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08-23-2023, 11:17 AM (This post was last modified: 08-23-2023, 11:19 AM by quiet.)
Requesting Guidance regarding min pressure
Hello all! - longtime lurker, first time poster.
I come to you all with hopes of resolving an issue I have been having. To start, I have been utilizing my Resmed Airsense 10 for a little over a year now. During this time, I have always maintained a healthy 2.5 - 3.5 AHI with my primary min and max pressures 9 - 15cmH20; albeit I wish it was lower. Recently I lost about 20 pounds and with that there was a fluctuation in my AHI. For the past month I have been tweaking the settings a bit, trialing a different min pressure for a short period, in hopes of acclimating, but to no avail.
Attached are a few screenshots - notice the epr was turned on recently, which is a setting I had turned off without realizing how much I needed it. I get aerophagia if I do not utilize it and I will leave it at that.
Attempts I have made to mitigate my increased AHI have been lowering the min pressure to 8 and 7, but that increases my AHI. Further, I have tried raising my min pressure to 11 as well (Median) but that keeps it around 5ahi or higher.
I certainly encourage you to continue using EPR for your obvious flow limitation and RERA. Your obstructive apnea are clearly clustered, sometimes within seconds or minutes. All of those events that are close together are the result of a positional apnea or chin-tucking. This pattern is discussed in our Optimizing Therapy wiki https://www.apneaboard.com/wiki/index.ph...onal_Apnea and of course in the Soft Cervical Collar wiki https://www.apneaboard.com/wiki/index.ph...al_Collari.
Read the wiki articles and look for opportunities to improve your sleeping position. If all else fails, most of your obstructive events will likely resolve with a soft cervical collar. If we can resolve the obstructive events, then it might be possible to reduce pressure and perhaps minimize the CA events as well.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Thank you all for your collective support/feedback. I have taken your advice. I had a travel pillow lying around so I decided to use it as temp cervical collar... surprise! My AHI decreased to 3.8 and my flow limits have decreased as well.
Do you all think I would benefit from narrowing my pressure? For example 10 - 12cmh20. This would be to mitigate the CA's. Would a cervical collar be sufficient?
There are a lot of variables in how collars fit. We look for one that stabilizes the chin or jaw and prevents the kinds of angles that restrict air flow. Experiment with the concept and the aid (collar). Work with the fit, and don't expect that the first effort will be completely successful. You achieved an improvement with a simple travel collar. Everyone with a positional apnea issue has their own individual need for support or to avoid the restriction. Don't be frustrated with a setback as this is very common. Look through your chart and notice how early every apnea is followed by another very quickly. This is why you are unrested. The first apnea only arouses you to open the airway, the second arouses or awakens you to shift position. This particular collar, or the way you wore it didn't work. Try something else.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
