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Positional Apnea Problems
#1
Positional Apnea Problems
I've been using CPAP for 20 years and have felt very tired for the past 6 months.  I have an Airsense 10, min 10, max 20.  I tried the tennis ball thing, but that didn't work.  I seem to have trouble when I'm on my back and sometimes on my side.  I tried a 2.5in soft cervical collar.  Last night I tried a sleep noodle.  That kept me on my side, line between shoulders vertical, much of the night.  The results were not encouraging.  My flow limit was 0.26 with all sorts of events.  In my doctor's visit yesterday, all he had to say was lose weight and use pillows to stay off my back.  He's my general doctor.  I feel like I'm on my own with this.

Here's a picture with the soft cervical collar and a tennis ball.
 Greg


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#2
RE: Positional Apnea Problems
Sometimes it's not so much as sleeping on your back, but how you sleep.

You apparently are "chin tucking". This can be from a too tall bed pillow that tilts your head/neck forward and can occur in any position. Opt for a thinner pillow, one that supports your neck but doesn't tilt your head forward.

I would use the EPR setting at 3, as this should bring the Flow Limitation and Hypopnea down.

Try to stay on your side as much as possible, use a soft cervical collar and a flatter bed pillow. You'll have to experiment to see what works best for you.

Also, know that no amount of pressure increase will help with positional apnea.
OpalRose
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#3
RE: Positional Apnea Problems
It's safe to say the 2-1/2" collar did not keep your chin up to avoid the obstruction. The difference in a 4" collar can be significant. Read the reviews forum to see other member's experience with different collars and maybe something there will be helpful.
Sleeprider
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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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#4
RE: Positional Apnea Problems
The best way I have found to get the right height collar is to sit where your comfortable, with no obstruction and measure the distance from your chin to your sternum.

We all have different length of neck.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Positional Apnea Problems
A little more about me.  I'm 57, 240lbs, 5ft 5in.  I used a 2.5in soft collar last night and a tennis ball.  A review of pictures from my security camera shows I spent very little time on my back, possibly because the dog kept me from rolling onto my back.  I do have a 3.5in collar but it is uncomfortable.  I feel like my chin is forced up.  I will try setting EPR to 3 tonight.  My numbers were better last night but I'm still tired today.  Thanks for the ideas.

     Greg


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#6
RE: Positional Apnea Problems
Took me a while to find my ideal height. Initially, I tried measuring, but it's hard to know if I'm measuring correctly. I had to order several sizes and see which works the best. Interestingly, the standard sized one at Walgreens worked the best. I'd start with standard size and make deducts for either up or down sizing from there.

Also, I find that collar being tight doesn't work well either. Two finger test doesn't make sense to me. You can fit two fingers no matter how tight it is.
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#7
RE: Positional Apnea Problems
I've attached last nights OSCAR graphs.  About equal numbers of RERA's, Hypopeneas, and Obstructive apneas(15, 13, and 18 respectively)  I'm still using the 2.5in soft collar.  A 3in one should arrive tomorrow.  The 3.5in leaves me feeling like my chin is being forced up, so I haven't tried sleeping with it.  The camera shows not much time on my back and some on my side.  Still feeling tired today.  I did set EPR to 3 last night, instead of 2.  I'm not sure where all the RERA's are coming from. 
     Greg


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#8
RE: Positional Apnea Problems
Well,   I'm improving as far as tiredness goes, but I still had more events last night the the previous two.  I received my 3in soft collar this morning so I will try that tonight. Hope it helps.
     Greg


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#9
RE: Positional Apnea Problems
Well, the 3in soft collar made no difference last night.   I have a 3.5in that I will try tonight and a new flatter pillow that is coming in today.  Very frustrating.  I do feel somewhat better, but I'm still getting many hyponeas, OA's, and RERA's.  I hope the 3.5in will fix it and be tolerable. 

       Greg


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#10
RE: Positional Apnea Problems
I find it odd that you had better results with 2.5 in collar. Your collar experience is inconsistent so far. My best guess is that you have your better nights off your back, on the side. You probably have better result sticking to side-sleeping.

I encourage you to work on the weight loss and also trying to stay sleeping on the side position.
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