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Back on cpap after some months off. Vauto at Post #71
#21
RE: Back on cpap after some months off
Well the removal of Ramp should be a small victory at any rate. It's not helping the therapy as I see it. Best to ya on the collar.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#22
RE: Back on cpap after some months off
The close up of the OA and CA observed by Dave were both classic OA with increasing flow limit leading to the apnea. The collar has to be a loose fit that stays in place. If it compresses the tissues behind the chin in front of the throat that will undo any benefit, so we are looking mostly for jaw support, not strangulation. You seemed to do much better on the second half of the night, and I think you're on your way.
Sleeprider
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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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#23
RE: Back on cpap after some months off
(05-02-2020, 10:19 AM)Sleeprider Wrote: The close up of the OA and CA observed by Dave were both classic OA with increasing flow limit leading to the apnea.  The collar has to be a loose fit that stays in place.  If it compresses the tissues behind the chin in front of the throat that will undo any benefit, so we are looking mostly for jaw support, not strangulation.  You seemed to do much better on the second half of the night, and I think you're on your way.

Yeah so I found out the hard way not to use that other collar but the one that is the wedge works fairly well. I'll go another few days and if anything a week and post a new thread with results.
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#24
RE: Back on cpap after some months off
Ok so not sure what happened this night as I used the Dr Dakota anti-snoring collar again and it wasn't too tight or anything. More I look more it makes me think I am going to need to reach out to my Dr. and see about getting a bipap machine.

Here are 2 other segments from last night.


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#25
RE: Back on cpap after some months off
Two out of three of your zooms show classic flow limitation to a fairly severe degree. The one below in particular show obstruction approaching apnea, but you keep fighting back to get a breath. You can see how the breath starts normally then reaches a peak flow rate prematurely as the resistance hits, and then you hit it with a second effort.  This created a lot of chest pressure and the effort results in arousals. This is really bad for your heart as well as your sleep.  That said, your event rate is lower using the Dr. Dakota wedge, and this is an improvement from where you started. 

In my experience, we have had relatively few members find the Dr Dakota was a good long-term solution. It's currently the best you you have, and you should continue using it and looking for a better solution that will fit.  Your focus should be finding a support that comes under the jaw without causing pressure on the throat.

Blevel therapy allows the machine to replace some of your chest-effort in getting a normal breath through this restriction by providing higher pressure during inspiration. It would be more comfortable and healthier for you to have this assist. We want you to continue trying to lose excess weight, and to find an aid that mitigates the airway resistance from your airway closing due to chin-tucking, but as a bilevel user I can assure you that it is a far better solution than CPAP. My suggestion for a machine is the same one I use, the Resmed Aircurve 10 Vauto. With bilevel pressure you can eliminate the hypopnea and be very close to a zero AHI, but more importantly is the easier respiratory effort that would give you more refreshing fulfilling sleep, rather than a struggle for each breath.


[Image: attachment.php?aid=22542]
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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#26
RE: Back on cpap after some months off
I believe I did wake up and I fell back asleep after turning to my left side to sleep. I'll try and side sleep tonight see if that will help.

I appreciate the feedback. I am going to contact my Dr and insurance about it. I had a different insurance when I was diagnosed last year should that diagnosis be good enough for my current insurance?
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#27
RE: Back on cpap after some months off
Last night my sleep kept getting interrupted by my cat or stuff going on outside. I started with the wedge on but took it off in my sleep and can see why at the start I made sure not to make it very tight just really have it sitting there. The rest of the night I slept on my side which seemed to help with the hypopneas and OA's.


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#28
RE: Back on cpap after some months off
I'll let the charts to others, but I just wanted to chime in on one thing. I think you're running pressures starting at 16. This could be a reason to try for a BPAP, maybe up to a VAuto. The need of higher pressures to resolve events such as yours, a BPAP in some flavor may increase comfort. If it's something you want to pursue, I think a lot of that machine transition would be based on a lot of complaints from you the patient, assuming comfort is compromised that is. I know it would be that way for me, as in fact I did face that 3+ years ago. Something to consider.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#29
RE: Back on cpap after some months off
Yeah I plan on talking to the Dr today and reaching out to my insurance see what they will cover.
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#30
RE: Back on cpap after some months off
Let us know if we can help suggest how to approach this. I'll say this, it may help to write down the complaint aspects and show doc. Best to ya.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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