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I've Never Seen This Before
#1
I've Never Seen This Before
What happened in the third session?  Last night I tried a cervical collar to control my mouth breathing.  I had always used a chinstrap, but I found the cervical collar to be more comfortable.  When I looked at my Sleepyhead stats, I found my AHI had risen to 2.89 (I have been averaging less than 1.00) and my RDI had risen to 5.23 (I have been averaging less than 1.5).  The night had four sessions (I have been averaging two or less).  The third session of 1 hour 28 minutes had an AHI of 13.03 and an RDI of 23.32!!!  Without the third session, the other 5 hours 49 minutes had an AHI of .34 and an RDI of .68.  I do remember being restless after the first half of the night and my mouth was very dry.  Leaks were nonexistent or very minimal in all sessions.  My nose was very stuffed up when I went to bed.  Any ideas on what happened?  Should I ditch the cervical collar and use my chinstrap?  Any insight would be appreciated.

[Image: FO1lCO6.png]
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#2
RE: I've Never Seen This Before
Could it be that you had the cervical collar on too tight? Try loosening it enough that you can move the collar around but that it is still on your neck and supports your jaw dropping down. It may be that you also need some time to get used to using the collar. Perhaps give it a few more nights but at a looser setting?
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#3
RE: I've Never Seen This Before
Please look at Marillion's signature: "Organize your SleepyHead Data"
The pressure and flow waveform is very important in dissection data.
Without it, little can be inferred.

As a pure guess, you got into a position where you needed more pressure; but hit your set maximum.

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JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#4
RE: I've Never Seen This Before
I didn't realize that I had to have the graphs pinned to keep them in the preferred order when taking a screenshot.  Attached is a corrected version.  There is no Flow Limit Graph as I have a Resperonics Dreamstation.

[Image: Za9DHPJ.png]
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#5
RE: I've Never Seen This Before
Also, I know I hit the max pressure at 11.0.  However, I reduced it from 12.0 recently (even though it is not updated in my signature) because I seldom exceed 11.0.  Should I increase it back to 12.0?
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#6
RE: I've Never Seen This Before
I would increase it back up, the cluster events from 3:30 to 4:30 coincide with the 11cm pressure limit. Unless you were laying there awake for an hour before you broke treatment at 4:45?
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap from machine data, or software. Set the min pressure at 'med' median pressure or 90% OR 2cm below 95% pressure. max pressure at 20cm for now. Forum will help you fine tune settings
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#7
RE: I've Never Seen This Before
I am concerned about what I see around 04:20. After a long period of respiratory effort, hypopneas, and Obstructive Apneas, it appears like you are just choked off. BND (Breathing Not Detected) is flagged too. And, this is all happening while you are at max set pressure.

On the average, your breathing is rather shallow at 340 ml TV and 15 BPM. You are not moving a lot of air.

So, I have to ask:
1) Do you have any known cardiac issues?
2) Hate to ask, but are you of advanced years (elderly for lack of a more tactful term)?
3) What brought you to Auto CPAP? Did you have a diagnosis and a sleep study?

I'm not sure you should be using nasal pillows with a taped mouth. If your nasal passages are closing down, you have no oral route to breathe by.

Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#8
RE: I've Never Seen This Before
I do agree that I should move max back to 12.0.  For several months I have had great success at 8 min - 12 max, with a chinstrap and tape.  Most nights, I either sleep through the night or wake up only once. Before apap, I was awake at least four or five times a night. I have averaged under 1 AHI and under 1.5 RDI over this time.  The only change I made last night was to reduce max to 11 and try a cervical collar.  I don't believe it was too tight. I tried the collar because the chinstrap is hot in the summer.  I believe I'll go back to it.

I have no cardiac issues. I'm 68 and in excellent health.  I lift weights and perform aggressive aerobics four or five days a week.  My resting heart rate is around 45 to 50 BPM and I test in the 99th percentile for strength and aerobics conditioning in my age group.  Since apap, I have more energy and my heartrate drops around 30 BPM within a minute after an aggressive 30 to 45 minute aerobc workout on top of a 45 minute weight lifting session.

I tape using 3M micropore and can break the seal by opening my mouth. I need the tape and the chinstrap to stop mouth breathing.  I tried a FFM but did not have success.  I have only seen events like the third session once when I was definitely awake tossing and turning at the end of a night.  I vaguely recall adjusting the collar at one time last night.  Perhaps I was awake during most of that third session.  Returning to 8 - 12 and the chinstrap may be my best bet.  Any other thoughts?
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#9
RE: I've Never Seen This Before
I wish I was at your level of fitness. I wonder about the reflex bradycardia after a workout. Sounds low; but likely just something I don't know about.

I guess the plan is: back to 12 cm-water max pressure, delete the collar and back to the chin strap.
Best Regards, jM.

Admin Note:
JustMongo passed away in August 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#10
RE: I've Never Seen This Before
My best guess is that you had a major REM cycle during that bad session, probably combined with back sleeping and/or the cervical collar not quite doing what you wanted it to do.

I'm not sure leaks are the problem here. (But then again, I'm not sure they're NOT the problem either.)

Could also be a visit from the aliens. Sometimes we just have a bad night or a bad stretch in a particular night for no obvious reason. If those visits from the aliens are few and far between, sometimes the best thing to do is not to get to worried about them.

I'd suggest continue experimenting with the cervical collar for a few more days. If this session turns out to be an outlier, then it's nothing to worry about. But if you see a lot of this stuff when you use the cervical collar and none of it when you don't, then the cervical collar is doing more harm than good.
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