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Struggling. Advice on sleep report
#1
Struggling. Advice on sleep report
Hi everyone,

Looking for advice on how to improve my sleep. I've been using my machine for over a month and I'm still exhausted. I've attached my latest Oscar report (with two zoomed in shots of the most events). PLEASE, offer your advise and wisdom.

Most appreciative!

TMac


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#2
RE: Struggling. Advice on sleep report
TMac, at a pressure range of 9.0 to 14.0 with EPR 3 your therapy actually looks pretty decent, and pressure only varies by 1.5 cm between the median and 95%. There are some obstructive events that seem to arise out of otherwise good respiration, meaning that there are not preceding flow limitations or snores. Where obstructive events seem to somewhat cluster with no warning, it might suggest a positional issue. I think your therapy settings are very good, but you should focus on how your head is positioned, if there might be excessively tall pillows or somehow you find a way to tuck your chin. Your event rate does not seem clustered in a way I would immediately point to positional apnea or a soft cervical collar (see link in my signature), and it may just be a random occurrence.

Your images are a bit difficult to see as they are relatively small. The OA events you zoomed in on at 01:24 are clearly an arousal and appear to be a physical movement with a breath-hold ahead of the flagged event. I doubt the first two events are an apnea, but the third may be.
Sleeprider
Apnea Board Moderator
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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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#3
RE: Struggling. Advice on sleep report
Two things, 1 try EPR =2 to reduce your centrals bit.

The events you highlighted t
I think are chin tucking. The fix is a soft cervical collar but I'm reluctant to recommend that based on one night with so little of it.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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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: Struggling. Advice on sleep report
Thanks, Sleeprider. It's good to know that my pressures seem fine. I probably do tuck my chin. I've tried a cervical collar and I felt like I was being strangled. I remember ripping it off in the middle of the night...violently ripping it off.  Too-funny I think my jaw drops back at night, too. Before trying the apap I had a Tap device, which didn't seem to help my apnea.  I'm wondering if I should try the Tap with the apap? Thoughts?  And thanks for everything! I really appreciate it!
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#5
RE: Struggling. Advice on sleep report
Thanks, Bonjour! I will reduce my EPR to 2. Should I leave it on full time or change to ramp only?

Also, I've tried a cervical collar and really had a horrible experience with it. Felt like I was being strangled. Very unpleasant. 

I was saying to Sleeprider that before getting my apap a month ago, some years back I had a Tap device to made to move my jaw forward. Do you have thoughts on wearing the Tap along with my apap?

Thanks for much for your help!!!
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#6
RE: Struggling. Advice on sleep report
EPR should be full time
A TAP device is intended to position your jaw forward to help maintain the airway and may help with the obstructions we are seeing here, but most people find it difficult to maintain a seal while using dental devices that prevents air from entering the mouth during PAP therapy. You can try it, but if you find a lot of air trys to bypass through your mouth, remove it.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
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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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