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90 days in -- How am I doing?
#1
90 days in -- How am I doing?
[attachment=3471][attachment=3471][attachment=3471]  I have been working with my CPap machine for 90 days and have had some big up and downs. I started with a Simplus mask and went to the Mirage Quattro very briefly, the Amara View, and now the AirFit N20 with a chin strap. I was diagnosed with pollen allergies 40+ years ago and have been a mouth breather for a long time. 
       I like the Simplus but it farts alot and even with a liner it leaks a bunch. The Amara View was my next hope but when I roll from side to side it loses it's fit. The N20 works most nights, if my sinuses are bad I switch to the Simplus for a night, but the strap gets hot and a little confining sometimes.
        I am trying to work my way through the Sleepyhead data but would like someone else to look at this data and see if I improved much over the month. 
        Thank you for your time in looking this over.
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#2
RE: 90 days in -- How am I doing?
Hi bbigh1t, welcome to Apnea Board.

I think your data looks pretty good.

I would suggest working your minimum pressure setting higher until it sits around 0.5 lower (or at most 2 lower) than your median Pressure of 10.8.  But this should really be based on a weekly (or longer) average Median Pressure rather than one night.

The minimum pressure setting acts as a target the pressure algorithm is always slowly trying to return to, and if the min pressure is set too low the pressure will drop too quickly between obstructive events, leading to more frequent obstructive events and less restful sleep.

Take care,
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#3
RE: 90 days in -- How am I doing?
Vaughn usually has very good ideas on optimization, and this case is no exception. It looks like your minimum pressure wants to be about 10.5 to head off the flow limitation that is very prominent in your data. This in turn should help with the hypopnea events. An alternative to the chin strap is the soft cervical collar. For many people it is comfortable and works better because it applies pressure to the jaw from behind, rather than pulling back from the chin, which causes more obstruction. It has the side-benefit of keeping the airway better aligned. Just a though you could try inexpensively as you explore options. Good luck!
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: 90 days in -- How am I doing?
Hi bbigh1t,
WELCOME! to the forum.!
You have come to the right place for guidance.
Good luck to you with CPAP therapy and getting it optimized to meet your needs.
trish6hundred
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#5
RE: 90 days in -- How am I doing?
Thanks everyone for the replies. Vaughn, I will adjust up to 8 tonight and see if I have any problems. I noticed in your sig you use 2 liners with your Simplus, is that to keep leaks to a minimum? 

    Rider, how do you size a cervical collar? Isn't that kind of hot? Where is the best place to buy/rent one?

Thank you Trish, I have been lurking for awhile, there seems to be some very nice, concerned people here.

Lee
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#6
RE: 90 days in -- How am I doing?
(05-15-2017, 07:16 PM)bbigh1t Wrote: Vaughn, I will adjust up to 8 tonight and see if I have any problems. I noticed in your sig you use 2 liners with your Simplus, is that to keep leaks to a minimum? 

Lee

Yes. 

Also, I find that when using only one it will get too stretched out to use in about half the time as two when used together, so it's not more expensive for me to use two at a time. A pair of liners will usually last me at least a couple weeks.
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#7
RE: 90 days in -- How am I doing?
I don't use a CC, but those that do, suggest 2-inches larger than your neck circumference. You have to decide the height as best you can, shooting for comfort. Surprisingly, I don't hear complaints about the collar being hot. I used to think these cervical collars were the worst idea ever, but damn if they don't actually work and give some folks a good nights sleep.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: 90 days in -- How am I doing?
the cost is under $10 for the soft foam collar sizes s, m, L, most drug/chemist shops will sell them.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#9
RE: 90 days in -- How am I doing?
I was also surprised that they are not hot.  I was expecting that to be a problem.  I sleep very hot (my wife says I am like a furnace) and I am prone to heavy sweats.  But the one place it never bothers me is under the collar.
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#10
RE: 90 days in -- How am I doing?
I had trouble finding a selection of sizes for cervical collars. The OTC Cervical Collar, Soft Foam, Neck Support Brace, sold by Amazon for $11.50 comes in 2.5", 3". and 3.5" heights and 5 different sizes for neck circumference. I got mine for $10. I see they are now $11.50.  They have sizing instructions for getting the right height. Mine is quite comfortable.
Download OSCAR

Organize Charts
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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