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Congrats! I knew the collar was going to have remarkable results, and it's not the first time.
Going back to Coffee Man's comment above where he couldn't understand why your machine was only going to 11.0 cm pressure with all that obstruction. The answer is the Philips Auto poor challenged algorithm for pressure that relies heavily on snoring to warn of impending apnea. With positional obstruction, there is often no warning. The airway closes, and it's too late to increase pressure. Resmed uses flow limitation (a decreasing flow rate during inspiration) to raise pressure, and it usually raises pressure pretty fast ahead of obstructive events, including positional apnea, but even Resmed can't break through a positional block.
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.
I'm doing great, feeling a lot better but thinking I can get it down a bit more. The AHI last night was 4.8, which is still a lot better than it was. I'm wondering what your thoughts are on these readings and if there is anything further I can do to lower it? Again, many thanks.
Now that you have resolved much of the need for higher pressure by using a collar, we might be able to try lower CPAP pressure to start. Keeping the Flex setting low (1) and reducing minimum pressure to 10.0 may result in improvement of CA results without triggering more obstructive apnea. CA events will tend to be transient and they are not at a very severe level for you. My suspicion is that they will eventually attenuate even if you do nothing.
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.
I don't know if you've been using a PAP machine for a long time or if you just began recently.
If you started recently, your CAs may be "treatment-emergent CAs" caused by the fact that your breathing is now more efficient and therefore clearing out lots of CO2 from your blood. Although that sounds like it is a desirable thing to achieve, the brain uses excess CO2 levels as a trigger or reason to breathe in the first place.
The CAs may be caused by this new level of CO2 that your body is experiencing. After 2 to 3 months of continuous PAP machine usage your body will acclimatize to the new lower levels of CO2 and the CAs may spontaneously disappear (or attenuate as sleeprider said). Sometimes CAs don't clear up after 2 or 3 months but we won't know until you've been on therapy for a while.
For more details on treatment-emergent CAs read the information in the link from my sig.
I like to add that many users get concerned at the total number of events, but it only takes 10 seconds of not breathing to record an event. Expand the Events ⇾ Clear Airway on the left side of the Daily Screen. The value within the parentheses "( )" is the time in seconds. I look at these numbers as a magnitude value. I regard any number below 20 as "Don't lose any sleep over". As these numbers grow (if they do), I would start to take a closer look to see what conditions may have precipitated them.
The bottom line is to remember that you are in a better place than before you started treatment.
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.