In Need of explanation of results of Cervical Collar Experiment

[Plmnb]

Hello.

I have started a new thread for this question because my original thread: Plmnb's Never Ending OSA Journey (Data) has gotten so long.

At the suggestion of one of the esteemed Apnea Board Monitors- Bonjour, I tried a soft cervical collar for the past two nights.  The first night I was instructed to be sure my EPR was set at 3.  The second night, last night...I was told to put the EPR to 0 (off).

I have no clue what these charts represent but I am going to tell you, last night was AWFUL.  Not sure why, because the charts seem to indicate a better night last night than the night before?  Of course, not being aware of the meaning of the TOTALITY of the numbers....?

NIGHT 1 (EPR 3)

[attachment=18118]


NIGHT 2 (EPR 0/OFF)

[attachment=18119]

It was so uncomfortable this morning that I could no longer tolerate trying to sleep.  Could someone explain why?  Do these charts support the suggestion that I need to change to a BiLevel machine?  Any information is greatly appreciated.

Plmn

[Gideon]

Not expecting that
This is one reason you see us asking how you feel

[Plmnb]

Not expecting that
This is one reason you see us asking how you feel

I apologize Bonjour, but I don't understand your post. What do you mean?  I'm sorry if I am being dense.

Regards,
Plmn

[Gideon]

With EPR = 0 you have a leak issue the leaks often around the max leak threshold even when not exceeding it. Wasn't expecting that.

Pressure in both examples is driven by flow limits which look similar but somewhat worse at EPR= 3 At EPR =3 you are at the max pressure of 15 for a while. At or above 15 is a consideration for a BiLevel. I would increase your max pressure

Your flow limitations and RERAs are not being managed by your AutoSet. That is one thing this shows.

More Pressure Support should be tried and that requires a BiLevel.

I was expecting to see an increase in flow limits at EPR=0.

[Gideon]

Sorry, I'm on my phone and fat finger posted the first message

[Plmnb]

hmmm.

Does this mean I do not have a "chin tucking" problem? Does this mean I still may or may not have something physically wrong with my airways as previously mentioned may be an issue? And/or possibly an issue with this mask combined with the cervical collar with the settings we tried?

Do you think the following plan is appropriate:

I will go into clinicians menu and increase max pressure to ?

In the meantime, contact my doctor and insist he change my current machine to a bilevel?

Then, if this IS appropriate, how do I configure settings for the bilevel?

[Plmnb]

Sorry, I'm on my phone and fat finger posted the first message

 No problem, I understand. Did ponder that for a sec though.

Thanks.

[Plmnb]

hmmm.

Does this mean I do not have a "chin tucking" problem?  Does this mean I still may or may not have something physically wrong with my airways as previously mentioned may be an issue?  And/or possibly an issue with this mask combined with the cervical collar with the settings we tried?

Do you think the following plan is appropriate:

I will go into clinicians menu and increase max pressure to ?  

In the meantime, contact my doctor and insist he change my current machine to a bilevel?

Then, if this IS appropriate, how do I configure settings for the bilevel?

Sooo, I am getting ready to call my doctor and then my DME.  What brand/type/model ? Bilevel should I be telling them I want?

And any suggestion as to what I should set my max pressure to on my current machine until I receive the new machine?

[Gideon]

Chin tucking has to be managed in order to see other things. Chin tucking will cover up a lot of issues. I did not see evidence of significant chin tucking in your recent post.

Something is wrong with our airway, my airway, everyone that's here airway or we wouldn't be here in the first place. There is nothing that makes you significantly different than any of us here.

I want your pressure to go over 15 not because it will better treat you but because it will better qualify you for a BiLevel (VAuto) so set max to as high as you can stand it. More is at the machine max but I never get there

A BiLevel will not be worse than what you have. Facts, your CPAP is not managing your flow limits and you need more pressure support. your pressure is high for a CPAP over 15 frequently

BiLevel pressures will be set by titration. A good starting point is
Mode = vauto
Min EPAP = current min press - EPR (3)
PS = 4
Max IPAP = 25 (machine max)

[Gideon]

ResMed AirCurve 10 VAuto

Current machine max is 20. I'd try it there.