First nights with APAP - looking for guidance

[swisssnor]

Hi there,

I've had a home sleep study done a few months back that came out negative. I talked with my doctor as my wife was still reporting me having sleep apnea episodes.  I have an appointment late November  for a full sleep study but in the meantime I thought I should give a go to APAP therapy.

I feel it's not really getting better and was wondering what you guys think.

Thanks for your help !

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[Gideon]

Welcome to the Forum.

You have a fairly common problem in that you are likely tucking your chin causing a greater restriction/obstruction in your airway thus causing a clumping obstructive events which is causing an increasing pressure and pressure variance, which is,in turn, causing an increase in treatment emergent Central Apneas.

Your obstructive events, OA, H, FL, RERAs, indicate a min pressure of 6 may be better for you, also a loose fitting cervical collar or an anti snoring wedge would prevent the chin tuck and all that results from it.

I would like to see how you respond to those changes

Cervical collar and 6cmw min pressure before additional changes.

[ajack]

You weren't doing too bad, till it hit the fan at 5:30. Were you awake then by any chance? Being awake will throw your numbers around. I think bonjour has it at min pressure 6 for a week or so. Let everything settle down.

[Gideon]

I'm at a min pressure of 6 then see what that gives, also to try the C-collar, and see the data.

[swisssnor]

Thank you for the advices !

I've upped the pressure and wore a C-collar and the AHI dropped to 5 so great !

Let's see how this goes for a few more days and I'll post new data :-)

[swisssnor]

Here's an update:

Definitely an improvement with the C-collar and 6min pressure but not quite there yet.

Do you have any suggestions ?

[mesenteria]

Hi.  If you look at your second chart that you posted, notice that the pressure rises as time goes on, and so does your leakage?  While you'd expect the two to go together...largely...it's not exactly ideal.  Your machine doesn't accuse you of large leaks, but it's having to work pretty darned hard to keep you treated with the leaks you DO HAVE.  You will have to figure out why this is happening and what, if anything, you can do about it with the equipment (including the headgear, mask, and cushion(s)) you are using.  This isn't a grave problem, nor insurmountable, but it really should be dealt with before much longer.  The closer you get to perfection, whatever that is to be for you, the more easily you'll adapt to treatment and the better off you'll be because the treatment is so well dialed-in for you.