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Help needed please
#11
RE: Help needed please
I found the one local DME that is covered by my insurance and called the doctor's office yesterday, so they can send the perscription to that DME.  Now I am waiting to be contacted by the DME, who knows how long that will take.  I have already decided that I won't except anything but a Aircurve 10 VAuto (with 0 hours on it).  One possible good thing I found out is that normally my insurance will pay to rent a machine for 3 months, before buying it.  But because we are at the end of the year and I have met my deductible for the year they will wave the 3 month rental and authorize a purchase now, instead of waiting to next year and forcing me to pay a new deductible all over again.

Another piece of information.  From the titration study they were using some type of Phillips Respertronics machine.  When they where testing bipap mode, it woke me up.  The inhale/exhale cycle I described to the sleep tech as feeling like being punched over and over again.  I asked her what the pressure was and she said 18.  I told her I couldn't continue like that.  She turned the pressure down.  I think I layed there for another hour, and never went back to sleep, before the test ended.
Cheers.

Craig
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#12
RE: Help needed please
I finally have a bipap machine.  Picked up a new AirCurve 10 VAuto.  Used it for the first night and got the following results.  Any suggestions?  Thanks.


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#13
RE: Help needed please
It look like you have positional apnoea look at our wiki article and read the section on positional apnoea a soft cervical collar may be useful http://www.apneaboard.com/wiki/index.php...ng_therapy
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#14
RE: Help needed please
I think I'm getting closer.  For last night I made major changes, I upped PS to 6, Ti Max 3.0, and trigger very high.

My reasoning, the titration study suggested epap 13, ipap 20, which would be a PS of 7. So 6 should be a good starting point.  I don't know what the default TI Max is but the machine came set to 1.9.  I looked at the last month of Airsense data, and 95% inhale time was 2.6 with a max of 2.9. So again 3 should be a good starting point.  Lastly raising trigger appears to be the normal suggestion on this forum to reduce central apnea.

For the next step I'm thinking raise PS to 6.4 and see if I can get rid of the last of the flow limitations?  Any other suggestions?  Thanks.

Craig


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#15
RE: Help needed please
I am still seeing positional apnoea, I don’t think increasing ps is improving your numbers much, it is very rare to see a PS so high. Have you looked at using a cervical collar
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#16
RE: Help needed please
I'll ditto the soft collar. Very few of your event flags are singular, most are grouped of 2 or more consecutive event flags at a time.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#17
RE: Help needed please
I think PS 6 has destabilized respiration, and I also agree that the results indicate clustering we associate with positional apnea. I would back off PS to 5.0 and move EPAP min back to 7.0. Get a collar!
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#18
RE: Help needed please
I have 3 different cervical collars that I've tried so far (2" high foam, 3" high foam, and a Caldera Releaf).  Every time that I have tried them I end up with a terrible AHI of 15 to 20, and feel terrible the next day.  Is it possible to have positional apnea, that is caused by side to side placement of the head, and not just simple chin tucking?

Another thought on the positional apnea:  I have at times noticed that it feels like the full face mask pushes my jaw back.  I wonder if in certain sleeping positions this could be the cause?  Maybe it would be worth trying a mouth guard?

I can certainly go back to EPAP min of 7, and PS of 5 and try that for several days.

Even with not great numbers, I still feel much better using the machine, vs before.

Thanks for everyone's suggestions.

Craig
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#19
RE: Help needed please
(12-16-2020, 01:33 PM)cfb289 Wrote: I have 3 different cervical collars that I've tried so far (2" high foam, 3" high foam, and a Caldera Releaf).  Every time that I have tried them I end up with a terrible AHI of 15 to 20, and feel terrible the next day.  
. . .

Hi Craig,
I am also a PAPer that has positional apnea.  In my case, the obstructive apnea was almost 20 times higher when supine.  I only started to find success when I managed to avoid rolling on my back.  This was before the (now common) suggestions to use a Cervical collar.  At that time, there were suggestions to sew tennis balls to the back of a T-shirt,  large pillows to brace against, various commercial sleeping devices, etc.  I ended up using a kid's school backpack loaded with light lumpy objects.  My average AHI then dropped from the 10-15 range to less than 1.  More recently, I started reading the board again, and saw the suggestions about "chin-tucking", and tried several SCCs.  Tried SCC by itself, and SCC with the backpack.  These experiments all failed.  I'm still using the backpack to keep off my back, and I don't tolerate any SCC very well.  If my AHI is as high as 1, I count it as a bad night.   

Just be aware there is more than one solution to positional issues.
Hope this helps.
A.Becker
PAPing in NE Ohio, with a pack of Cairn terriers
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#20
RE: Help needed please
OK on the mask, do you wear the straps tight? And is this still the F20? If so and if this is for leak control, I know the F20 may need fairly tight straps, but as with me the tendency is to get them too tight. Relatively speaking, my F20 needed tighter straps than my Vitera, but I do not mean tight so as to cause discomfort or pain or a feeling of jaw being pushed backward.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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