours I think.


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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 12:29 pm
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If the diagnostic AHI was more in the single digits I might be more inclined to get on the dental device bandwagon.
Your oxygen levels didn't go in the toilet...so that's a plus.
Good results with a dental device is a 50% reduction in apnea events and that's IF you get good results.
You would need another sleep study using the device to see for sure what results it would give you.

How restful do you think your sleep would be if I came over to your house tonight and poked you with a stick 20 times an hour and woke you up or at least caused an arousal? Heck...even the 11 times an hour????

How old are you? Male or female?

No rush to answer...I gotta some errands to run and I am on my my out the door right now.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 12:38 pm

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Male, 44.

I have heard that the dental devices can help about 50%. However, I guess I am hopeful that it could help me more than that due to my AHI readings being so heavily weighted in the supine position. I am hoping that by keeping the jaw forward (along with the exercises I am doing—I am even taking up the didgeridoo!) it will help my numbers. In both my studies almost all my events were tightly grouped into one or two periods of sleep. So, if you take that 45 minutes out (which, yes, I know you can’t do because we need to look at this as a whole) my AHI would be under 1.
I am all for doing another sleep study. I would rather do a home study if I could, I have seen one of Jason’s videos about his and it looks intriguing. I don’t know if they would let me wear a dental device or use my cervical collar to see if that helps or not. I am also trying to lose some weight, currently I have lost about 10 pounds in the last 6 weeks or so. I am not obese, BMI is about 27 but I would like to get it down to about 25.


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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 3:53 pm
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A dental device along with staying off your back (easier said than done) might be enough to get you where the OSA isn't bad.

A home study using the dental device would probably be an adequate study.

Check your sleep study reports to see if there is any mention as to REM sleep...maybe your OSA is also worse in REM. Mine is 5 times worse in REM than in non REM but supine sleeping makes no change. Go figure that one.

At age 44...can't say as I blame you for wanting to look at the alternatives but don't compromise your health for the next 20 years either by not taking care of the problem effectively. The damage it can do can sneak up on a person.

Investigate the alternatives if for no other reason than to satisfy your curiosity itch but don't give up on cpap in the meantime.
It does get easier and better and you might end up like me...had to sleep one night without my cpap because I sent somewhere and forgot the long hose and I got a real rude reminder how bad I could feel.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 4:21 pm

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REM AHI was 7.6 in the first study and 6.9 in the second.
Supine was 33 and 59 respectively.

I don’t want to hurt my overall health at all. I would much rather sleep with CPAP than have a heart attack or something else. I will continue to explore other options and like I said, I never really felt like I was getting bad sleep until I got mono. I wonder how many ‘healthy’ people would pass under the 5 AHI level if they did a in lab sleep study.

Has anyone here done one of Jason’s home studies? I would have to do a level two I think because of my job


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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 5:40 pm
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I have never done any of Jason's studies but if I was going to do a home study I would do one of his.

I do know someone who is going to have a level II from Jason in the next week or so. I forget if it is this weekend or next weekend.
He wants to compare a questionable level III study to the level II because the one he had said he was asleep and having apnea events when he was in the kitchen eating and fiddling with the pulse ox. Can't say as I blame him there...and that study only came up with an AHI of 7. I would be doubting it also since not only didn't he sleep well but it said apnea events and desats were happening when he was in the kitchen.

Remind me later after he gets it all done and the results and we will see how it went.


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