Advice for dealing with apneas longer than 30 seconds

[artspace]

Hi everyone,

Thanks so much to everyone who contributes to this community! 

I just started using a CPAP machine 3 months ago and this community and the OSCAR software have been so useful and supportive. This is my first post. I'm wondering if someone has suggestions for me to reduce the length of some of my apneas. I just started using EPR which has been amazing at lowering my flow limits (yay!) and yet I'm noticing longer apneas than I had before. Last night for example, I have one apnea that lasted a total of 68 seconds. The previous night I had an obstructive apnea that lasted 44 seconds. In both cases the EPR was set at 2. Prior to this I've had a few nights with individual apneas lasting over 30 seconds, but they've been uncommon. I've never had consecutive nights with apneas greater than 30 seconds in length.

What do you suggest I do? Should I back off on the EPR and reduce it to 1? Is this a positional issue (ie sleeping on my back)? Other thoughts?


Thanks so much!

[Jay51]

Good questions.  Since your very long apnea is recorded as an OA, it would be appropriate to try positional apnea techniques to try to solve it first.  Thinks like lowering pillow height; side sleeping instead of back sleeping (and keeping something between your chin and chest to prevent chin tucking); or even wearing a soft cervical collar at night.  Just measure the distance between your chin and sternum in inches and fractions of an inch to get the correct size. 

Most of your statistics look ok.  0.03 95th percentile flow limitations is good.  Tidal volume, respiratory rate, minute vent, etc.  

You may have gotten "stuck" in a position with your chin tucked to your chest that completely blocked off your airway (and no amount of pressure could break through this clog - it took some sort of position change by your body to free yourself.  

You can keep your setting just as they are.  When experimenting to optimize therapy, only make one change at a time to see how it affects things.  

Here is the link to the reading from our wiki on positional apnea: 

• 5.3Positional Apnea                                                                                                                                                                                                                                                                                                                                           You have some large leaks as well.  Short spikes are usually mask leaks (rolling over, etc.)  The longer duration leaks are usually mouth leaks - which you have a lot of.  Here are some tips to help improve that as well:
  

      

• 1Mask Primer
  

[artspace]

Jay,

Thanks so much for the suggestions. I'll leave the EPR where it is because I've brought down my average flow limits using it.

I'll work on the positional first; I've been sleeping with a wedge pillow which raises my head and will see what happens if I remove it. I'll also see what happens if I work on mouth breathing further. I've just started using tape with a slit for my lips and was using a chinstrap before (which didn't seem to completely prevent mouth breathing either). I'll try the tongue trick and then the cervical collar.

Thanks so much!