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Looking for guidance
#1
Looking for guidance
So recently I changed my pressure settings on my BiPap to

Min EPAP 5.0
Max IPAP 9.0
PS 3.0
Trigger Setting Very High

I cut way back on the number on the number of CAs I was having. I was experiencing CA numbers in the 90s and have cut them down to 3 CA events two nights ago and 18 last night. What has taken it's place though is the number of Hypopneas I am now having. I was consistently in the single digits for Hypopneas to now in the 60s (did have 136 Hypopnea events 3 nights ago). Not sure if a pressure setting change would work or if I need to change something else. I feel like I slept through the night last night and was surprised to see such a high number when I woke up. Any guidance or assistance would be greatly appreciated.

Last two nights charts.

       
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#2
RE: Looking for guidance
You are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Looking for guidance
Appreciate the feedback. I actually did some research yesterday after I posted (maybe I should have thought of that before posting ??) and found a link that showed that what it potentially was. I'm thinking it may have something to do with a recent neck surgery I had last week. I'm thinking it's due to not being really able to fully tilt my neck back as normal that's causing it. I'm gonna look into the collar option because I've served to have gotten CAs under control not just to get the Hypopneas and OAs under control.
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#4
RE: Looking for guidance
(05-01-2024, 03:13 PM)staceyburke Wrote: You have to find out what position you are getting into and cutting off your own airway.

It's not easy to figure out the answer to this, but you could start by checking to see whether it's simply a matter of which way you are lying in bed. Supine is often a key suspect, but it could be lying on your left and pressing on your heart, or no doubt many other possibilities.

I personally have a low AHI, but I would still like to understand the few events I do have better — so I might be able to eliminate them. I have worked first on establishing ways to find out exactly how I am sleeping (i.e. my precise rotational position) — and I have been very surprised at the results. It appears that arousals have been turning me into unexpected positions (without waking me)!

Let me know if you would like me to elaborate.
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#5
RE: Looking for guidance
(05-02-2024, 08:31 AM)BigWing Wrote: Let me know if you would like me to elaborate.

I'd be all for hearing more of your experiences that may in turn help me or others. 

I'd say I spend the majority (90%) of my time sleeping on my right side. I will occasionally flip to my left side, but rarely do I sleep on my back. In the past I experienced a majority CA events every night and during my sleep study. I adjusted my cycle to very high in an attempt to reduce my CA events. That truly seems to have worked. I am thinking about changing out my pillow tonight too one that has the contours in it that cradle the neck to see if that works. I don't think I've experienced positional apnea in the past and feel it's probably more due to recent neck surgery (lifting my chin up is more uncomfortable than letting it fall forward) than anything else.

I also switched my humidifier from auto to manual to get more humidity and that seems to be helpful somewhat as well (not suffering from dry mouth).

Appreciate your feedback.
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#6
RE: Looking for guidance
(05-02-2024, 09:15 AM)wxmcpo Wrote: I'd be all for hearing more of your experiences that may in turn help me or others. 

Actually, this post I made just yesterday has a good explanation of my latest finding (which was new to me, but probably well known by others on here):

https://www.apneaboard.com/forums/Thread...#pid512715

Take a look at that and feel free to ask any questions.
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#7
RE: Looking for guidance
What are you using to track your movements throughout the night? I know I mainly sleep on my right (well at least I think I do) with some shifting to my left side. I did try a different pillow last night, one with contours to cradle the neck and my AHI dropped significantly. It's still a little too high for me, but I'm gonna keep using it until I find an alternative. I also bumped my pressure settings up slightly to

Min EPAP 5.4 (Previously 5.0)
Max IPAP 9.4 (Previously 9.0)
PS 3.0 (I didn't change this)

Here's my previous two night's Oscar charts

       
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#8
RE: Looking for guidance
(05-03-2024, 02:25 PM)wxmcpo Wrote: What are you using to track your movements throughout the night?

As I wrote in that post I pointed you at, SomnoPose. My own sniff flags give me a coarse guide to whether I am on my left, or right, or supine - but only when I am awake - but SomnoPose gives me the precise angle I am at, and clearly shows when I turn during arousals which don't wake me!
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#9
RE: Looking for guidance
I think you need to take StaceyBurke's advice.  You have a lot of positional apnea and need to sleep in a soft cervical collar, try a very flat pillow or buy a pillow that tips your head back slightly.  I used to wear collars and tried lots.  The most comfortable was the Caldera Releaf Collar, which you can find on Amazon.  I sleep on my back and have been very successful using a child-sized pillow that is low and that keeps my head tipped back slightly.  I hope you find something that works great for you too!  Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#10
RE: Looking for guidance
I've been researching the collars a lot since receiving her advice and the Caldera is the one I'm actually leaning towards. I tried adjusting the head of my bed last night (we have a Sleep Number bed) and trying my pillow in a different position and saw much better results that previously. I am gonna stick with last night's setup for a couple of nights and see how that works. I actually feel like I slept longer and better last night than I have in a long time.

Here's last night's chart

   
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