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Positional apneas suddenly worse post flu
#1
Positional apneas suddenly worse post flu
Hi all,

I had been doing fairly well with AHI's in the 2-4 range most days with a cervical collar as I do get a lot of clustered apneas/positional apnea. Since recovering from the flu a few weeks ago, however, I've been having many more positional apneas and higher AHI's (6-10). I'm wearing the same cervical collar and pillow without any changes I can identify. I've attached a pre and post- flu oscar chart with the higher AHI reflecting more recent nights. I do notice more mouth breathing potentially when I wake up in the middle of the night recently (I wear a full face mask). I don't think I have any more nasal congestion than usual. Any ideas would be greatly appreciated.

I have a continuous pressure of 9 and EPR 2. Cannot tolerate APAP.


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#2
RE: Positional apneas suddenly worse post flu
Any thoughts?
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#3
RE: Positional apneas suddenly worse post flu
The consistent leaks look like mouth leaks, the spikes are usually masks leaks. Maybe someone can speak to this about a full face mask.
The leaks are compromising your therapy, IMO.
Don't over tighten your mask.
How did you decide on the fixed pressure of 9cm?
You flow limits are high,  try EPR of 3 and them bump your pressure to 11 cm
Lose the calendar and the settings will show.
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#4
RE: Positional apneas suddenly worse post flu
J is right about using EPR 3.  Your leaks are a bit high, but they are not compromising your therapy.  It would still be good to lower them, but it's not urgent.  As J mentioned, your mask being tighter is not always the solution.  Try loosening the mask just a little and see what happens.  Sometimes that helps.

As to pressure settings, I think it would be better if you tried a narrow range of pressure to see how much you really need.  I think a range is better overall because we don't breathe exactly the same every night, and the range allows us to get what we need each night.  I suggest setting to Apap mode and setting a range of 9 to 13.  Let's see how that goes, then we can re-assess.

Also, your Oscar chart needs a little help.  Instead of Mask Pressure, we need to see Pressure.  Your chart should contain the following, and only the following, in the order listed:

Event Flags
Flow Rate
Pressure
Leak Rate
Flow Limits

Thanks! Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution and F&P Nova Micro

Link to thread about switching from Autoset to Bilevel:
https://www.apneaboard.com/forums/Thread...+a+bilevel

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#5
RE: Positional apneas suddenly worse post flu
The inconsistencies and spikes in your leak rate, even though they are below ResMed's high leak limit can cause arousals and can affect your therapy.
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#6
RE: Positional apneas suddenly worse post flu
I would check the collar.  it has to be tall enough.  The height is the distance between your chin and sternum.  It has to be tight enough so your chin can not slip down called chin tucking and no change of pressures can help that.
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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#7
RE: Positional apneas suddenly worse post flu
Thank you all so so much! I will make these adjustments and report back.
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#8
RE: Positional apneas suddenly worse post flu
staceyburke, is this a good diagram to help us with that measurement, the distance between your chin and sternum?
   
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#9
RE: Positional apneas suddenly worse post flu
J, that's a good way to measure, but the size may differ from brand to brand, so check the brand you are interested in.
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution and F&P Nova Micro

Link to thread about switching from Autoset to Bilevel:
https://www.apneaboard.com/forums/Thread...+a+bilevel

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#10
RE: Positional apneas suddenly worse post flu
I have only found the caldera releaf to be comfortable for wearing. I’m not sure if the foam is sturdy enough although I was previously doing OK with this brand. I have found the Velpeau and several others from Amazon to be really uncomfortable on the back of the neck while sleeping. Do you recommend any particular brands other than these?
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