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Pressure setting help needed
#1
Gross 
Pressure setting help needed
New to the site - long time bipap user 15 yrs - after 3 years of changing settings and 3 sleep studies, current sleep doctor has not been able adjust setting to achieve AHI below 10.  Suffer from significant daytime drosiness.  I am 63 yr old male, retired, 6', 180 lbs good health.  

Doctor has tried Cpap, Auto Bipap, Bipap with all sorts of settings but no success.  Currently on cpap with setting of 6.  any suggestions?  If I stop using cpap I wake with head ache and exhaustion.  

Last nites Oscar chart included as attachment.

Thanks,

Joe


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#2
RE: Pressure setting help needed
Has he tried a soft cervical collar? Your obstructive events are clustered/grouped. This is generally a good indication of chin tucking resulting in obstructive events. A characteristic of this type of apnea is a VERY POOR RESPONSE to pressure and pressure support. You also have a good amount of Flow Limitation and RERA and we should also be able to manage that but let's first manage the positional apnea/chin tuck with the collar. Please read the Wiki article in my signature. Anti-snoring and sleeping collars may be more comfortable because they have a strap in back instead of supporting foam.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#3
RE: Pressure setting help needed
No he has not tried the collar - will discuss with him on the next visit.  Thank you for the input - do you have any other advise do you have after seeing the data?
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#4
RE: Pressure setting help needed
As I said before let's get this "positional"/chin tucking managed first.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#5
RE: Pressure setting help needed - update
OK - So I went and purchased the cervical neck brace from Walgreens and have worn it for two nites.  AHI numbers seem to be worse and wake feeling VERY tired.  Any other suggestions?  Am I doing something wrong.  No change in machine settings - just added the neck brace.


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#6
RE: Pressure setting help needed
I suppose collars aren't effective for all users but they're effective enough to suggest you keep trying. besides loose vs tight, collar height makes a difference. alternate styles, e.g., snoring wedges, work better for some too.

I wear a collar to avoid clusters and to minimize mouth leaks. the conventional advice here is to wear it as loosely as possible for comfort while still keeping one's chin from tucking under it. because of the way I'm formed I find I have to wear my collar quite tight to keep my chin up and lips mostly closed. less comfort for more effect but after a week of wear it's hardly noticeable, at least until the heat of summer.

it could simply be that the initial effect of the collar, until you get acclimated, is disturbing and you just didn't sleep as well with this new thing strangling you. it's really no worse than a mask. persevere and we can adapt to a lot.
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#7
RE: Pressure setting help needed
Thanks for the tips - will try loosening a little for a few nites and see what happens.
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#8
RE: Pressure setting help needed
I'm really new to the forum but I spent a bit of time configuring the UI of OSCAR to get rid of some things like the calendar and the pie chart.
Why?  It makes it easier for people to see the settings on our machines without needing to ask or trying to remember. 

That will be really helpful as @Bonjour and others take you through the settings tweaks over the coming days/weeks.
Check out my sig for the "Organize Charts" tips and tricks.

Good luck getting things sorted.
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