CPAP Produces Variable Results New User

[marklang]

My results are still good with the collar and the BiPap.  The first two sessions on the new Resmed Aircurve 10 aAuto without the collar had AHI of 22.61 and 30.17.   The sessions with the collar added had AHI of 0.68, 0.15, 0.56, 0.41, 0.41, 0.23, 0.31, and 0.20.  The few events remaining are all classified as central apneas.   It is amazing how much the collar impacted even over pillows.   I was using the Popitz pillow the night I had an AHI of 30.17, and it has a pretty radical head position.  I am guessing that my positional issues are largely turning my head to the side.  

I shared these results with my doctor today.   He noted the impact of the collar in his record, but he did not really comment on it.  He seemed OK as long as I am happy with my therapy.  He also did not comment on my choice of the Resmed over the Philips Dreamstation for BiPap, even though he recommends the Dreamstation.  He and the equipment dealer seem to feel that both the Resmed and Dreamstation machines provide pretty much the same therapy based on their features.  Again, however, as long as I am happy, the doctor seems happy, and the equipment dealer was very responsive to get me my choice of the Resmed, including the auto version and the heated tube (she said they only carry auto machines with heated tubes).  

I have not tried using the auto mode to see if I can deal with lower pressures.   I will probably give that a try sometime.  Right now I want to focus on getting the right mask for my high pressures and how to use and adjust it. 

Thanks again for all the help here.   I don't believe I would be here without the advice from this forum.

[Sleeprider]

Mark it's fantastic to see these results. If you don't mind I have referenced this thread in a wiki discussing flow limitation, and may do a wiki on positional apnea in a future wiki. Here is the link. http://www.apneaboard.com/wiki/index.php...Limitation

[marklang]

I am happy that my experience might help someone else.   It was this forum that helped me through this positional problem. 

Just FYI.   I only used the Poplitz pillow on Oct. 20.   I can supply more data from that day if it will help.  I received the new Resmed Aircurve 10 vAuto on Friday, Oct. 19.  This moved me from Cpap to BiPap at higher pressures (23/19).  My first night I had poor results, just as I had been having with the Dreamstation Auto Cpap machine.   That is despite a hospital-based sleep study that reported that Bipap at 23/19 would clear up my issues.  I tried the Poplitz pillow on Oct. 20 thinking it would resolve any positional issues that might be causing the remaining problems.  However, that night was even worse.   I tried the Caldera collar on Oct. 21, and that did the job.   As noted, my results have been good since then with the Resmed and collar.

[marklang]

I have now had very good results using the Resmed vAuto and the Caldera collar for more than a month.   I changed the machine settings as suggested to auto Bipap with min IPAP of 16 and max EPAP of 23.   Since then, I have still had good results, almost all nights with AHI of 0.5 or lower, even zero some nights.  The pressures stay within the minimum range of 16 and 20 almost all the time.  

I noticed that most of remaining events are identified as Clear Apneas or Hypopneas.  It seems like the Resmed does not respond at all to Clear Apneas, probably because I understand clear apneas cannot be solved with higher pressures.   Its response to other events is almost immediate, within a few breaths.   If the situation clears up in a few breaths, it does not respond to the hypopneas.  This is much faster than the Dreamstation I had earlier (auto CPAP).  In fact, I see responses even when events are not registered.  It seems that the machine detects a flow restriction, and it responds even before any event occurs.   I see increases in the flow restriction graph when this happens that decrease as the pressures rise.    I suppose I could try for even lower pressures. 

Needless to say, I am very pleased with the Resmed vAuto and the collar.   While a bit uncomfortable, the discomfort is minimal when it provides much better sleep patterns.  Masks still seem to be a challenge at these pressures.   I currently use a Resmed F20 most of the time, but I have to wear a band aid over my nose to prevent serious reddening there, even to cuts.  I also get marks on my face because of the pressure of the mask against the skin, but they, for the most part, do not discolor the skin, and they go away after a few hours.

Thanks again for the advice from this forum.   I am certain I would be where I am without it.

[Fats Drywaller]

I currently use a Resmed F20 most of the time, but I have to wear a band aid over my nose to prevent serious reddening there, even to cuts.  I also get marks on my face because of the pressure of the mask against the skin, but they, for the most part, do not discolor the skin, and they go away after a few hours.

Have you seen Kosoku's post about the F20 homemade mask liner?  Looks like a success story.  There are online retailers that sell mask liners, pads, and frame wraps, but those items tend to be expensive.