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Here is what a Sleep Tech Supervisor told me about my recent sleep study
#21
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
People that are not diagnosed with OA have no way to know the severity of their positional or any other apnea. It's a combination of an anatomical predisposition to obstruction, combined with the actual sleep position, and the sufferer is generally unaware of it. Some of the worst positional apnea I have seen has been with the use of an ergonomic pillow. It will be interesting to hear what you observe. A pillow is a more passive aid that works as long as you are in the expected therapy position, but fails when you turn on your side, or out of the intended position.
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#22
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
(10-28-2018, 08:01 PM)Sleeprider Wrote: People that are not diagnosed with OA have no way to know the severity of their positional or any other apnea.  It's a combination of an anatomical predisposition to obstruction, combined with the actual sleep position, and the sufferer is generally unaware of it.  Some of the worst positional apnea I have seen has been with the use of an ergonomic pillow.  It will be interesting to hear what you observe.  A pillow is a more passibe aid that works as long as younare in the expected therapy position, but fails when you turn on your side, ormout of the intended position.

So I just tried on my soft cervical collar , along with my chin strap, mask and dental appliance. I don't think I'll be able to lay on my side with the cervical collar. So I'll just lay on my back like always. It is a bit much gear to wear at night, but maybe with the collar it will keep my airway open somehow? How do I know if I'm in the right position with the collar? 

Because I don't know where the right position to be in, without obstructions, is for me. It could be with my head tilted a little to the right or left. It's just impossible to know. All this collar will do, is keep my head centered and stationary at night. And when i fall asleep, that centered position could be the "bad" position to be in.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#23
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
If that is the case your charts will show that.  I will add that the soft cervical collar and its cousin the anti-snoring collars are the most successful aid for positional apnea that we have seen.
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#24
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
Thanks. I guess all I can do is try the collar again for a few days and see if it helps.

I was just looking back at the DISE Procedure findings I had back in July. He kept saying my tongue was my major collapse. But I've been reading about sleep apnea, and how the epiglottis can also collapse. But apparently that is not the case for me? I'm not sure what "retropalatal" is? Would a dental appliance or CPAP help with retropalatal obstruction?

"Significant retropalatal obstruction with obstruction seen from an anteroposterior dimension. There was no lateral wall collapse. Additionally, there was prominent tongue-based tissue, which was obstructive. The hypopharynx, supraglottis, and glottis were otherwise normal."
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#25
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
Last night was uneventful. A great night. If I could consistently sleep like last night, I would be more productive and happy every day. The video recording didn't show any movement at all. Maybe my hand and arm moved, but I was perfectly still laying on my back all night long.

The only changes I made were to use a soft cervical collar and I adjusted my dental appliance forward a half millimeter. Adjusting my appliance only half millimeter I doubt made much of a change. I was at this setting in the past and kept having bad apneas.

So I suspect that the collar is keeping me from turning my head, which could be what was causing the blockages. I dont know. But I'll continue to try to use it for a week, and see if I have any bad nights with clustered events. I'm making an appointments today to see my ENT again, to get breathing better thru my nose, and maybe get this injection snoreplasty and pallate expansion to help breathe thru mouth too.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#26
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
If the collar continues to work for you, you might want to look at an anti-snoring collar such as the Dr Daakoda (I'm sure I misspelled that) to see if it is more comfortable for you.
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Download SleepyHead
Organize Charts
Attaching Charts

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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#27
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
(10-29-2018, 09:27 AM)bonjour Wrote: If the collar continues to work for you, you might want to look at an anti-snoring collar such as the Dr Daakoda (I'm sure I misspelled that) to see if it is more comfortable for you.

Thanks. I found Dr. Dakota collar online. The problem is I hate to add one more thing to my sleep. I feel like I'm a slave to my bed now and laying in a hospital bed. It is not comfortable, being so restricted in not moving.

Last night with the collar was good again. No obstructions at all. AHI 0.42. I did still get night sweats for some reason though. Could be that I'm still struggling a little to breathe? Although my flow rate chart seems pretty stable.

I know my tongue base is an issue, but now I think my posture is also the issue. When I stand up straight, my neck and head lean forward. Also when my chiropractor did an xray, my neck was also crooked to one side. I think I need to see some type of other doctor to correct my neck posture.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#28
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
(10-23-2018, 08:47 AM)MyronH Wrote: The only thing I notice is that every 20-40min, I'm taking a deep breath for some reason. But I've always done that. Probably a learnt response to apnea or 
This may be a sleep position change. Try to correlate the event with the video.
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#29
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
(11-01-2018, 04:46 AM)yrnkrn Wrote:
(10-23-2018, 08:47 AM)MyronH Wrote: The only thing I notice is that every 20-40min, I'm taking a deep breath for some reason. But I've always done that. Probably a learnt response to apnea or 
This may be a sleep position change. Try to correlate the event with the video.

The last four nights I used a cervical collar. Had no issues and when reviewing the video, I hardly moved at all. Stayed on my back the entire time, and maybe moved an arm once. So it looks like cervical collar is helping. 
I'll keep using cervical collar for a few more nights. Then maybe stop using it to see if issue comes back. 

Only issue I had last night was one CA 12sec that caused SpO2 to go to 82%. That seems low for such short apnea but my sleep doctor could care less.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#30
RE: Here is what a Sleep Tech Supervisor told me about my recent sleep study
I cannot comprehend why a sleep specialist would believe a 2-hour titration is all that is needed to determine "optimal pressure" settings. That isn't even long enough to achieve REM sleep when apnea is worst.

I have been on ResMed S9 VPAP S for past 6 years 21/17 ps 4. My AHI is below 2 every night. But the averaging disguised what is really happening during the night. Examining graphs, I found that I sleep about 6 hours with virtually no events. But in the middle of those 6 hours, I had 2 hours (25% sleep time) with large cluster of repeated OA events systaining an AHI at 20. This was likely due to supine sleeping position and REM sleep.

With graphs I convinced my sleep doc I would do better on Aircurve S10 VAuto. I likely need lower IPAP/EPAP most of the night but need higher pressures during some parts of night due to position and/or REM sleep.

I previously tried increasing IPAP/EPAP for entire night on my S9 VPAP S. Running higher pressure when not needed to cover the 25% time when I needed it resulted in CA events all night that I didn't have before.

So my prescription is for new Aircurve S10 VAuto is 23/15 ps 4. I will be monitoring my data to see if I stop having cluster of OA 25% of each night without apprarance of CA.
Everyone has a bad hair day once in a while.  Same with a night on xPAP.
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