What's the problem?

[hkcl]

Your OA frequency is way too high. I've gone through these. I suggest that you change to a fixed pressure, probably starting from 10 and work your way up and see what happens. Variable pressure does not work because it induces apnea! I am not an apnea professional, just speaking from my own experience.

[PaytonA]

Sorry, I wasn't clear enough. What I wanted zoomed in on is the flow rate chart.

Apneas most often occur on the inhale so what immediately follows is a large inhale and then, of course, a large exhale. The system does not see a high pressure jolt at the end of an apnea. If anything, it sees a short rapid pressure reduction until the signal from the pressure reduction reaches the machine (not very long). I think that the leaks are merely from the high pressure from the machine. Do you use the mask fit feature of your machine to adjust your mask for the highest machine pressure the mask will see? If not, you should. I use an F20 mask and my pressure goes above 20 at times and I do not get leaks.

Best Regards,

PaytonA

[slaterslater]

I think this is that you want PaytonA
And use mask fit function every night before sleep and have no leak in 20 smH2O
http://imgur.com/obnPnKQ

[slaterslater]

Thx hkcl for advices.
   Right now, I'm just starting to experiment to see where the problem is and it turns out that pressure is a problem, and it creates my discomfort and the number of apneas. Last night I set a maximum / minimum pressure of 10/14, this evening 11/13 and the result was 7.32 and 7 AHI. And looking at the next step is to flatten the top with the lower limit at 12 cm.

[DeepBreathing]

Variable pressure does not work because it induces apnea!

I don't think that's generally correct. Variable pressure doesn't suit some people, but for the majority of users it provides a superior treatment.

PaytonA: Looking at Slaterslater's charts I'm seeing a very severe obstructive apnea occurring in distinct episodes, with few or no apneas in between. The episodes are quite long, as are the individual events. Do you think there might be a positional effect happening here? It could be Slaterslater is moving into a position where he is obstructing, such as chin tucked to his chest. The recovery breaths are really big, which could be caused by violent gasping, which in turn is loosening the mask and causing the leaks?

In any case the length of these episodes worry me - they can't be much fun at all. Slaterslater, do you have a bed partner who has observed these events? It would be good to know exactly what's happening physically. Alternatively (and without wanting to sound creepy) are you able to video yourself sleeping and see what's going on?

[Sleeprider]

Slaterslater, get a soft cervical collar with a loose fit. You are looking for one that you can insert 2 fingers between the collar and our neck, and just tall enough to gently pressure the jaw. Those are very distinctive obstructive events typical of your chin dropping toward your chest. This may be because you use too many pillows or just need more support. Pressure alone may not pry open your airway, but we have seen amazing results using the soft collars.

[slaterslater]

Well I did record with a phone and it turned out that I just did not sleep well I was trying and just getting apnea after apnea with a duration of about 30 seconds and more after there is release of air and the grief starts again. During my review at the hospital, I found a severe sleep apnea with AHI 50.
I think that this happens when the pressure can not overcome the apneas, and these episodes are actually being seen on the diagrams and until the position is turned or I do not know exactly what it is. The problem is that under 7 AHI I did not take off even with the machine but I feel brisk and sleeping which for me is good overall. Last night AHI 7 and Total Time in APneas give mi 20 minutes from 7 hours sleeping time.
I have been treated with an automatic cpap and average pressure of 11 cmH2O. And now want to recover what is reason for AHI 14-15 with mashine.

This is chart from night with AHi 7,32
http://imgur.com/Mr06kA3

[slaterslater]

Sleeprider: I think that's just the reason you wrote, but I do not know what happens when I sleep with only a tiny pillow and on my observations I sleep on my right side as I occasionally spin on my back and maybe get these episodes of apnea. May be soft collars is a good idea for me.

[Sleeprider]

Most people can simulate the obstruction by tucking the chin towards the chin and just relaxing and letting everything go limp...if you find that obstructs your airway, a soft cervical collar can prevent the critical posture obstruction for most. This physical obstruction can occur in nearly any sleep position including your side or back. Comfort is important in selecting a collar. You want support, but not impingement on the throat. This problem is much more common than we thought, and the professionals have yet to catch up with it. You can blast a CPAP at 20 cm and bilevel even higher and it won't open up the airway on some people, but if they get supportive positional therapy, it's amazing. I would not be surprised if a poll showed 15-20% of members on this forum are using this technique. Searching "soft cervical collar" on the forum or google search would give you some idea of how widespread this is. https://www.google.com/search?q=soft+cer...8&oe=utf-8

[Melman]

Slaterslater,

I'm a perfect example of what Sleeprider has recommended. When I first posted data after getting my new machine he suggested my high AHIs were due to positional issues. In my case, I got a buckwheat chaff pillow to stabilize my head position but the idea is the same. It helps prevent chin tucks. My AHI numbers immediately dropped to 0-2.  I have since started using a soft cervical collar as well. We later tweaked my pressures a little but resolution of the positional issue was the game changer.

Thanks again Sleeprider