Larrypac [Therapy Thread]

[Larrypac]

I am confident that I don't have heart failure.  My BP runs about 115/70 so I assume I'm not at high risk for stroke.  Would false flags show up every night?  Either way, I'm getting some answers from my FNP on Monday or finding a new one.

[Ratchick]

Yes, because it records periodic breathing, which INCLUDES CSR, but isn't LIMITED to it. So all CSR is periodic breathing but not all periodic breathing is CSR - and confusingly, the Resmed label is CSR, when more accurately, it would really be periodic breathing. It's not a false reading, per say, the machine's algorithm has spotted a pattern of increasing and decreasing depth of breaths and tagged it. But if it's associated (as it seems to be at least on your last chart) with a huge cluster of obstructives, then it's simply the pattern of breaths from that that the machine spotted, I suspect.

And yes - a collar can stop your head from lolling to the side as much, and hopefully those clusters of OAs. That's part of why I wear one even though I don't have positional OSA because it stops my head lolling, stops my jaw from dropping and the associated drooling, stops me getting a horrific dry mouth and mouth breathing instead of through my nose and I generally wake up feeling a lot less uncomfortable.

[Larrypac]

Thanks!

Yes, because it records periodic breathing, which INCLUDES CSR, but isn't LIMITED to it. So all CSR is periodic breathing but not all periodic breathing is CSR - and confusingly, the Resmed label is CSR, when more accurately, it would really be periodic breathing. It's not a false reading, per say, the machine's algorithm has spotted a pattern of increasing and decreasing depth of breaths and tagged it. But if it's associated (as it seems to be at least on your last chart) with a huge cluster of obstructives, then it's simply the pattern of breaths from that that the machine spotted, I suspect.

And yes - a collar can stop your head from lolling to the side as much, and hopefully those clusters of OAs. That's part of why I wear one even though I don't have positional OSA because it stops my head lolling, stops my jaw from dropping and the associated drooling, stops me getting a horrific dry mouth and mouth breathing instead of through my nose and I generally wake up feeling a lot less uncomfortable.

[Larrypac]

Well, one night is only one night but last night I used a thinner pillow and  tried to arch my head back to open my airway and the change was dramatic as shown in the screenshot below.  I have also ordered a Releaf collar.

[staceyburke]

It is only one night but you got rid of all of your positional apnea.  Great job.

Now I think you could make the pressures normalized by making a couple of changes.

I would suggest a min 7 and EPR 3.  That should even out your pressure chart and make for a more peaceful nights sleep.  If you look at the pressure chart it looks like a mountain range.  The more it goes up and down the less likely you will get to a deep sleep.

[Larrypac]

What about the max?

[staceyburke]

Leave it where it is. It will only go up to the pressure it needs to stop apnea. We would raise it IF it got to the max and you still had events and we would lower it if it kept going higher without O events. 

Pressures move up because of flow limits. Compare the pressures chart with the flow limits chart. When you have a large group or large single flow limit you can see your max pressure goes up. 

EPR controls flow limits but you need an increase in the min for it to work.

[Larrypac]

Here is the data from last three nights.  Last night I took a benedryl and slept better but not according the the AHI.  Input is welcome.  LP

[SarcasticDave94]

Looks to me like your Positional Apnea is back. If you don't have one, it's time for a soft cervical collar. And you are getting random nights with high CA reported. One thing with CA is that Ramp isn't your friend. From there, CA versus Obstructive events and FL is that they're on opposing sides of the treatment teeter-totter. Work to combat CA with actions like reducing EPR will likely increase Obstructive and/or flow limits and vice versa.

[OpalRose]

I have also ordered a Releaf collar.

Have you tried the Releaf collar yet?

Just know that no pressure changes are going to help much until you can get the Obstructives (positional apnea) under control.

Keep using the thinner pillow, but be aware of how you sleep. Back sleeping is ok if you can keep your head from dropping forward. Even with side sleeping, you can tuck your chin easily and cause those clusters of obstructions.