[Diagnosis] Need help understanding the flow chart

[michael9346]

I have changed minimum pressure to 9 as you asked. The machine is set to Auto. Does that mean it will only go between 9 and 12.5 pressures? I have been afraid a cervical collar will keep me awake and that is why I never considered one. Is there certain types made for sleep apnea? I know very little about them. Also would you have a suggestion where I can get explanations on my graphs so I better understand what I am looking for? Thanks.

[Sleeprider]

In the graph for June 6, 10 of 17 total events happened between 02:00 and 02:45. On June 7, you had clusters from 20:45 to 21:05, 22:10, and 01:40 to 02:10. All of these cluster occur shortly after starting or a break in therapy, early in the sleep cycle when pressure is at the minimum. The first thing we should try is to increase minimum pressure in hopes of preventing these clusters from occurring.

Many times this pattern emerges from positional apnea when your chin tucks towards your chest. A soft cervical collar prevents the chin from dropping to the point that the airway becomes restricted. You can try an experiment sitting comfortably in your chair. Just relax and breath normally, then allow your chin to drop as you stay very relaxed...did you snore or have an airway cutoff? If so, the collar prevents that. A recent thread suggested a number of styles, and it seems the Dr Dakota may be a winner because it does not have any bulk behind your neck http://www.apneaboard.com/forums/Thread-...oft-collar

Try increasing minimum pressure. If you are prone to a positional apnea, consider a collar. While many expect it to be uncomfortable it has proven so effective and mostly comfortable, that it has become a standard recommendation here to keep pressures lower while improving results. An extra benefit is that it helps prevent leaks by stabilizing the head position and supporting the lower jaw keeping your mouth from opening.

[sheepless]

hi michael9346. if you are reluctant to try the soft cervical collar, take it from a recently dubious convert: give it a whirl. I can't stand ties or turtlenecks around my neck and I doubted a collar would help me, but it turned out to be the single most effective tweak to my pap therapy. I can't say I love wearing it; I'd really rather not, but it made a huge difference in reducing events and leaks. they can be had for $20 +- at many local drug stores or online. you might have to fuss with it for a while so it's worth getting one that's adjustable. to my surprise I survived the first night just fine and within a few days it was broken in to my neck size and shape. it's still noticeable but tolerable and because it helps so much I wouldn't want to go without it. now that I know it's so effective I'll need a second one for when the first is in the laundry so I'm looking for one that will be cooler and less intrusive. in my desperate need for rest I'm learning it's to our benefit to be willing to try any reasonable suggestion. this one's cheap and easy and doesn't require a lot of time and effort. for many of us it's much less difficult than finding the right mask and the impact is almost as great. good luck!

[gregger]

... it turned out to be the single most effective tweak to my pap therapy....

... for many of us it's much less difficult than finding the right mask and the impact is almost as great.

What he said!!!

I very quickly adapted to the soft collar. Now, I am testing the Dr. Dakota approach, more minimal, and will post results in the thread that Sleeprider mentioned.

As Sheepless points out, you really have little to lose in trying a soft collar. I too was not enthusiastic about putting yet another "thing" on my head/neck, but even the standard collar turned out to be not at all uncomfortable. I switched to a somewhat flatter pillow so that I woudn't feel it around the back of my neck, but...frankly I should have done that sooner for lesser airway blockage anyway.

Otherwise...My wife was startled by the sound of the velcro strap when I adjusted it, so now I'm careful to be sure it's fitted well while standing in the bathroom before bedtime so as not to disturb her. And there you have it: The only negative I can think of!

[michael9346]

Sleeprider, Last night I tried the Wisp nasal with mouth taped and this was certainly no solution. My AHI shot way up (7.52)and this is not a comfortable mask for me, so I will discontinue using the Wisp. I have attached the results and please note everything recorded after the break happened while I was awake. 

I will look into the cervical color at Walgreen's or Amazon today. It never dawned on me bending my neck down could cause obstruction in my airway. I am hoping it won't soak me as I am an easy sweater. Thanks for taking the time to help me.

       

[Sleeprider]

Read a couple of the threads on collars and get one that is comfortable for you to use. If you want to simulate what a collar can do for you, try laying on your side and pull a corner of your pillow over the top of your lower shoulder so that your jaw comes to rest on it. Feel the support and comfort? A collar does not need to be hot to work.

[michael9346]

Sleeprider, I will try a cervical color. I looked at the reviews of the  Dr Dakota and that seems to have good reviews. As far as last night I seem to be getting worse. I have attached 3 attachments. 1) whole night. 2) before break. 3) after break. I t seems no mask seems to work very long for me. I've used a machine for a year and do not feel one bit better. They says sleep apnea can lead to Heart Disease, High blood pressure etc. Well I have had a heart attack, triple heart bypass, high blood pressure, diabetes, prostate cancer and live every day of my life with Afib. I would be so happy if I could just get a few nights of restful sleep before I pass. My sleep doctor is useless and there is not a good DME within 100 miles of Fayetteville, Arkansas. I regret the day I was forced to retire. At least when I worked I didn't have time to think about it. 


           

[Sleeprider]

The apnea clusters have all the markers for obstruction. I'm confident you will get considerable relief from the positional therapy using a collar. What is your current Flex setting? It appears to be off, and I would suggest setting CFlex or AFlex at 1 for comfort.

[michael9346]

The A-Flex is set at 1.

[michael9346]

Sleeprider I purchased a cervical collar yesterday and slept with it on last night. Here are my results and it did keep me from bending my neck down. Unfortunately the results were not what we were looking for. Maybe it will come down over time.