Anyone on a fixed 20cms CPAP?

[Gideon]

Part of the fight is that you are at an AHI of 1.29 with your machine nearly maxed out.  That's why we have to talk about arousals and other symptoms.

[katestyles]

last night.  I rigged up a chin support with a section of pool noodle

Awake at 
12.26
1.42
3.33
4.07

[katestyles]

OK.  I have been at this for another week.

The chin support seems to make very little difference.  Compare Tuesday with collar [attachment=11344] to Thursday with no collar [attachment=11343] 

It does make me very uncomfortable however, so I prefer not to use it.

I received my sleep report from the lab, and there is no note on it indicating why they did not follow protocol and switch to Bilevel when they increased pressure above 15.

I will ask the sleep clinic why I was not switched to Bilevel.

Having had a cold this week, I could have used a little extra pressure.

[ajack]

I hated the cervical collar - it made me too hot.  I already struggle with heat intolerance, and having padding round my neck was just miserable.  Is there anyway to achieve the same thing without having to wear a scarf?


I did ask for a bilevel.  I'm going to need to ask again and repeatedly.  She did suggest a dental device too.

The collar is a diagnostic tool,.Can you put it on for another night,without using a pillow, 3-4 hours should be enough. It needs to get your head right back and open your airway. Given the 20cm isn't clearing the obstructions, I doubt the 25cm from a bpap will. The iVAPS I have runs to 30cm as will other bpap. You will need to be titrated, I would go to a different lab, if you do need high pressures.. I would also swap to a full face mask that also covers your mouth, while you are sorting it. It takes out a variable.

[katestyles]

Sleeping supine with no pillow, so my neck is as extended as it will go.  I don't have my cervical collar available this week.
I'm at a fixed pressure of 20 cms.  Still have FL, OA. CA probably not real, but after arousals.  Leaks woke me several times last night.


What do you suggest I try next?

[ajack]

See if this CPR picture is worth 1,000 words

[Sleeprider]

Something that works better than no pillow is a U shaped travel collar or pillow. It works especially well keeping your neck aligned and jaw closed when you lay on your side. Your results are less than 2-AHI and are at the highest capacity of your CPAP machine. You might want to talk with your doctor about bilevel which provides more pressure and pressure support.

[katestyles]

See if this CPR picture is worth 1,000 words

Great!  Do you have a suggestion on how I achieve that head position in my sleep?  Both versions of the cervical collar I have easily achieve the first image, but get me nowhere close to the second!  I don't have a personal EMT to hold my head back and jaw forward.  I have tried to achieve that position, and find it rather uncomfortable.  If you are trying to save my life, then I accept its need, but I'm pretty certain I don't want to spend night after night in that unnatural position!

[katestyles]

Something that works better than no pillow is a U shaped travel collar or pillow.  It works especially well keeping your neck aligned and jaw closed when you lay on your side.  Your results are less than 2-AHI and are at the highest capacity of your CPAP machine.  You might want to talk with your doctor about bilevel which provides more pressure and pressure support.

I have tried two cervical collars since you suggested it earlier in this thread.  The first, a regular foam collar, essentially just made me too warm.  You suggested I try a Dr Dakota pillow when I mentioned temperature issues.  I looked at the Dr dakota, and made a wedge pillow with a larger angle than the Dr Dakota, and a firmer structure, since I was not confident that the memory foam would prevent chin tucking.  

I said at the outset of the thread that my Doctor is not willing to switch me to bilevel, and I have posted screenshots of my results with and without cervical collars.

I am looking for further suggestions, since I have already tried everything you suggest here.

[ajack]

It was to show you how it works. I understand your frustration, but if you can open you throat through positional adjustment. That would be better and easier on your body. The specialist machines goes up to 40cm, you could ask for a sleep study on those. As I said, I doubt if 20cm isn't clearing your airway, 25cm from a standard bpap will. Hitting up to 40cm of pressure isn't going to be fun, but you will get use to it. It may even be done in conjunction with a throat operation. You may need to change doctors.