MountainGoat

I've suffered with seasonal hay fever, allergies and sinusitis all my life and have sensitive skin also, including nose and face. To complicate things further, the ENT said I have very small nasal passages, so much so that when he did the nasal endoscopy, he couldn't get the camera through the right nostril and had to use the left. We spoke about CPAP and using a nasal mask. His advice was to use steroid nasal spray every night. Apparently the dose is so low that it doesn't have any systemic effect and can be used permanently.

When the time came to buy a mask, I opted for the Resmed N30i. It doesn't have anything that go into your nose, it just seals against the underside of your nose and have openings corresponding to the nostrils. The starter pack is supplied with three different sized pillows, so finding one that fits your nose is important. The air pressure inflates the pillow and I find it seals quite well. I'm a side sleeper and find the mask reasonably comfortable overall and will probably be even more comfortable for a back sleeper. The air connection is at the top and swivels in both directions, so it isn't in the way of your arms when you turn around while sleeping. I tuck the hose between the pillow and the headboard and haven't found it to be restrictive or get in the way.

I found that at higher pressures, I ended up breathing through my mouth but tucking a pillow tightly under my chin helped for that and I so far don't find it to be a major issue.

Depending on the pressure you have to use, it may not work for you though.

Ah yeah, the causality v correlation bugbear. I often think the only reason politicians keep funding Statistics Bureaus is because it is so useful to be able to slice and dice statistics until it shows the picture you want it to.

I for example love that if you're unemployed and got so dejected with your job applications being continually rejected that you stop looking for work, then you are no longer deemed to be unemployed, because you're not looking for work!

If you want to read some real eye-poppers as far as statistics go, Google heuristic CPI and look for The Quality Adjustment Method. A link to a fascinating article below. A relevant example as far as CPAP goes, if a newer machine reduces AHI by 50%, then the price of the new machine is reduced by 50%, because it is 50% better than the old machine. That 50% discounted price is then compared with the full price of the old machine. I'm sure you can see where this leads.

And if you can then suppress CPI in this way by adjusting many things, the discount to get from nominal GDP to real GDP is smaller, meaning you can claim more economic growth.

https://larouchepub.com/other/2000/ref_quality_adj_2742.html

Thanks for the detailed information Sierra.

Last night turned out to be a pretty good one, with an AHI of 2.93. It looks like the machine chasing events and then creating others apply to me too.

For the night, I had 1 hypopnea event, 4 OA and 20 CA. 11 of those CA events occurred within 10 minutes of the machine ramping up the pressure to 10 in response to two OA events, 11 and 10 seconds each. The longest of the CA events were 13 seconds, so nothing to write home about. Interestingly enough, if the limit for an event to qualify as an event was set at 15 seconds, I would have had one event the whole night.

Looking at the graphs below, it appears that the CA events dissipated when the pressure dropped below 9.5, so I'll set max pressure to 9.4 for tonight and see what happens. I can live with a few more short OA events in exchange for a lot fewer CA events.

Habit forming is a very good way of putting it. Bad habits, and I have many of those, are unfortunately also habit forming.

The body is very adaptable and will always rather adapt than die. Changing for the better fortunately can use that same mechanism. As an example, I was treated for very high blood pressure in 2016 and because the treatment was so effective, it dropped my blood pressure quickly, although it still was slightly above normal. However, that quick change was enough to make me feel dizzy every time I got up. My blood pressure is now lower than that and I feel fine.

I think this is the mechanism for real change, but it works in both the good and bad direction, depending on what is happening in your body.

The way I understood it is that your body will become used to the higher level of oxygen and undo the changes its made to cope with the lower oxygen saturation caused by OSA.

The OP's experiences are interesting. If her sleep issues didn't cause O2 desaturation, there isn't an obvious reason for the body to have adapted either by changing breathing patterns or making more red blood cells. However, I find the same thing when my red blood cell count is as high as it currently is. Very pink hands and red lips, especially when back at sea level.

I have to add that I was in the same position with buying a CPAP v having another sleep study, which is what the pulmonologist wanted. The cost of that, plus the titration was almost as much as the CPAP, so decided to rather buy the machine as my elevated haemoglobin and haematocrit definitely pointed to an issue with O2 desaturation.

So far, I think it was the right decision.

I have a small fingertip pulse oximeter and found that even while awake and relaxing or working at my desk, my SpO2 would drop below 90%, even going as low as 86%, especially at the altitude I work at (~7,200 feet). This had me ask the endocrinologist treating other issues for a referral to a pulmonologist. The pulmonologist reviewed the sleep study that was done in May 2017 and suggested that I try CPAP.

I asked him how CPAP could possibly help for daytime oxygen desaturation and he explained that the body's 'setpoints' for breathing becomes disturbed with long term untreated OSA and that when that is 'reset' with CPAP treatment, resting O2 desaturation while awake often resolves too. I've only been using CPAP for four days, so way to early to tell but I'm hoping he is right.

I'm sure it is different for everybody, but it did make sense to me.

I have a condition M on my driver's licence (Queensland) due to type 2 diabetes that isn't controlled by diet and exercise. The last medical certificate was valid for two years as the doctor agreed that with T2DM that is well controlled, there is no risk to other road users. The sleep lab that did the sleep study sent me a whole bunch of literature with the report, which I duly ignored as I don't suffer from excessive daytime sleepiness, although diagnosed with severe OSA. It is really up to the opinion of the doctor, in my case the GP, who issues the certificate if your condition impairs your ability to be a safe driver. My only advice is to speak to your GP about the potential issues. Hopefully he or she is a reasonable person that can have a mature discussion. If not, you may need to reconsider the relationship you have with the GP.

Sadly though, in my view there are many other medical conditions that should also require a condition M, but don't. This includes high cholesterol, because you could have a heart attack while driving etc. Blood disorders that could cause a stroke, the use of some ED drugs that could cause sudden blindness etc. etc.

Did the doctor do any other blood tests before referring you for a sleep study? A friend of mine is a haematologist and in his opinion, more GPs should do a simple haematocrit blood test before referring people for a sleep study. It is relatively cheap and significantly less intrusive and way cheaper than an overnight sleep study. His view is that if someone's haematocrit and haemoglobin levels are well within the normal parameters, it is unlikely that they suffer from apnea significantly enough to cause noticeable issues.

Many other physiological and psychological problems can cause fatigue, poor sleep and the need or want to sleep long hours. I for example really struggled with fatigue until hypothyroidism was diagnosed and treated properly.

Hi All,

I started another thread about what experiences people's had with objective medical tests like blood tests to show an improvement possibly due to CPAP, but as a further introduction, reposting my intro from that post here.

I was referred for a sleep study as I suffer from type 2 diabetes, hypothyroidism, hypertension, obesity (31 BMI), polycythaemia and elevated haematocrit, high triglycerides and low HDL cholesterol as well as low testosterone. The doctor who referred me felt that the only way all of these can come together is due to OSA and that treating this will resolve a lot of these issues.

During the sleep study done in May 2017, I was diagnosed with severe obstructive sleep apnea, AHI 31.5. Due to the quality of the sleep study, which by the looks of it from other's comments here are pretty standard, I wasn't convinced that CPAP was really indicated. My reason for this was that the study found only 2.9 events per hour of obstructive apnea when on my back (NREM) and zero for other positions, including during REM sleep, for an average of 1.1 NREM and 0 REM. The hypopnea events though was a lot higher at 31.9 NREM and 26.7 REM. The thing is, I don't sleep on my back and the NREM OA events of 2.9/hr was actually while I was awake, waiting for day to break.

After subsequent visits to an ENT and a pulmonologist, both recommending CPAP, I decided to take the plunge. Interestingly enough, and admittedly after only three nights of use, the machine reflects similar findings to the sleep study with an average of 0.43 obstructive and 0.73 hypopnea events. However, the clear airway events are 4.57 average, pushing the AHI up to 5.73. The sleep study didn't recognise any of the hypopnea events as central apnea but again understand that often happens with sleep studies.

I started using a ResMed AirSense 10 Autoset with N30i nasal mask three nights ago, but have done a lot of reading on machines, masks, OSA etc. before the time and found this forum to be a fantastic resource. We're currently still fine tuning the settings on the machine, so hopefully the central apnea events can be reduced while maintaining the obstructive and hypopnea events at a low level.

What makes life more complicated for me is that I work at an altitude of 2,200 meter (~7,200 foot) above sea level for up to 16 days at a time, with a break of 7 to 10 days at sea level. This also has an effect on my polycythaemia and elevated haematocrit, as the wonderfully adaptable body adjust for the lower level of oxygen by creating more red blood cells.

Thanks a lot for the advice and doing more research. Using Ramp and EPR only for falling asleep makes sense and I'll note those done to try in a couple of days. Given the good results I had for the second part of last night, I want to see how those play out and having more than 6 hours sleep may have some benefits too, not having to change settings every few hours.

Please guide me on inserting pictures. I'll paste a few screenshots from Sleepyhead, if that helps form a clearer picture.

We have 2,000 people working on site, so it will be quite a row of machines : )

I tried to paste a photo of what the mountains look like. It is truly stunning but I'll need advice from someone on how to post a photo. I searched the help and the forum but couldn't find info on inserting pictures.

I had a look at the Kogan Pulse+ Wellbeing Tracker. I'm looking for something that can track SpO2 continuously, but it looks like this only does it when exercising. It's cheap enough, so I may buy one to try. Hopefully one can convince it you're 'exercising' the whole night, if the battery will last that long.

Apparently the Versa and Ionic have SpO2 sensors, but it isn't activated in the software as yet. Hopefully soon.