Newbie, 7 days and still trouble TICKLING

[Kessy]

Okay. Thank you for your reply. I changed my pillow and tried to change my sleeping position (with the neck) but its still bad then.. But then there is little hope for me. I have herniated disc's in my neck and nerve damage affecting the arms making it impossible to sleep on my side or stomach - can only cope with side about 10-20% of the night, on good nights. 

Sad and exhausted. Will talk to my doctor and explain this. He never spoke about it being necessary to sleep on the side for the machine to help.

[Old Steve]

It may or may not help sleeping on your side, in my case it was like night and day.  Once I got off my back and started sleeping on my side my AHI dropped from about 4.5 to under 0.50 most nights.  I also have some back troubles and it took me several weeks to get to the point that I could stand it.  I still have pain in my left shoulder every morning, but it is no where near as bad as it first was.  Have you looked at a soft cervical collar, some folks have great results with them.  I used a collar for a few weeks, but it did not do much for me. If you do have to sleep on your back,  I would try a soft cervical collar, they are available on amazon and are not costly.

As to talking to your doctor most of them do not think that your sleeping position has much effect on the quality of sleep you are having with a CPAP.  When you do talk to him, take a copy of the last OSCAR chart you posted with you, that might help.  

You may need a BIPAP machine rather than a CPAP,  the BIPAP machine can supply you with more inhale pressure along with less exhale pressure. This should help with your very high flow limits.  You should discuss this possibility with your Doctor also.

 With all the Positional Apnea it is hard to tell for certain what you need for minimum pressure.  Although, I can assure you that you do need to raise your minimum pressure.   On your chart during the times you are not experiencing positional Apneas the machine is still running with 13cm of pressure.  So at least try raising the minimum up to at least 9cm and also raise the maximum to at least 16cm to start to see if it helps. 

 I will see if someone else more knowledgable that me can take a look at your charts.

[OpalRose]

Kessy,

Look through the information in this link:

https://www.apneaboard.com/wiki/index.ph...onal_Apnea

You should notice from the example charts that your chart shows the same "clumping of apneas".  This is called Positional Apnea and is caused by sleeping in such a way that is cutting off your air.  Although back sleeping isn't ideal for someone with sleep apnea, many here have to adapt due to not being able to sleep on their sides same as you.

The secret is to not let your head tilt downward into your chest area.  This is what is called "chin tucking" and is cutting off your air supply, like a kink in a hose stops the water from flowing.  

The one thing that can cause this is by using more than one pillow or a pillow that is too tall.  This will push your head forward.  Use one pillow that isn't too tall and will allow your head to lay flatter or slightly back.  

In the link above explaining Positional Apnea, you will notice that soft cervical collars often help stabilize the head and neck.  But if you can correct this by using the proper pillow to obtain the desirable head/neck alignment, you can avoid using a collar.  

Correcting this should be a priority, as higher pressure usually won't.  

Your mask needs some attention too.  Read though this link to see if you can obtain a better fit without over tightening.

https://www.apneaboard.com/wiki/index.ph..._Jeffy1958

[Kessy]

 I also have some back troubles and it took me several weeks to get to the point that I could stand it.  I still have pain in my left shoulder every morning, but it is no where near as bad as it first was. 

Sorry to hear you too have pain and problem with your neck. 

I will try to set the pressure to higher, but when it was 16 last time (I tried it) I had more leaks. I'm not sure this mask is the best for me. I will try a few more nights, and try to prop my thin pillow even more so that my neck is position right. I'm not allowed to use a collar for my neck,since when I did due the pain it straightened my neck too much and the physiotherapeut told me it was bad and could cause other discs so break. (My spine isn't good.) Right now I feel pretty discouraged. Especially since the AHI increased after starting to use the machine. It really doesn't make sense to me. I wonder if my jaw falling open might contribute: and no; I can't cope with taping my mouth (PTSD). Not sure strapping my head even more would be good for the neck either. But the mask acutually make me able to have my mouth closed more.

[Kessy]

The secret is to not let your head tilt downward into your chest area.  This is what is called "chin tucking" and is cutting off your air supply, like a kink in a hose stops the water from flowing.  

The one thing that can cause this is by using more than one pillow or a pillow that is too tall.  This will push your head forward.  Use one pillow that isn't too tall and will allow your head to lay flatter or slightly back. 

thank you for the reply, and I will try to search for more solutions. I've changed my pillow, and have only a thin one now and propped it so that it will not make my chin move towards my chest, but it didn't seem to make much difference. I'm not allowed by the physioterhapist to use a soft collar; since it straighten my neck too much when I used it due to nerve pain. He said it could cause other discs to break or other problems. But I wonder if it's partly because my jaw falls open.. But I still don't understand why the AHI has increased so much after I started using the machine.

Either way, I will keep on trying to adjust and search for solutions a while longer. Despite it feeling very hopeless right now. I will talk to my doctor and provider about the mask though; I don't think it's a good fit; and I've tried to adjust it a lot. But it doesn't seem to fit my face that well.

[Deborah K.]

If you cannot wear a cervical collar there is another option.  I purchased a child-size pillow (they are lower than regular pillows) that has a raised front edge.  This holds my head tipped back slightly and completely solved my positional apnea.  My pillow is no longer made, but there are a couple on Amazon that might work the same way.  Here are a couple of links in case you are interested:

https://www.amazon.com/Tiny-Twinkle-Todd...r=8-7&th=1

https://www.amazon.com/MLILY-Adjustable-...=8-44&th=1

The second one has three layers, so you can make it lower if needed.

Best wishes for finding a solution quickly!  

[Kessy]

If you cannot wear a cervical collar there is another option.  I purchased a child-size pillow (they are lower than regular pillows) that has a raised front edge.  This holds my head tipped back slightly and completely solved my positional apnea.  My pillow is no longer made, but there are a couple on Amazon that might work the same way.  Here are a couple of links in case you are interested:

Thank you. I will check it out. But right now I will paus me using the mask and contact the provider, since my AHI was SO high tonight (I slept with my bed slightly raised so I didn't fall back as much, and really propped the pillow well, but the AHI went to over 25) and there is still leaks (if I put the mask far enough up on my nose it leaks down at the mouth, and putting it well over my mouth make it press unpleasently over my nose so bad it causes a mark for hours afterwards). 

Also I seem to have more central sleep apneas now, had 25% of them last night, and more with high pressure. :-( So I will take a break, and calll my provider and 
discuss at least changing the mask.

Have a great day!

[Kessy]

You may need a BIPAP machine rather than a CPAP,  the BIPAP machine can supply you with more inhale pressure along with less exhale pressure. This should help with your very high flow limits.  You should discuss this possibility with your Doctor also.

 With all the Positional Apnea it is hard to tell for certain what you need for minimum pressure.  Although, I can assure you that you do need to raise your minimum pressure.   On your chart during the times you are not experiencing positional Apneas the machine is still running with 13cm of pressure.  So at least try raising the minimum up to at least 9cm and also raise the maximum to at least 16cm to start to see if it helps. 

 I will see if someone else more knowledgable that me can take a look at your charts.

Again, thank you for your kind reply. The lady (nurse) handing out the machine at the clinic seemed very tired of her job, soIhope I get to see someone else when I go there now. I really do think the mask is not working for me, I can't make it fit well and stop leaking. And I tried chaning my sleeping position even more (raising one end of the bed, and propping the pillow even more to make my neck kink in the right direction) but AHI went over 25 tonight and 25% was central sleep apneas.. :-( 

I changed the minimum pressure to 8, because couldn't cope with 9 and fall a sleep. I tried 15 at first before I went to bed, but I struggle with 15, badly. It makes me feel like I'm suffocating and as if no air is getting out (even with 3 being the pressure set for the release of breath). 13 seem to the limit right now. Possibly I could train to be able to cope? (possibly the body needs time to adjust) But also the central apneas seem to increase with high pressure. I will paus my efforts for now, and talk to my provider about the mask and it's not going well, and hope they will accept looking at the OSCAR charts and not get angry with me for changing the pressure my self (they sent me home with 4 to 20, despite me not coping with the hightest pressure when they tested it there). 


Either way, thank you. Have a great day.