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Granny7 - Newly Diagnosed- Looking for Help
#21
RE: Granny7 - Newly Diagnosed- Looking for Help
You're going to be fine. The new settings avoid the pressure that caused the higher respiration rate. Please don't overlook my comments concerning pillow height. It appears your are experiencing high flow limitation as a result of chin-tucking.
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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#22
RE: Granny7 - Newly Diagnosed- Looking for Help
I elevate my upper body with pillows to reduce GERD but position them so my head is tilted back. I will try to be more careful about that and ask my husband to observe me. He needs to get up 2 or 3 times a night.
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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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#23
RE: Granny7 - Newly Diagnosed- Looking for Help
Well, now you know Melman is my nerdy husband. When I posted about my pillows and head position last night I didn’t notice that he was still logged on so it appeared to be from him.


He thought I should start my own account and didn’t want to do a “please help my wife” thread. He thought I should learn as much as I could on my own and I agreed. He believes there are others much more knowledgeable than him to help me if anything complicated comes up. I hope we haven’t upset or offended anyone. He really didn’t know about the size limit for posting so that was a necessary question. He also wasn’t sure what tidal volume was and was surprised that I knew.

He is genuinely surprised and puzzled with my first night results and more so from those from last night that I’m about to post. He did say I had very high flow limitations but didn’t understand why.

He observed me for a few minutes at 1:10, 2:20, 4, and 6:30 and saw no what he called chin tucking. He said I was in the position I described previously. The times do not correspond exactly with the clusters of apnea events he says are typical of chin tucking but thinks he was still awake at those times and would have noticed if I changed positions. He says I hardly move at all when I sleep. He said the usual fix is a soft cervical collar like he wears which looks like a torture device to me. I’ve told him I couldn’t stand to wear one. Can anything else cause clusters of apnea? He doesn’t know but is pretty sure I wasn’t tucking my chin.

As for the pressure settings, I mistakenly told him Sleeprider recommended 8 to I4.

Here's the data. As for the previous night, the first several hours are me watching TV getting accustomed to the higher pressures.


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#24
RE: Granny7 - Newly Diagnosed- Looking for Help
Do you sleep on your back? If so, I would recommend sleeping on the side if possible.
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#25
RE: Granny7 - Newly Diagnosed- Looking for Help
One of the things we do when looking at your charts is to look for perfect therapy amongst the chaos. In your case, that happens between 02:10 to 03:20. During this time, you had no events or flow limits and pressure dropped back to the minimum. I hate to tell you this, but I was the one that identified the need for a soft cervical collar in Melman when he joined the forum. His excellent response to that was the inspiration for the Positional Apnea wiki showing the contrast of the same person with positional apnea before and after the use of a soft cervical collar. http://www.apneaboard.com/wiki/index.php...onal_Apnea Later we wrote the soft cervical collar wiki: http://www.apneaboard.com/wiki/index.php...cal_Collar

I'm glad you're here, and are open to idea of how to make your CPAP therapy better. I also think my wife would be more open to suggestions from others, than if I was the one to make the same suggestions. I'm sure Melman in in the same boat. Read the wikis linked above and compare to your own results. There is one very clear answer that will point the direction for you to greatly improve your results, and it does not involve more pressure.

[Image: attachment.php?aid=38009]
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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#26
RE: Granny7 - Newly Diagnosed- Looking for Help
while we talk about "chin tucking" the same events could be caused by turning the head to the side and your clusters above are pretty classic. The collar traditionally encourages a cervical/neck alignment that is proper for either neck problems or anatomical breathing issues with traditional cervical alignment being its main purpose. We have since found articles discussing cervical alignment as helping obstructive sleep apnea events though in a small study.
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#27
RE: Granny7 - Newly Diagnosed- Looking for Help
(12-16-2021, 12:27 PM)Sleeprider Wrote: One of the things we do when looking at your charts is to look for perfect therapy amongst the chaos.  In your case, that happens between 02:10 to 03:20.   During this time, you had no events or flow limits and pressure dropped back to the minimum.  I hate to tell you this, but I was the one that identified the need for a soft cervical collar in Melman when he joined the forum.  His excellent response to that was the inspiration for the Positional Apnea wiki showing the contrast of the same person with positional apnea before and after the use of a soft cervical collar. http://www.apneaboard.com/wiki/index.php...onal_Apnea   Later we wrote the soft cervical collar wiki: http://www.apneaboard.com/wiki/index.php...cal_Collar 
Thanks. We both noted the results between 2:10 and 3:20 but he didn't make the connection you did. He says that's why you get the higher salary I'm going to try the collar tonight. Melman's is a good fit for me also so he's willing to go a night without his. We have another on order because even if it doesn't help me he realty needs a new one.   [Image: sHa_biggrin5.gif]
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#28
RE: Granny7 - Newly Diagnosed- Looking for Help
Glad you appreciate just how much those Apnea Bucks mean to our retirement! Wink
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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#29
RE: Granny7 - Newly Diagnosed- Looking for Help
Here is my chart from last night. No period of perfect therapy. I was wearing the soft cervical collar. I had to remove the mask after 4 hours because it was irritating the skin around my nose. I have rosacea which may make my skin more sensitive. Melman tried to hep me adjust the mask so it wasn't to tight and still didn't leak into my eyes. I don't think I can wear the mask tonight and may need to get a different mask. But that's a separate problem.

Not sure what's going on. Melman is worried that I may have something called UARS which he doesn't know much about. Any help will be greatly appreciated and I want to thank those who have responded so  far the time you have spent for me.


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#30
RE: Granny7 - Newly Diagnosed- Looking for Help
Before we get into a more extended discussion of UARS and flow limitation, you have a reading assignment http://www.apneaboard.com/wiki/index.php..._and_BiPAP There is improvement visible from the use of the collar, and your inclined sleeping position certainly contributes to the problem. UARS is usually related to an upper airway restriction to airflow, and ENTs are specialists that usually deal with this, often with surgery, because that is what they do best. The article discusses using bilevel pressure support to assist inspiratory flow.
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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