Sierra

It is true that that the AirFit P10 headgear is poor, the straps stretch, and the adjustment clips they give you are next to useless. That said it is easily the most comfortable mask of the 5 different ones I have tried. I now use a Breathewear Halo chin strap to both keep my mouth closed and keep the mask straps in place. I keep intending to cut the straps, overlap them and sew them back together again (to make them tighter). I'm at 6 months and still on the complete original mask.

Karen, what was your AHI at diagnosis, and what is it now? For what it is worth, I never noticed any immediate ah ha benefit. But, after 6 months I do think my sleep quality is significantly improved. My AHI has come down from about 34 to around 3.

Another example an hour or so before waking.

Sure looks like the example in the ResMed Clinician Manual to me. About the only difference is the length of the apnea period. Mine are around 10 seconds, so most, but not all get flagged as CA's.

I can't think of any possible way that the CPAP cleaner could cause pressure in the ear problem. However the CPAP itself could whether or not you use one of these cleaners.

I put the So Clean in the category of devices that are not harmful, but not helpful either. Or, a solution in search of a problem.

This is an example of what my ResMed A10 flagged as Cheyne Stokes in July. It gets highlighted in green. My conclusion is that it is a breathing rate control system instability. This one started with an obstructive apnea, and the instability it caused was flagged as Cheyne Stokes. You can also see that the instability was there before that but not bad enough to get an apnea flag. Flow rate in the top graph, and mask pressure in the lower.

Here is a link to some screening questions to determine if you are at risk of sleep apnea.

SLEEP BANK & Epworth Evaluation

I am also 68 years old, but have only been wearing a CPAP for 6 months. I tend to open my when the pressure from the CPAP gets up, and that causes a loss of air and a high leakage rate when using a nasal mask. I have tried a Mirage Quattro, and AirFit F20 full face mask, but could not tolerate the mask on my face, and the unreliable seal and leakage. So, the short story is that I have not used a full face for any significant time. I have also found that a ResMed AirFit P10 nasal pillow mask best suits me. I also address the air leakage from my mouth with a Breathewear Halo chin strap and paper medical tape on my mouth. I was initially adverse to doing it, but it seems to be the best solution overall, and I plan to continue with the nasal pillows, chin strap, and paper tape on the mouth.

I find it surprising that you have incurred dental damage due to the full face mask. It would suggest you may have been using a pretty significant force to seal the mask. But, your dentist could be right. Obviously something to keep monitoring.

Yes, I do the same. However, one has to be careful about the machine you get for treatment. If you are going to monitor your own results it works much better with an Auto CPAP that has the capability to record detailed data that can be read by SleepyHead. Some machines are just dumb bricks that supply a fixed pressure and record no detailed data. You can't do anything with that except to keep going back for a titration test to determine if your pressure requirements have changed. And unless you have good insurance to pay for that it can be a big Cha Ching!

Have you reviewed the article at the link below which concluded:

"OSA is the major risk factor for developing glaucoma. Studies show strong association between OSA and glaucoma. Complete ophthalmic evaluation should be advised at every follow-up for patients with OSA. Glaucoma patients with obesity and progressive VF damage even under low eye pressure (NTG) should be evaluated for OSA and other sleep disorders. OSA patients treating with CPAP therapy should undergo regular glaucoma screening and IOP monitoring because CPAP therapy may trigger the glaucoma damage and its progression by raising the IOP."

Glaucoma and its association with obstructive sleep apnea

There are two things that I can think of to consider. One is that for whatever reason you have or are bordering on cheyne stokes breathing. Have you expanded your flow rate (use up arrow when cursor is over the area of interest, or keep left clicking) to see what it looks like around the events? You can recognize the cheyne stokes pattern by the rhythmically increasing and then decreasing flow rate with each breath. See this link for an example of what it looks like.

Cheyne Stokes Breathing

Recognizing it is easy. Figuring out the cause is much harder. The most frequent reported cause of central apnea is the use of opioids or similar sedatives. Heart disease unfortunately is another potential cause. Lower blood flow seems to negatively affect the breathing control system. That said I have it from time to time and I know I don't use opioids, and hope I don't have heart disease. I do use bisoprolol (beta blocker) for blood pressure control and I have blamed that, and even had my doctor cut my dose in half. I think the frequency of it went down, but not away.

There are some things that can be done with a BiPAP machine like the AirCurve 10 Auto. It involves the timing of pressure support on inhale. The more direct way is with a ventilator like the AirCurve ASV, but that would be for pretty serious cases of central apnea probably along with other heart or breathing conditions.

The other possibility is what some call sleep wake junk. That is when you keep waking up and going back to sleep. In that situation your body can simply forget to breath and that is flagged as an apnea. It can be recognized by a more garbage looking breathing pattern than the rhythmic breathing of Cheyne Stokes. Some would say that this sleep wake junk is not real apnea, but if you stop breathing, you stop breathing. One possible cause is trying to sleep too long. Most people only need from 7-8 hours per night. If you are sleeping much longer than that, you are likely going to be having wake up and go back to sleep issues toward the end of the night. Here is a video that is quite annoying to watch, but if you can endure it, the guy does give a few bits useful information as to what the various types of events look like.

How to use SleepyHead

Hope that helps some...

I would suggest that the most frequent and significant side effect of CPAP therapy is discomfort from the pressure, mask, irritation, leaks, etc. This in turn causes a significant number of users that have apnea to not use their CPAP. I have seen statistics that suggest from 30% to 50% of CPAP machines are prescribed but after some time are no longer used.

I have heard of some instances where CPAP therapy pressure may have some effect on someone with glaucoma. I believe it is very rare, but if one has glaucoma it is something that you should discuss with your eye doctor and sleep doctor.

This said I'm sure there are many minor side effects or imagined side effects. One I have is some dizzyness about a hour after I get up. I suspect it is somehow related to the inner ear pressure slowly equalizing after a night of therapy. It is a touch annoying, but nothing more than that.

The most serious practical side effect in my opinion is discomfort and resulting non compliance. The non compliance can lead to a number of other issues including heart and stroke problems. It is unfortunate that many give up on CPAP and take on that side effect.

I know you didn't ask, but you state your goal is to get AHI below 7. The normal treatment standard is to get AHI below 5, and many get well below that and some close to zero. Is there a reason you only strive for 7 or less?