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Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
#11
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
Well, well! Your central index dropped nicely. You will probably get further advice from the experts about your settings.

Meanwhile, please do give a collar a try. As Bonjour says, the fit should be loose. You are not trying to immobilize your neck; you are just trying to keep from tucking your chin down toward your chest.

If you find that the standard collar you can get in the drug store isn't comfortable, you can try something like the Eliminator collar, whose back is just an adjustable strap with a soft cover.
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#12
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
(01-19-2020, 12:20 PM)Kernelhappy Wrote: I guess to answer the previous question, yes I do wonder what the graph would look like with someone sitting on their chest.

That was a rhetorical question, well maybe the guy wasn't sitting on your chest, but his hands were around your neck with his thumbs on your trachea.  
That's how much I feel you need the collar.
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#13
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
The good news is that last night my AHI dropped to 2.10.  I can't say I felt super refreshed, but at this point if I can keep my AHI's low, I may actually try getting to sleep earlier and getting some more time.  Most often I fall asleep on the couch for an hour or two.  

I do want to spend some time learning more about what my graphs tell me. 

I'm considering it,but I still don't think I can sleep with a collar on.  I had thought about video taping myself to see what I'm doing when I get into the OAs, see if maybe I can be more proactive about something to limit them. 

In any case, I'm off to sleep, here's hoping for a 1.9 tonight.


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#14
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
The most notable feature of your charts are the flow limits. This is best illustrated by your RERAs. A RERA is a SERIES of flow limitations that ends in arrousal.

Please increase min PS to 4 for now

You should look at RDI vs AHI. RDI = AHI +RRRAs
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#15
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
Bonjour just out of curiosity do you think this is a case of UARS that’s stubborn even with bi-level?
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#16
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
Too early to tell. I thought of it. RERAs are often associated with UARS. I tend to think of UARS as something that is left after the detected events (RERAs) are gone.
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#17
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
Ok so if flow limitations and flow limited breathing are still having a negative impact on how you feel after events have been eliminated then you know it’s a case of UARS. Thanks Bonjour.
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#18
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
I agree with Bonjour's suggestion to increase PS min. I'd be reluctant to make any additional changes since you seem to be closing in on much more comfortable and effective therapy. I really don't see a continuing positional issue at this point since you ejected the second pillow. Good luck with continued improvement!
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#19
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
Night before last I went from a 2.10 to a 2.13, overall a decent night. 

When I woke up this morning I was really tired and figured my numbers would show it, instead I'm down to a 1.88. Whats really weird is that I had a 2 hour stretch right before I work up with only one registered RERA and maybe 2-3 dips that didn't even register as events (there were about 17-18 VS2 throughout the period).  I did make the change to the PS Min 4.0 last night.

Overall it's positive progress to a nights sleep that doesn't suck!

I was thinking about the obstructive aspect, I should mention that I have some sinus issues and many nights I end up mouth breathing, I'm wondering if some of the OAs might be related to that instead of chin tucks.


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#20
RE: Almost 20 Years and I need help - CA with a BiPAP and I'm still tired
Could we try a min PS of 5
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