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A short update: I noticed that with those settings, when I lie on my back and relax the muscles, the air pressure was not strong enough to hold the airway open, so I upped the min EPAP until it did so (even when falling asleep on my side, I often wake up on my back. And yes I would even wake up on my back with tennis balls or a whole backpack to keep me on my side).
This helped somewhat, but I still feel so, so tired.
Took a closer look at the flow rate in general and noticed that there are quite a few bits where it looks like an apnea event, but it only lasts 8, 9 seconds or so, so doesn't get flagged by the machine. I guess there's no setting to change the threshold...
Does anyone know what the recommendation is then? My head is so foggy I can't think clearly. Might go back to the dreamstation for a few days to clear the fog...
Hi everyone!
For the past few days my therapy has been awful. Used to get low AHI numbers between 2 down to 0.4 once, now I see in OSCAR that it went up to 40 last night, and up to 25 this night, with a total average of 8.07. Does anyone have any insight what to try to hunt down what could have happened? Wearing a soft collar, full face mask, can not feel any leaks from the mask although OSCAR shows a leak rate of about 40? What do you recommend?
The collar seems to not be working as expected. Does your chin drop behind the collar, or does the collar cause pressure on your neck or throat? Your events are mostly obstructive and in the clustered pattern we associate with positional apnea. In your previous thread your AHI was less than 1. If the collar is causing this increase, the you should discontinue use of the collar.
I have merged your two threads because there is important information that needs to be considered from the BiPAP settings thread that should be in your therapy thread
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.
Thank you for your insights, Sleeprider.
I have tried different settings and found that, when my mouth is closed, my back throat and my tongue are touching each other. However when my mouth is open, there is more space for air to go through.
Does this make sense? Sorry, due to over a week of poor sleep my mind is so foggy.
Also, the problems seem to have started after my DME "checked" the CPAP (yearly control). Can they have changed something which would not show up in the settings change overview in OSCAR? It already showed that they "secretly" (without telling me) changed heater settings and from C-Flex to A-Flex, for whatever reason.
Thank you for merging the threads, and sorry not to have continued all in one thread, wasn't sure if the bipap issues were relevant as it was with a different mask, different machine, and apparently with some other problems (low AHI but still feeling horrible). Might try it again for a change and see if it helps in any way.
We can look at settings in your Oscar chart to see what changes might have affected your sleep. You use a full face mask and describe breathing orally rather than nasally. I use a nasal pillows mask and the back of the tongue prevents air from migrating from my airway into my mouth. If you find that prevents you from breathing altogether, you are probably breathing orally. All I can suggest is that you learn what enables comfortable breathing and play with different tongue positions to isol ate nasal and oral breathing. If moving your tongue back blocks your airway, this may explain the appearance of positional apnea in some of your previous charts.
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.
Thank you for the good points!
Last night's data (with spo2). Without soft collar for now. Somehow the AHI seems ok-ish/low, with OSCAR detecting more events than the machine did, but the SpO2 events are wayy higher than expected. Are those events as relevant as apnea events?
Any recommendations based on this (one night only so far)?
Based on the close-up you seem to have obstructive flow limitations that are reducing your respiratory intake. My best guess is that these are related to chin-tucking. as they occur in clusters, with alternating flow limitation that is near hypopnea levels, followed by recurring arousal and more flow limitation. There are places where respiration rate increases but just doesn't move air. It's odd the machine does not seem to be picking up the FL and is leaving you at near the minimum pressure of 14 with PS 3. With the Vauto, pressure support is proportional to inspiratory flow, so I suspect if we look at the mask pressure during the sequence below, you will see you are being short-changed on PS. I think you may be better off correcting the positional issues with the cervical collar.
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.
12-09-2021, 09:06 AM (This post was last modified: 12-09-2021, 09:09 AM by Shnorky.)
RE: Shnorky's therapy thread / BiPAP Settings
Thank you for your very kind and patient (and good!) explanation.
After this and reading more about the titration protocols, I set the PS to 4, trigger to very high, and Ti max from 4.0 to 2.5 (and wore the soft collar again).
Scrolling through the flow rate it seems to me like there are bits of "normal" breathing and then it starts to go all jumbly, with some very fast deep breaths, without any events registering. Some events do happen. But the pressure barely moves throughout the night.
Feeling like somehow I slept long enough, woke without an alarm clock, but my eyes are soo puffy, and I can barely keep them open.
It might not be important but is it normal that the tidal volume goes down with increased pressure support?
