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Highest Periodic Breathing, Leaks and Apnea Ever!
#31
RE: Leaks and Continued Daytime Tiredness with CPAP
I would get another sleep study and start over......should get them every three years
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#32
RE: Highest Periodic Breathing Percentages Ever!
Jen, the clustering of the obstructive apnea and hypopnea has intensified from when I pointed this out before. You can resolve all of this by using a soft cervical collar.  The problem is caused by chin-tucking which causes a restriction in the airway by compressing the tissues in the throat.  Read the wiki and take a look at some of the example charts. You need to act on getting a soft cervical collar now.
Positional Apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical Collar: http://www.apneaboard.com/wiki/index.php...cal_Collar 

The need to obtain a new machine has not changed. I suggest you contact the in-network supplier of your choice and tell them that you are due for a new machine and are having increasing reliability issues with your CPAP. Ask for the Resmed Airsense 10 Autoset or Autoset for her. They can determine your eligibility with insurance and contact your doctor for an updated prescription. If he does not cooperate, you need to change doctors. I think you probably need to change anyway, especially if a new sleep study is required. You should be able to get a new CPAP machine without a study, however for your extreme flow limitation, I think a Resmed Aircurve 10 Vauto bilevel might not be a bad idea.

I merged your new post with this thread because the topic is the same and the history is relevant. We appreciate members keeping their therapy threads together so that we can see the history rather than searching multiple threads.
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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#33
RE: Highest Periodic Breathing, Leaks and Apnea Ever!
You are not going to like this answer.

It is extremely apparent via the clustering of obstructive events that you are tucking your chin.  This is causing a "Positional Apnea".  Do note that to your doctor "Positional Apnea" is the difference between sleeping on your back or side.

If you do not fix this there is nothing that can be done!!!  it is that critical!!!

Why could you not tolerate the collar?  Which collar do you have?  Did you try the Eliminator?  Look at anti-snoring collars, these have no 'support at the back of the neck and that's OK, we are not looking for support, only to keep the chin from tucking.

Getting a new machine, IMHO there is no point if you cannot stop this chin tucking.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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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#34
RE: Highest Periodic Breathing, Leaks and Apnea Ever!
So you have some homework!

(1) Try the collar again. Unfortunately, a little searching reveals that the Eliminator collar is not currently available (nor is its twin, the Dr. Dakota collar). Think of it this way: the collar is uncomfortable, but you can get used to it, and what if it turned out to be the key to restful sleep? Wouldn't that be worth the process of getting used to it?

(2) Do you know exactly how you tuck your chin down toward your chest? Are you on your back with your bed pillow pushing your head into a chin-tuck position? Your side, maybe curled into a ball? Understanding how it happens might give us some ideas of how to minimize it.

(2) Get a new or newish machine, preferably the ResMed VAuto Aircurve. Your current machine is old and needs to be replaced, so I do think you need a new machine, though I understand the point Bonjour is trying to make. The VAuto would be best suited to your needs. You mentioned, I think, that you could buy one yourself, so I would recommend that you look at the list of suppliers (link at the top of the page) and get going on that.
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#35
RE: Highest Periodic Breathing, Leaks and Apnea Ever!
I actually did see my Sleep Doctor 2 days ago and mentioned to him that I need a new machine because it's been well over 5 years on this current machine. He said the insurance companies only like to pay when your current machine is not working properly or that it's broken beyond repair. Then they will pay for a new machine. I've mentioned this before to my doctor and he basically says, "if it ain't broke no need to fix it."  I'm not in a position to argue with him since he's the professional and I'm but a lowly patient. Would you recommend I purchase a machine out of pocket and if so would I need my doctor to send me a prescription? I am more than willing to do this but would like a final recommendation as to what machine would help me the most. My doctor did not even mention my AHI's when I was in the office but he did note that I was having about an hour or so of leaks throughout the night with the machine on. 
Are there any other parts of my chart that could help you make a better determination as to what's more going on with me or the seriousness of my sleep issues?
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#36
RE: Highest Periodic Breathing, Leaks and Apnea Ever!
My respect for your doctor was low already, but this is ridiculous. You do not wait until your aging machine conks out before getting a new one. The normal replacement schedule is 3 to 5 years.

I would recommend that you get a VAuto. It does everything the ResMed Airsense 10 Autoset does but has additional capabilities that could be helpful to you in addressing flow-limited breathing and even hypopneas, if to some extent they are independent from the chin-tuck problem.

If your primary care physician will write a scrip for a VAuto, great, but some of the suppliers on the list will work with you to get you taken care of even if you don't have a scrip in hand. Take a look at Supplier #2.
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#37
RE: Highest Periodic Breathing, Leaks and Apnea Ever!
I sent a message to my doctor about my concerns and what was recommended and his reply was "6/19/2020 no need for cervical collar for pulmonary or sleep disease. Dr. Baker" 
So I have seen 2 other Sleep Medicine/Pulmonary doctors here in Louisville since starting to see Dr. Baker and honestly they had just as little concern about my poor sleep quality as Dr. Baker did. 3 different sleep medicine doctors in the last few years and I still am at square one. Any recommendations for someone in my general area that I may reach out to and finally get the care I need for my sleep apnea? 
It's ridiculous that when you get to a certain age that you can't find health professionals that actually care to help. So I won't get a script for a new machine, so what now?
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#38
RE: Highest Periodic Breathing, Leaks and Apnea Ever!
You really don't need the doc's "permission" to buy or use a collar. I'd also look at replacing doc and machine. Dr. Half Baked is completely out of touch and has no interest in quality patient care. I wish you find the success in this that is needed.
Dave

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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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#39
RE: Highest Periodic Breathing, Leaks and Apnea Ever!
Few doctors know about the relation between chin-tucking and AHI or the potential that collars have to improve AHI. I hope the knowledge will migrate into medical training before long. But in the meantime, just give it a try. You have nothing to lose and can't possibly harm yourself by wearing a collar at night.

Meanwhile, please work on getting a new machine.
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#40
RE: Highest Periodic Breathing, Leaks and Apnea Ever!
FWIW the one that was just reviewed seems promising. I think it's listed in the Wiki for SCC by Sleeprider doing an edit.

Aludj wrote about the collar from Coreflex. See here: http://www.apneaboard.com/forums/Thread-...#pid355222

See what you think about this one.
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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