RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
I can understand the discomfort of a cervical collar. I don’t like anything wrapping around the back of my neck. More of a claustrophobic thing.
But knowing that I had a habit of tucking my chin to my chest regardless if I was on my back or side, I started to look for something comfortable.
You only need something to prop your chin. Think of it as a “ledge” for your chin.
Some recommend rolling a small towel or washcloth and placing it under your chin.
I finally settled for a very simple Toddler sized neck cushion. It’s crescent shaped and very soft. The kind that is used for travel or to support a child’s neck in a car seat.
You use it by placing it under your chin with the open part toward the back of the neck.
I have not rigged up anything to hold it in place as it seems to stay in place most nights. I only lost it a couple times.
I have been doing it this way for over a year.
Bottom line, find something that works for you.
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
I do realize this site is for all of us that suffer with OSA and use CPAP - I know I am not alone out here. And I do try and consider all of the advice I am getting on this forum and it jumbles my brain sometimes. But as an individual with very different problems outside of my sleep apnea I sometimes feel like I'm just thrown in a group with others who have OSA - I just don't feel like a "one size fits all" is the solution. I can see the benefits a cervical collar may provide but is it for everyone? My neck/throat anatomy is already compromised due to a very narrow airway that either I was born with or became inflamed/narrowed over time due to my asthma and other lung and breathing issues (if you google Mallampati, my cardiologist put my score as a 4). So I have other health problems in addition to my sleep apnea. I get so much conflicting advice - for example my ENT whom I've seen for 10-15 years now who has treated me for GERD, allergies, a deviated septum, sinus problems and most recently skin cancer on my nose. I've had 3 surgeries with him and his suggestions have always been to sleep with my head elevated for my acid reflux. That's all well and good; then on here the advice I get is to reduce the number of pillows so my neck is more aligned and use a cervical collar so my airway stays open more. That seems to make sense; so on the one hand I can try to tolerate the cervical collar and less pillows and maybe get my AHI's down and have the discomfort of sinus drainage and mucus that settles in my chest and throat or I can use the elevation under my head and neck to aid the sinus drainage from my reflux. It's a give and take as I see it. On another note, I spoke with my Sleep Medicine office this morning and I was told that they never suggested a cervical collar for any of their sleep patients for OSA; nor did they ever hear of the Neck Helper (which is not meant to be used during sleep anyhow). So in conclusion I go in next Monday to discuss another titration with their in-lab sleep study dept. It's been 10 years so they thought it may be time to look into things again and see what's changed since my original study in 2009.
I have appreciated all of the help everyone on here has offered me, but for now I feel my best recourse is to see what my doctor can offer to help me get better sleep and lower my AHI's. Thanks.
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
I'm not aware of any DME that has suggested soft cervical collars, wedges or other neck support devices. It simply is not on their radar, and these devices are not prescription items anyway. Our suggestion for using such aids comes solely form anecdotal evidence of their effectiveness in resolving problems ranging from mild flow limitation to severe obstructive sleep apnea that does not respond to any pressure up to the capacity of a CPAP or BPAP machine. It works and allows users to achieve efficacy with lower pressure. Don't expect your doctor, DME or even the manufacturer of these things to know of this. Your choice not to use them is your choice, and if you don't tolerate the collar or derivative means of preventing the tissues at the front of your throat and back of the chin from being compressed, then your remaining solution is to use higher pressure and/or tolerate the obstructive events. You fit the profile of someone that could benefit from some aid that prevents chin-tucking. We can only show you the option and how it has worked for others. The choice is entirely yours.
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
On C collars none of us ever advocated anything that would restrict your throat, and we have found alternatives for you.
Here is another one. Elevate the head of your bed so the entire bed is on a slant. That should help your Gerd and allow some of the other things to work.
As SR indicated your alternative to the collar is to increase pressure, so raise pressure by 2 cmw and evaluate, looking at possibly going to 20 cmw.
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
fwiw (I say for what it's worth because, speaking for myself, about all I can do is relay my experiences in hope something they haven't thought of might work for someone else), the reflux I had been taking prescription meds for all but disappeared after I finally got my ahi down. also, it's possible and even desirable to raise the head of the bed, by chocking the bed legs, rather than stacking pillows. a long body wedge rather than one that mostly lifts the head would work too. this way you can elevate your head and keep your airway straight at the same time.
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
Thanks sheepless.
Good comments.
I dug out my old cpap pillow; I'd forgotten about wedge pillows.
Everyone's comments here really help me. Thanks to you all.
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
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Haven't posted any data for a couple of weeks so I thought I would update things. I have since seen my Sleep Doctor (APRN) on July 29th. Again when she looked over my data and saw that it was still consistently high we discussed another study. I am set up for a Titration (in the sleep lab, not a home study) on August 20, 2019. I am getting more and more concerned that I may be actually having Central Apnea events more than OSA, but hopefully this will be brought out into the open after my titration. I am desperate in need of answers - as I said, my last sleep study was done in 2009 so I'm thinking that a lot can change in 10 years. All they've done over these 10 years since that initial study was look at my data from the memory card and occasionally bump the pressure up. I told her that I was getting advice on a forum online about using a soft cervical collar and about the chin tucking that was suggesting my AHI's were so high because of the Positional Apnea. She said that none of the doctors in that practice ever suggested a cervical collar or such to any of their OSA patients. So, I am back to being totally confused as to what I can do to improve the quality of my sleep.
So to just show some of the contrast in my data I am attaching the data from the night of July 25, 2019 and last night August 5, 2019. Can anyone shed any light on this and why things jump around so much? Just FYI, this is the VERY FIRST TIME (July 25th data) that my AHI EVER got below a 5 or 6!
Please reply with any help you can provide on my recent data...
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
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One more piece of my charts that for some reason I wasn't able to attach to my prior post...
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
I told her that I was getting advice on a forum online about using a soft cervical collar and about the chin tucking that was suggesting my AHI's were so high because of the Positional Apnea. She said that none of the doctors in that practice ever suggested a cervical collar or such to any of their OSA patients.
I totally understand this, It was my thought also as I was an EMT, Cervical collars are used for stabilizing the cervical spine!!! It couldn't possibly do as we claim. Guess what? it works. You need a way to keep your chin from tucking. A Cervical collar, anti-snoring collar or wedge. Pillows under the chin, rolled towels to keep the chin from tucking, Pillows to keep your head extended, anything to keep the chin up. This is definitely NOT a recognized treatment for apnea let alone a standard one. IMHO It should be.
things jump around so much? Not unexpected, the chin tucking is not consistent and will vary considerably. That is by far your biggest issue, and I don't think your doctor is either recognizing nor considering it. There is nothing in the "treatment" manual to handle this.
RE: CPAP Data Always Inconsistent - AHI's STILL HIGH!
Jennie I've used cpap for over 30 years.
The only reason I am successful now is this group.
My sleep-doc-from-heck only wanted to see my machine was on every night. This system worked because it was.
The only good advice he ever gave me was to keep it simple. So I use a nasal mask. I had used an early nasal pillow mask, a Breeze. I've used many masks since i gave that up after 5 years of use. And because I tuck my chin, then mouth breath, I use a wedge under my chin. I also use a cpap pillow that's wedge shaped, and not puffy.
My story isn't important here; I'm offering it to offer hope and help. Last night my score was 0.0, for about 7-1/2 hours of sleep. That's thanks to the good people here.
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