Not able to bring my AHI reading down

[Cliffh]

Good day All,

Herewith some more results. Please view the 2 attachments, one for sat 14th and the other for sun 15th.

Sat 14th:
EPR=1
Min Pressure setting = 10.4
Max Pressure setting = 16
AI = 1.3
HI = 1.3
AHI = 2.63
Did not have a cervical collar yet.

Sun 15th:
EPR=1
Min Pressure setting = 12.0
Max Pressure setting = 17
AI = 2.6
HI = 5.2
AHI = 7.86
Now using cervical collar.
These changes were made from suggestions given.
It looks as though OpalRose's suggestion of not changing too much too soon is valid.

Looking at the graphs, and I may be wrong, it looks as though the max pressure should be lifted to 20 as mentioned by RonAKA.


Suggestions welcome.

Cliffh

[Ron AKA]

Despite the AHI setback on the 15th, I think you are making progress. As suggested before I would increase the maximum to 20 to find out just how much pressure you need. Most of your events are occurring when the machine is limited by your maximum pressure setting. 

When you have tried that for a few nights, then I would reduce EPR to 0, and see what that does. When you see how that works, you may then be able to lower both the maximum and minimum by a corresponding 1 cm. The way I have both my machine and my wife's machine set up now, I apply the EPR at 3 to the ramp period only. It provides a bit more comfort when you are trying to fall asleep, and more pressure support after you are asleep.

[Cliffh]

Hi Ron AKA,

Max pressure now at 20.
Please see the report.....does this mean I have to go higher than 20?

Regards

Cliffh

[Walla Walla]

Soft Cervical Collar.

[Cliffh]

Already using a soft cervical collar.

[Walla Walla]

Are you sure the collar isn't too loose and your chin is slipping inside the collar?

[Cliffh]

You have a point.
Unfortunately I have been built in such a way that my chin and neck are almost one. (Don't have much of a protruding chin)
I had it on for most of last night, and made it so tight that it starts creeping up and into my mask causing some leakage.
As you can imagine it becomes pretty uncomfortable.
I already have a plan to try and modify it for myself.......unless you can think of something else that will work.

[Walla Walla]

The one I use is only an inch thick and 2 1/2 inches wide so I'm able to slide up under my chin. Look on Amazon you should be able to find one like that.

[OpalRose]

The collar should not be worn tight.  You should be able to insert at least two fingers under it.
Also, the collar should not be too tall.  Measure from your chin to the neck and subtract a couple inches.

All you want to do is stop the chin from dropping and tucking into your chest. Like a little ledge for your chin to rest.  Even a rolled up towel placed under chin could do the trick.

From the graphs, some of the obstructives look to be a positional problem.  Try to stay off your back.
I know...easier said than done.

I don’t think the max pressure needed to be raised that high.  If you look at the graphs, the flow limitation and snores will send the max pressure as far as you set it.  Although you have obstructives at the same time, the minimum may need raised just a bit.

[Sleeprider]

I agree with the above comments. I'd like you to try increasing the EPR setting from 1 to 2 or 3. This will help to reduce the hypopnea, however since it drops your exhale pressure, you should compensate by adding 1 or 2 to your minimum pressure of 12. EPR should make the therapy more comfortable, and we have seen good results on reducing hypopnea. Give it a try and see if it works for you. I think if you can resolve the positional apnea issue, you will end up with very good results and better sleep.