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Cervical collar results
#11
RE: Cervical collar results
The higher pressure has reduced the incidence, severity and length of the flow restriction/obstruction events, but not fully eliminated them. I think the variable pressure is not a problem as the machine quickly reaches maximum pressure at 20 when events start. We still see clustering of events, but this looks better than were we were at lower pressure. Hopefully, you feel a bit better with the improvement of events. The need for pressures higher than CPAP normally qualifies the patient for bilevel device which has the capability for more pressure support and higher maximum pressure. It may be worth talking to your doctor or supplier to see if that is also true in Quebec.
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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#12
RE: Cervical collar results
Quote:Sleeprider
It may be worth talking to your doctor or supplier to see if that is also true in Quebec.

I will do that, thank you.

You suggested before that I should get the ResMed AirCurve 10 VAuto.

Is it still the best machine for my condition?

DanEm

"If life hands you lemons, make lemonade! Words to live by, especially when you keep in mind that the only way to make them into lemonade is to squeeze the hell out of them."
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#13
RE: Cervical collar results
Quote:Sleeprider

...The need for pressures higher than CPAP normally qualifies the patient for bilevel device which has the capability for more pressure support and higher maximum pressure. It may be worth talking to your doctor or supplier to see if that is also true in Quebec.

...The solution is either going to a significantly higher pressure support by a bilevel device, or working with an ENT or other specialist to identify the physiological source of obstruction and airway resistance.


I had a consultation with my lung specialist.

The main conclusions are :

To get a bilevel machine in Quebec you need some lab test (titration and settings) and a prescription from a lung specialist.

It seems my mask might not be the right size (I have a medium AirFit F20).

Although it is sized according to recommendations, with higher pressure I feel air going out when I wake up so I tighten the headgear to max.
Doing so, I would have too much pressure on the jaw that would interfere with airflow.
Apparently a full face mask should not be too tight.

I will get a small size mask and do a two-three-week run to see how it goes and then have another consultation with my lung specialist.

The recommended pressure by the specialist is low 15 and high 20 to give the CPAP more room to work with. 

This seems reasonable Thinking-about

DanEm

"If life hands you lemons, make lemonade! Words to live by, especially when you keep in mind that the only way to make them into lemonade is to squeeze the hell out of them."
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#14
RE: Cervical collar results
Dan, I have no disagreement with your specialist. Getting bilevel will enable a lot more comfort at high pressures, and it has reserve capacity if it turns out you need that. We have seen that higher CPAP pressure turns into better AHI for you, the bilevel allows pressure to 25 cm. If your specialist is saying set the CPAP at a minimum 15 and maximum 20 to have more room to work with, I don't actually think it will make much difference. With minimum pressure 17 and maximum pressure 20, your machine went straight to 20 cm. I think setting the minimum pressure at 15 will be exactly the same. Having more pressure support and more pressure with bilevel remains the end-game.

For bilevel, I like the Resmed machines because they offer Easybreathe™ which is a more comfortable transition of pressure between IPAP and EPAP. They also offer some inspiratory timing and trigger/cycle sensitivity that you don't get from Philips. The Vauto has auto-adjusting pressure, but you can get very good results with the VPAP S which is fixed pressure. Whatever you can get your hands on in Quebec is beyond our control, so if you can get the Vauto, better; if you are issued a VPAP-S, fine. We can work with whatever you get, but you have exhausted the capacity of CPAP.
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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#15
RE: Cervical collar results
Quote:Sleeprider

Whatever you can get your hands on in Quebec is beyond our control, so if you can get the Vauto, better; if you are issued a VPAP-S, fine. We can work with whatever you get, but you have exhausted the capacity of CPAP.

The thing is that I can get any machine that is sold to public.  I guess I could also import.
But if I go outside the Medicare system I won't have access to a specialist nor a regular therapist.  
"Who cares!" Well I kind of care some.
What I want to do is to use up all the other options before I do that.

So, as I said earlier, even if there's very little chance that it will work I will try for a time the smaller mask.  I should get it tomorrow or the day after (Amazon is very good here).  A few nights should be enough to see any difference/improvement.

I also question my past results. I'm still trying to find a way to see my progress if any.
My last gizmo was to get Oscar's statistics for weekly periods and plot a few variables (see included Excel file).
I am wondering if you agree with my conclusion that it is showing signs of improvement for the last week.

And, it is a bit confusing.  I get it when you say I need more pressure thus most probably a different machine.
At the same time, I see results that might be a sign of improvement with what I have right now.


I wish it would be more black and white. 

I will be patient and go through all ideas I could get (even the not so bright ones).

But if it comes to definitely no other option than get a bilevel. I will go for it.

DanEm

"If life hands you lemons, make lemonade! Words to live by, especially when you keep in mind that the only way to make them into lemonade is to squeeze the hell out of them."
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