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Still struggling after 4 months
#1
Still struggling after 4 months
New user still struggling after 4+ months.  Thought the primary problem was major leaks, and in some cases that's true.  Leak rate often much better without humidifier, so I usually turn humidifier off and put up with super dry mouth.  (Have experimented with various humidifier settings, heated tube, even then have dry mouth). Unfortunately, even with no humidifier and minimal "time over leak redline,"  the apnea numbers are still not so good many nights, as in the attached example.  Any tips or suggestions for changes to try? Thank you.


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#2
RE: Still struggling after 4 months
It looks like some Positional Apnea clusters from about 01:30-02:30, maybe other areas too. This requires an edit to your pillow or a soft cervical collar.

On the pillow aspect, is there a stack or a very thick single pillow? Yes then go thinner. If this doesn't help, then the collar may be your best bet.

If this is Positional, no pressure can power through. This Positional issue isn't like what's referred to in sleep testing. On the test, it means side, back, prone, the physical body position. Here with Positional Apnea, it means head and neck being positioned to kink the airway.

You can test to see if positional Apnea is an issue while awake. Sitting upright, point your chin down to your sternum. Any breathing issues?
Dave

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#3
RE: Still struggling after 4 months
I totally agree with positional apnea. The second thing I would look at is flow limits. You have quite a few flow limits. They are obstructive apnea just like O ant H events. We use EPR to treat them. The left hand column is cut off and showed you do have EPR on but not the level. It can be set at 1, 2 or 3. I would suggest setting it to 3.
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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#4
RE: Still struggling after 4 months
His EPR looks to be 3 if looking at the pressure chart at the starting point on the left. Your chart looks like how mine used to look for awhile when I was on full face masks. Now, I'm on nasal mask and with a collar, and my FL and AHI is lower.
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#5
RE: Still struggling after 4 months
Thank you for the several suggestions.  I will work on positional apnea factor.  As for EPR, I am using it at Level 3, so presumably no further change there is possible.
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#6
RE: Still struggling after 4 months
Yes that is as high as EPR does go. You could try raising the min number a little that can help the flow limits
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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