PutSleepApneatoBed

The excessive mask leaks may be causing the APAP pressures to elevate to a point that is causing difficulty in exhaling.

There are a couple of ways to address that :

1) Leaks are the enemy, so get the best fitting mask you can. That usually involves trying several different types. But persevere with it because it is critically important. Are you currently using a full face, nasal mask or something else?

2) be sure your machine is set for expiratory assist;

3) a chin strap may help with the leaks, especially if you are using a nasal mask.
But I would be wary of mouth taping, especially given what you are experiencing.

4) have your sleep lab set the range of pressures to a narrower range, perhaps two or three cm/H2O on either side of your average pressure usage. A fixed pressure didn’t work for me, because, like most people, I required very different pressures during REM and non-REM sleep. Check your sleep study for those requirements.

Achieving successful Sleep Apnea treatment is a journey, but it is totally worth the effort.

BTW, successfully and faithfully treating the Sleep Apnea may improve your cholesterol levels. It did mine, and that of many of my friends. Specifically, it raised HDL levels and in a very short period of time.

I’m wondering if you could be experiencing a form of sleep paralysis?

Are you taking any sleep inducing meds of supplements? or using an Ozone generating sanitizing machine? I ask, because in my experience, those can sometimes cause sleep paralysis. (But I’m sure there are also other causes.)

I was diagnosed with OSA in my fifties, but, in retrospect, had it from childhood, as did most of my family on both sides (undiagnosed at the time, of course.) Moreover, although not overweight until much later in life, I desaturated severely, below 70% every night. Sometimes as low as 60%.

By the time I was in my fifties, I was experiencing seizures from the brain damage caused by the nightly hypoxemia and after three days of neuropsychological tests, tentatively diagnosed with Early Onset Alzheimers. At the time of the EOAD diagnosis, I had already been diagnosed with, and was in treatment for, the OSA. But six months into treatment, I was still experiencing the seizures, which was the reason I sought out the neurologist.

The neurologist totally ignored the OSA as the possible cause of the abnormal neuropsychological testing findings. But after the neurologist did genetic testing without my knowledge or consent (illegal in 14 states at the time, and merely unethical in the other 36) I changed neurologists. But the time of the appointment with the second neurologist, the curative effect of totally adherent, effective PAP treatment had started to kick in.

It took about four years to recover and fully “ get my brain back”. But considering that I was trying to rebuild my brain after a life time of nightly damage, perhaps the fact that it took a while to do so, should not have been a surprise.

This happened almost 20 years ago. I’m about to turn 76 and I’m doing fine cognitively. But I use my PAP machine absolutely EVERY time I sleep. I minimize mask and mouth leaks and have a residual AHI between 0.0 and 0.3.

Even if you have an AHI of only 1, if you want age well, I would recommend getting to a doc who will treat your SA.

Sierra: SA can be very a life threatening issue in the near term. Surgeons will usually ask you about your sleep status prior to any surgery, because if you have SA they will 1) use different meds and anesthesia; 2) monitor you with great care during and after surgery, probably keeping an anesthesiologist with you at all times for during surgery and perhaps keeping you in the ICU the first night; 3) they’ll make sure you have and use your machine anytime you sleep after surgery.

In an effort to lower post surgical death rates, some hospitals have even initiated pre operative SA testing for non emergency surgeries. I was terrified of going through a knee replacement, but they were able to use a nerve block rather than general, but still took all of the above precautions.

I sympathize. This aging gig is not for the faint of heart. It you aren’t already doing it, I suggest a medic alert bracelet, to give medical personal a heads up as to both the SA and any other problems you might need them to know about if you were unable to communicate on your own behalf. Another idea: keep a copy of your medical records etc., near the front door in case the EMTs come to your home.

DonMidwest: it’s very important to tell your physicians or surgeons that you have sleep apnea. They will monitor you very carefully, make sure an anesthesiologist is attending you at all times, and possibly use different anesthesia medications, if they know you have SA.

Have you tried a chin strap? They worked for me. And they avoid the hazard of suffocating due to taping, because you can still quickly open your mouth to breathe, if need be.

A leaky mask used with a variable pressure machine, such as an APAP, etc. can result in soaring pressures. I found myself trying to exhale against what felt like a hurricane. My normal average pressure was about 11, but it went to 18 with a bad leak. That will wake you up for sure, and probably many times a night.

So, the first order of business is to get the best fitting mask you can find, and eliminate mask leaks. People often have to try five or six to get one that works optimally. You also have to eliminate mouth leaks, so use a chin strap, if necessary.

However, there IS something else that can be done: optimize your pressure settings. Your sleep lab can adjust the pressure settings to a narrow band around your average pressure. That way, even if you experience a bad leak, the upper range of the variable pressures will stay within reason, and you will avoid the feeling of trying to exhale against a hurricane.

Finally, assuming your machine has the expiratory assist setting feature, make sure it is turned on. In general, you should study your user’s manual and familiarize yourself with your machine operations and settings.

Also, when I went from the gen 8 to gen 10 RESMED machines, my residual AHI went from 3.0 to 0.3, and I could feel a huge improvement in my general alertness and physical well being. Net/net, I am quite unconvinced that an AHI of 5.0 is remotely “normal” or acceptable. Even one apnea, if it lasts long enough, can kill you… 5.0 and above is just the level that the insurance companies and the medical system are willing to pay to treat…..

Sometimes you are better off using a nasal mask with a chin strap than trying to eliminate leakage on a full face mask. Many people have to experiment with a large number of masks.