Top Topics
I don't want to criticise the work of a fellow sleep tech without all of the data to hand, so please take the following with a large pinch of salt. Having saifd that, your results say that you are getting a butt-load of central (AKA clear airway) apnoeas. These are corrected by the difference between your pressures (and the timing settings but I don't know what they are), which indicates your machine breathing in and out to fill in the gaps where your muscles aren't breathing. In you case however, the difference between your pressures is just 4 cmH2O which is very low. It just may have been effective in your sleep study, but it would be extremely unusual if this were the case. Setting a BiPAP properly is quite complicated and very few people, even amongst sleep techs, know how to do it. I don't know how the system works where you are, but it may be worth you asking some questions to see how much your sleep doc and the staff at your sleep lab really know about using BiPAP. If you are not satisfied that they are experienced and competent you may need to go somewhere else.
You would think surgery would be effective, but the literature, and international standard practice, are quite clear that it is not. There is no surgery that is approved as successful for treating OSA. There are plenty of surgeons who will do them anyway, and there is the occasional random success, but there is no surgery that has demonstrated repeatable, reliable success. Also, they tend to be very painful, have a long recovery period, have a high rate of post operative infection and, in the rare cases that any improvement occurs it usually reverts within 10 years. Every doctor I know (except some surgeons) says avoid OSA surgery like the plague. Surgery also tends to be very expensive and, because the success rate is so very low, insurance companies generally won't touch it.
CPAP is not for everyone, and whether or not you use it is your choice, but I would suggest you consider that the problems you describe can be overcome. It may well be worth the effort.
105 per hour or 105 for the whole night? and if it for the whole night, how many is it per hour?
I know I mentioned this before, but It sounds like the Respironics DreamWear under nose mask may suit you well. Google it to get an idea.
Thanks for the Kudos Orvwik. It's fantastic that you are doing so well. I hope that your improvement continues. Glad to be of help. I am a big believer that education has a very positive on outcomes of PAP therapy, which is why I post here.
The size of your face is not necessarily relevant. The measurement that matters for fitting a Quattro is the distance between the bridge of your nose and the dip just below your bottom lip. You may have a big head/face but this distance may be quite small, or vice verca. Regardless, if you are getting this problem then any size Quattro will almost certainly cause the same problem. You are better off looking into a Respironics Amara View or, failing that, a Fisher & Paykel Simplus (google for images). The Simplus is softer on the bridge of the nose, and the Amara View doesn't touch it at all.
If your sore throat is being caused by dryness, then increasing the humidity should reduce the soreness. Turning up the temperature of your heated tube will prevent rain out (condensation inside the mask and tube). So, if you are dry/sore increase humidity. If you are getting rain out then increase the tube temp.
If you take the mask off, the machine will always go up to max pressure. It's part of the leak compensation mechanism. Because there is a massive leak the pressure goes right up to compensate.
How is your machine set? Is it a CPAP or an auto? It is possible that one of the settings is not right which is causing your problem, but its hard to tell without knowing what the settings are.
By the way, your CPAP machine blows plain old air, not oxygen.
It is possible that your oxygen was dropping lower when using your BiPAP because it was allowing you to get in to REM sleep which previously you were not due to you sleep apnoea. Having said that, if it is set correctly your oxygen level should not be dropping that low. Did you have a sleep study with your BiPAP on? The settings you describe seem rather odd. There is very little difference between your IPAP and EPAP, and it is the difference between these pressure which determines how much extra air the BiPAP helps you breathe. Your doctor should probably be looking in to that. Due to its relative complexity, BiPAP can only be set in a sleep study.
That is an interesting solution to your problem. To clarify a few things: all CPAP does is prevent your airway from being blocked. The regulation of your sleep is entirely natural. If you have OSA then your sleep is not natural when you are not using your CPAP machine because it is being constantly disrupted by stoppages in your breathing (sorry about the double negative).
Sleep cycles are not 30 - 45 minutes. They generally average about 90 minutes but can be a bit longer at the start of the night.
If you have OSA for a long time and then start using CPAP, your brain can take a while to get back to normal sleep cycles again. It has had so many years of disrupted sleep that, when the disruption is removed, it gets all excited about being able to sleep properly and you have way more of the deeper stages of sleep that you have been missing out on than would normally be the case. It's called rebounding. It can leave you feeling very groggy in the morning. If this is what is causing you trouble then it should pass in time (sorry, can't be more specific).
I have friends who have fitness trackers with a vibrating alarm. They think it's great - wakes them reliably without disturbing anyone else. Have you tried anything like that?
