Larrypac [Therapy Thread]

[OpalRose]

Larrypac,
I have merged your two threads.
It is helpful to keep your therapy questions and data to one thread. This way folk don't have to search for what has already been tried.

[Larrypac]

I decided to add the two days data  prior the the one attached  to the last post

[SarcasticDave94]

FWIW if your pulmonary therapist did a better job you might not need FREE internet advice.

December 30 both CA and OA increased.

Your pressures need set a bit better. Your Min. pressure is at 5, but you're asking EPR 3 full time to help. It cannot help to its fullest unless you raise Min. pressure to 7. Your Auto Ramp at 4 can add CA and disruptions. As you're at 5 still you likely don't need ramp.

[staceyburke]

Nothing is going to help until you are able to use your machine for several hours each and every night. It has been suggested to try wearing it while watching tv or reading and you have decided it won't work. It has for many people here on this site and was suggested because it does help some people. Lying in bed for 45 minutes fighting to go to sleep, in my opinion makes the situation worse. You are associating the pap with trying and failing to sleep.

There is something I noticed in some of the graphs you posted but not all of them. Take a look back through some of the nights sleep charts and look in the OA and H charts for grouped events (not central events). Where there are grouped events you are having what is known as positional apnea. Positional apnea is when you are sleeping in a position where you are cutting off your own airway.

There is no pressure setting that can help positional apnea. You need to find the position and stay out of that position. Sometimes it happens when you sleep on your back or bunch up the pillow and it is to high. It causes you to chin tuck. You drop your chin to your sternum and cut off your own airway. I have a link in my signature about collars - These help many people on this site and it may help you. Please take time to read it...

[Larrypac]

I alternate between sleeping on my back and my side.  I have a contour pillow that, when on my back, keeps my head tilted slightly back when my neck is straight but I think i have a tendency to turn my head to the side, which I think might restrict my airway.  Would the cervical collar help with that?  Not sure if I am tucking my chin when on my side but the pillow probably tilts my head to the side.  I guess a thinner pillow might help with the second issue.  I will look through the page on collars.

[SarcasticDave94]

Just a bit of clarification. You're thinking positional like sleep doctors do. It's not side or back sleeping he's referring to, but the chin tuck position that can cause positional Apnea.

[Larrypac]

I was simply wondering whether turning my head to the side while sleeping on my back, or in the case of sleeping on my side, tilting it left or right might restrict  my airway similar to dropping the chin.  I find that if I inhale while turning my head to either side, it affects my breathing

[SarcasticDave94]

OK, yes in that case there have been some comments about head turning affecting airway resistance. Maybe the soft collar could help out at that.

So that your question on CSR isn't lost, ResMed machines label periodic breathing as CSR. Do you definitely have a heart condition you're being treated for? If no, it's likely these CSR flags are false.

[Larrypac]

I had a heart attack 5 years ago and have 2 stents but I'm an active 72 YO.  I exercise every day and work in my wood shop, cut firewood etc.  The CSR question was the top of my list for the FNP since I read that it could be associated with heart issues.

[SarcasticDave94]

OK, I don't think that prior heart attack would be it then. I think the CSR aspect is associated with A-fib, congestive heart failure, possibly stroke issues.

Here's an article if you want to read up. But just my opinion, your CSR is the false flags type.

https://www.ncbi.nlm.nih.gov/books/NBK448165/