AHI gone a bit wrong

[Boxermum]

Hi All

I am new to the forum but not new to OSA. I was diagnosed in 2019 and have used the same machine (resmed airsense 10) and mask (f20) without any problems until April this year. Then things started to go wrong. Prior to April my events went above 5 once or twice a month. In April it was 16 times and the highest was 10. In May it was 29 times with the highest being 13.9 and June seemed to start off ok but looking at it now I have had 10 days over and the highest was 16.8.

So, what else has changed. I stopped taking amitriptyline in April and fluoxetine in May because I don't need them anymore. I got a mouthguard at the beginning of April to stop me gnashing my teeth and I have lost 26lb in weight since then too. We tried increasing the machine pressure from 8 to 12 but I was only tolerating it up to11.2. After 2 years of being stable what has gone so wrong?

My sleep clinic have no answers but have swapped my machine to a Resmed airsense auto with pressure range from 4-20 and I have started using OSCAR but I only have the data from 24th June when I started my new machine. OSCAR is amazing and such a good tool to understand what is happening. I am still getting used to the variations in pressure and wake up at least once a night and have to reset so the OSCAR data is a bit all over the place. Hopefully in a few weeks a pattern may emerge.

Has anyone got any insights as to why after 2 years of being fine things have I suddenly changed.

[OpalRose]

We would need to see a couple recent OSCAR charts.  Follow the Organizing link below.  It will show you how to organize a chart and post here.  

Without seeing data, we are only guessing.  The only thing I can say is you are using your machine with a wide open setting of 4-20, which is probably not optimal for you.  Depending on the "type" of events you are experiencing, your minimum pressure should be set somewhere between your median and 95% pressure  reading.  

Post some data... we can help.

[staceyburke]

Welcome to the board. 

Even a day of OSCAR would give some insight. Please post. I have a link on charts and which ones would be helpful. There are many very knowledgeable people here that can and will help.

[Boxermum]

Thank you. I have done a couple of charts from          the last week, hope these are okay

[staceyburke]

It looks to me to be positional apnea. You are cutting off your own airway by getting in a position where your chin drops to your Sternum. Chin tucking can happen (but not limited to) sleeping on your back or sleeping on to high of a pillow. 

Many people have fixed this with the use of a collar. Please look at the signature for a link for a collar  It will show you people without a collar and the same people after they used a collar.

[Boxermum]

It looks to me to be positional apnea. You are cutting off your own airway by getting in a position where your chin drops to your Sternum. Chin tucking can happen (but not limited to) sleeping on your back or sleeping on to high of a pillow. 

Many people have fixed this with the use of a collar. Please look at the signature for a link for a collar  It will show you people without a collar and the same people after they used a collar.

Wow, could it be somethng that simple? Will have a look at collars and try a lower pillow. 

[mesenteria]

Note that we intend that you seek information about soft foam collars, not the rigid hard plastic kind a la EMT and you hanging out of a car window with the engine smoking.

[Gideon]

Yes, literally that simple.  It took us a while to recognize the pattern and what it actually means, but it is one of the clearest and easiest calls we make.

[OpalRose]

Welcome to Apnea Board!  

Yes, a "not so tall" pillow, staying off your back if you are able, and a "soft" cervical collar that fits.

http://www.apneaboard.com/wiki/index.php...cal_Collar

[Boxermum]

Note that we intend that you seek information about soft foam collars, not the rigid hard plastic kind a la EMT and you hanging out of a car window with the engine smoking.

 I get the message