ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine

[SleeplessInPHX]

Well, a huge jump in AHI, Hypopnea, and Obstructive events. I'm going to put EPR back to 1 and see how tonight goes. 

I think after a few days I'm going to also raise the Minimum Pressure from 6 to 8. Looking at the overall Flow Rate and Events, it seems that on average when the machine drops pressure, when it gets to 9 or below (or in this case with EPR set to 2, pressure of 7) I respond with Hypopnea and the machine goes back up to 12. 

Last night's chart attached.

[attachment=18845]

[Melman]

Your obstructive events are clustered which suggests chin tucking which restricts flow through your airway. I suggest you consider a soft cervical collar. See the link below. It has resolved a similar problem for me and many others.

[SleeplessInPHX]

Your obstructive events are clustered which suggests chin tucking which restricts flow through your airway. I suggest you consider a soft cervical collar. See the link below. It has resolved a similar problem for me and many others.

Yes indeed. Sleeprider recommended one as well in his post on 1/6  Post 4 in this thread  and I have ordered one. Should be here on Monday. I'm hoping it'll help. I have not felt "well rested" ever, in my entire life. 

Thanks for taking a look @Melman, I appreciate it!  

[SleeplessInPHX]

The flow limits are cranking up your pressure, so let's start putting some EPR back in, and hopefully the CA won't come back this time. EPR 2, keep everything else the same.

That's where I was previously, but I'll give it a shot. 

Well, a huge jump in AHI, Hypopnea, and Obstructive events. I'm going to put EPR back to 1 and see how tonight goes. 

I think after a few days I'm going to also raise the Minimum Pressure from 6 to 8. Looking at the overall Flow Rate and Events, it seems that on average when the machine drops pressure, when it gets to 9 or below (or in this case with EPR set to 2, pressure of 7) I respond with Hypopnea and the machine goes back up to 12. 

Well, I forgot to change the EPR (like I said I was going to do in my quote above) and still had markedly better numbers. I think I'm going to leave it 'as is' (EPR=2) for the weekend and a few days after I receive the soft cervical collar for a few days.

Last night's chart:
[attachment=18859]

[Osiris357]

EPR 2 wouldn’t have increased those events just central apneas. If anything EPR 2 would help them. EPR 3 would be even better for those but you have to go slow to acclimate to the added ventilation. I had to do the same thing.

[SleeplessInPHX]

Huge amounts of events on 1/10 and 1/11, settled down a bit on 1/12. I seem to have a lot of problems within the first couple of hours of falling asleep. I'm trying to get to bed and sleep at a consistent time... which requires creating a new habit and breaking a lifetime bad habit of going to bed 'whenever'. 

In other news my cervical collar pillow arrived. I'll be trying that this evening.

Last three night's charts.


... what the heck? I've reached my attachment quota of 5.86mb? 

[Sleeprider]

First of all, the increased events are not because of the EPR. We originally suggested lower EPR because of CA events which have remained negligible, so your current EPR of 2 is just fine. Obstructive events and hypopnea may resolve with a higher minimum pressure, however the events are strongly clustered, so I think you will see a surprising change once you have the soft cervical collar and correct the chin tucking.

You should have plenty of attachment space, however each image is limited to 700 kb and there is a limit of 3-attachments per post. http://www.apneaboard.com/forums/Thread-...-explained

[SleeplessInPHX]

Last night was the first night using my new cervical collar (Eliminator, from Amazon). 

Highest number of Hypopnea, Obstructive, and RERA events, and and all-time high AHI.


   

[SleeplessInPHX]

Settling in a bit with the new neck pillow. Numbers better than last night, but woke up wide awake at 5:20am (after getting to bed after 1:00am (work)) so a measly 4h:18m of sleep. 

   

[SleeplessInPHX]

First of all, the increased events are not because of the EPR.  We originally suggested lower EPR because of CA events which have remained negligible, so your current EPR of 2 is just fine. Obstructive events and hypopnea may resolve with a higher minimum pressure, however the events are strongly clustered, so I think you will see a surprising change once you have the soft cervical collar and correct the chin tucking.

Noted, thank you. I agree that obstructive events may decrease or resolve with a higher minimum. Looking at the OSCAR charts it seems that oftentimes the event clusters always begin when the A10 has reduced the pressure for whatever reason. I've been thinking this for the past couple weeks but don't want to make more than one change at a time... speaking of changes:

I received the cervical collar on Monday and perhaps had it too tight Monday night and got really poor sleep and drastically increased event numbers. Last night was better (wore it a tiny bit more loosely) and I feel like I slept better but woke up at 5:20am and ... well, once I'm up, I'm up. <sigh>  Despite the barely four hours of sleep, I still feel rested. 

Interesting to note that last night was the first night that I had no events to speak of (one Obstructive, could be me messing with my throat and the collar) in my first hour of sleep. Of course right after that I had 22 events in 30 minutes... but that initial group of events that I've had immediately after falling asleep didn't happen last night for the first time. Not that it really means anything, just a data point.