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Bipap Titration advice needed. - Printable Version

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RE: Bipap Titration advice needed. - amafra - 03-17-2022

Buddy, thank you for great help.
I'm going to see if I can record. After your reply I'm thinking about how I could sleep for 4 hours at the hospital during the test. I took Ambien there, but I do in my home as well, actually I had 10mg before sleep and at 4am again to keep testing my sleep.
At the hospital, I had my bed at a 30 degree angle or something, maybe it prevented positional obstructive apnea.

So you think I may need Ipap 18? I was thinking my cpap is getting crazy due to the fact asvautop pushed to high pressures. Almost all modes are allowed.
I will keep the first settings and see what happens, next can be set like yours.

Regards.


RE: Bipap Titration advice needed. - Sleeprider - 03-17-2022

Let's not go there yet. Your best chart was bilevel at very low pressure of 12/6, but only 55 minutes. We just need more time to evaluate these lower pressure and try to identify why event clusters occur, just as they did in your PSG. Are you a side or back sleeper?


RE: Bipap Titration advice needed. - amafra - 03-17-2022

I usually start sleeping on my back and always change to the side afterwards. It may be when I change my chin position. 

During sleep study I mostly slept on my back due to bed angle.
I could not find a neck pillow or some sort of cervical collar.
Regards.



RE: Bipap Titration advice needed. - Sleeprider - 03-17-2022

When sleeping on my side, I find that pulling a corner of the pillow between my shoulder and jaw helps to improve position.


RE: Bipap Titration advice needed. - amafra - 03-17-2022

I'm trying to get my hands on a cervical collar today and see what happens.
Tonight I'm setting up Vauto to Epap 6, Max Ipap 12, PS 6. Let's see what happens.I usually fix my chin position but it will move for sure after sleep, best bet will be something in the neck.
Thank you for suggestion


RE: Bipap Titration advice needed. - Sleeprider - 03-17-2022

You are a younger person of normal weight and it's surprising to see severe obstructive apnea. The positional occlusion may be the entire issue. Did you ever try the exercise of relaxing into a chair, then deeply relaxing as you allow your head to drop towards your chest? If you find it increases relaxed breathing resistance that is the mechanism during sleep that cuts the airway and causes arousals so you can get a breath.


RE: Bipap Titration advice needed. - amafra - 03-17-2022

If I move my head towards my chest, I feel air resistance start to get hard after 20% with snore sound halfway to the chest. I never tested it until now. Two weeks ago, I went to the dentist and when I had been asked to open my mouth as much as I could, I simply could not breathe, I needed to close it until air flow gets back. It does not happen just by opening the mouth but when I put extra force to stretch open. In a regular neck position it blocks 90% of air fully stretched, If the head is leaning backward like on a dentist chair, it blocks 100%. You are helping me to understand why I had pretty bad sleep during my life. It may be associated with the scheuermann's kyphosis. I'm 6'. 190 pounds, 18-21% body fat depending on workout routine.  I workout so posture is improved, not fixed, it probably has an impact on airflow. I may not look like externally but looking at my x-ray, it is pretty bad.
I think you are straight to the point, posture problem.
I appreciate your follow up and help.
Thank you.


RE: Bipap Titration advice needed. - Sleeprider - 03-17-2022

Well, that is probably your main challenge is to find a device to prevent positional obstruction. You will be surprised at how common this is among the general population. I know of several people that fully resolved apnea by positional therapy. It's not that easy because the device has to maintain a good airway position without being uncomfortable, or letting the chin tuck below the collar or putting pressure on the airway behind the jaw. Most people have to try several solutions before they find the one that works. Hyperlordosis or "swayback" is a set-up that just makes it more likely.


RE: Bipap Titration advice needed. - amafra - 03-17-2022

Nice the blue collar, It makes sense since unlike the cervical collar it does not seem to choke or block when moving the chin down. It does work as chin support and support all the jaw. 
I will see someone that can make something similar.
I believe you found my apnea issue. The doctor says she doesn't understand why I have severe apnea and am not that overweight. I showed her OSCAR but did not help her.

Thank you 


RE: Bipap Titration advice needed. - amafra - 03-18-2022

Last Night Vauto Epap 6, PS 6  Ipap Max 12. Now sleep again or wait to become a zombie later?
Sleeping again now is not easy, even though it was a short rest, I believe I had some.
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