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Can pressure fix positional obstructive apnea?
#1
Can pressure fix positional obstructive apnea?
Quick history:
While using the P10 pillow, my AHI was less than .50. Events were entirely CA’s and HA’s. Max pressure was 9cm. My problem was extreme dry mouth and lip leaks that neither a chin strap nor collar would fix. Sleep was good but with waking frequently, I sought to improve the dry mouth buy using the F30 mask. This solved the dry mouth and lip leaks. However, my AHI jumped to over 2 and most of the events are Obstructive. Sleep has improved but in hopes making it even better I have increased the pressure to 12cm with no change in objective events. Mask leaks are starting to creep in and keeping me awake

Opinions welcome:
Based on information gained on this board, I believe the events are positional. 

Am I trying to fix a problem that does not exist or fix a problem that cannot be fixed with increasing pressure?
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#2
RE: Can pressure fix positional obstructive apnea?
As far as I know, there is no amount of a pressure increase that will overcome positional apnea.

Post a screenshot of your daily page... one using the P10 mask and one using the F30.
OpalRose
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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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#3
RE: Can pressure fix positional obstructive apnea?
If it's positional Apnea, then it's a physical cause. And it needs a physical fix, in this case by seeing it fixed in others on the AB would be the soft cervical collar. Gideon likes to compare it to kinking a garden hose. So put up a chart and let's see.
Dave

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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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#4
RE: Can pressure fix positional obstructive apnea?
By looking at Oscar charts we can determine if it is obstructive or not. Post oscar
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Can pressure fix positional obstructive apnea?
I have seen positional apnea reduced by increased pressure in some individuals, while in others the airway remains firmly closed. Even with increased pressure, we often see OA turn to hypopnea or severe flow limitation. It can be done, however the advantage of using the soft cervical collar is that efficacy can be accomplished at lower pressures and with more reliability.
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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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#6
RE: Can pressure fix positional obstructive apnea?
This is what I was thinking. I like the thought of lowering pressure and correcting the physical part. I have tried different collars and each comes with different results. 

I will post some charts that show what I am talking about later today.
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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#7
RE: Can pressure fix positional obstructive apnea?
Gee, and I thought we were going to "...not in Kansas anymore..." LOL

What I see is that if I chin tuck the events come slamming in, the pressure zooms to 20, and the pressure doesn't seem to matter at all.

Maybe a machine that delivers more than 20? From what I've seen, about the only good pressure would do is that it might wake you up and make you move your chin.

I'm becoming an expert on cervical collars for small necks. :-)

The main thing about them is that they are cheap, and not very precisely made, so the simplest thing to do is to buy several and figure out what's good and bad about the different ones.

Oh, and if you use an ffm, if the "dip" in the front is relatively deep that means that the sides around the dip are going to come up high enough to pop the straps off the mask.
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#8
RE: Can pressure fix positional obstructive apnea?
Here are 2 screen shots that I think are typical of the month. I also included the Monthly data from OSCAR to show these days were typical for the entire month. 
October 2020
Pillows mask and a chin strap
AHI = .47
OA = .02
HA = .19
CA = .20
RERA = .22
   

April 2021 F30 FFM
AHI = 2.44
OA = 1.85
HA = .51
CA = .09
RERA = .47
   
CPAP is a journey like “The Wizard of Oz”. It’s a long slow journey. You will face many problems and pick up many friends along the way. Just because you reach the poppies, it doesn’t mean you are in Kansas. 
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