BiPAP new therapy

[Sleeprider]

Dan, this is why we don't judge based on a single night. There will be days or nights like this that are completely random and not a consequence of the therapy. If the problem continues, we simply retreat back to PS 5.0. I'm not seeing problem that are so much related to PS, rather I see a few incidents of positional obstruction, but there is virtually no flow limitation when that is not happening. Go again, relax and we will make the decision of what to do based on more than one night.

[DanEm]

It is amazing how a little change affects the sleep.

Since you believe I have more positional problems, would it be wise to get a good quality thing to prevent my turning onto my back.

Maybe I am clutching at straws but if it is worthwhile to try , I would.

My (bad) last night sleep is affecting my humor. Today I feel very crappy.

Sorry again to be that inquisiting, I guess you could call me a questioning pain in the a$$.

[Gideon]

That last session of the night was nearly entirely positional. By that I mean likely cervical alignment., Not back vs. side. If it's a one-off then forget about it. If it is recurrent than it needs to be addressed. That showed both as OA and flow limits.

[DanEm]

That last session of the night was nearly entirely positional.  By that I mean likely cervical alignment., Not back vs. side.  If it's a one-off then forget about it.  If it is recurrent than it needs to be addressed.  That showed both as OA and flow limits.

For cervical alignment, is a cervical collar the best thing, or is there something else to try?

[Gideon]

First I don't like suggesting using more stuff to fix your apnea, that is unless I feel it's needed. If this is a persistent issue and a simple pillow modification, 1 vs 2, flatter, less firm, then yes a soft cervical collar is IMHO the best choice.
Read the wiki on positional apnea and soft cervical collar. A properly sized collar can work miracles overnight, all via an off-book use of existing medical device.

[DanEm]

Thank you for the advice that I will follow.

My last night results are good I think.

I am wondering if the flow limitation can be improved some more.
Past conversations underlined that a lower than 0.1 FL would be better.

I have mask leaks when I expire that are waking me.
The mask is tight enough that I have red marks in the morning.
Could lowering the EPAP help eliminate the leaks without affecting the positive results?

[Sleeprider]

Dan, you seem to be killing it with your therapy now. Your flow limits are a fraction of what they once were and your pressures are relatively stable. I'm really reluctant to chase flow limit numbers when results are this good. You can try PS 5.6, but I'll be surprised if we see a significant change for the better. What are your thoughts?

[DanEm]

Sleeprider

I agree that I am probably at the best results.

For a night or two, just to see what happens, I might try PS 5.6.
But I am prepared to come back to the settings I have now.

You did not pick up on the leak issue I mentioned.
It is small stuff, but they do wake me up.
I can try to work on the mask to cut them but I am not certain of the results I could get with the mask already very tight.
That is why I am asking about a possible reduction of the EPAP. But here also, it is just to see.

Gideon

I read much about cervical collars and got one which seems to be working fine.

I also have a rigid one that I tried once or twice.
It is not very comfortable but I can modify it for a better fit.
I would settle the PS and EPAP things first and then if the collar could improve yet more the results, I would work on it.
That would be my plan for now 

Any more ideas for me ????

[Sleeprider]

Dan, look where you came from on this therapy. It really makes a lot of difference in how your results appear and how you feel to be using bilevel. You're the poster child for the need for positional aids and when you tried to be naughty, we busted your chops. I sincerely hope you are now in control of your therapy and will make all the right decisions. We are here to make you independent and to understand how this works so you can help yourself and others. I think you're getting pretty darn close to graduation. To the extent we can help, we are here for you, and I hope you will pass it forward and help others.

[DanEm]

I decode that I should stop questioning flow limitations and mask leaks !!!

Not being English borned, I sometimes miss meanings.
I also screw up my writing so readers might not understand what I want to convey.
Also, I might as well confess that I do have some Irish blood.  Although very little, it does sometimes drive me to stubborness. 

I will keep things as they are, not promising not to do some tests.

I think it is Arnold S. who said "I'LL BE BACK" or something to that effect... 

Again thank you all for the replies to my comments.