Rreffner Therapy Thread

[staceyburke]

Both nights show positional apnea. You can not help positional apnea with pressure changes. You have to stop getting into that position. 

It is by also called chin tucking where your chin drops to your Sternum cutting off your own airway. 

A collar can stop this and I have a link to collars at the bottom of the post. It shows people without using collars and the same people with collars. Huge difference!!

[staceyburke]

Also you don’t have a good seal. Look at your charts - where there is gray you have a large leak that the machine can not provide therapy because of leaks!

[Rreffner]

Thanks for the prompt reply. Everything is so confusing too me. I lack the knowledge base to understand what’s going on and what I should do, except for the cervical pillow. I already sleep on a travel size pillow.

[staceyburke]

You can chin tuck in any position. Some people can stop it with a pillow change but many need a collar. Another reason is sleeping on your back.

[Rreffner]

Thank you. I’ll try a collar.

[staceyburke]

They come in size of the distance between your chin and Sternum.

[Rreffner]

This takes the cake. Their report has Obstructive Apnea and then is labeling complex sleep apnea with treatment emergent Central Apnea description. Answer to TECA is they decided pressure support of 10?!?! No the PS setting way too high. That's only outstanding problem number 2 though. I would consider PS of 3 or 4 to be a better answer.

Problem one is Positional Apnea that needs either a flatter pillow as in removal of a possible stack of pillows down to 1. Or a soft cervical collar to keep your neck aligned so the airway didn't kink closed. More pressure cannot help that big cluster of blue flags on OSCAR. Doc will not understand using a collar either.

What is TECA? I am seeing my sleep doctor tomorrow. Any suggestions on what to ask? Any hints on how to determine correct PS? I'll buy a cervical collar today. Thanks for your help.

[Sleeprider]

There is no way you can tolerate a pressure support of 10 cm without a backup rate and avoid inducing severe central sleep apnea. Based on diagnosis of complex sleep apnea, you will need ASV. I have never seen anyone try to treat any apnea patient with settings like this. Certainly what happened is that during titration you had an hour with few or no events, and they concluded that 17/7 pressure was demonstrated as therapeutic. If you have the page that shows the titration data with results at different pressures, we can interpret their error for you. This will never result in efficacy, and you might as well start calling the doctor's office tomorrow explaining that you continue to have Ahi from to 20 events per hour. We could make some adjustments and significantly reduce AHI, but I'm certain you will eventually need ASV and optimizing your settings to reduce events may just get in the way of the inevitable.

[Rreffner]

Hope this helps. Thanks

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[Rreffner]

My report scans look blurry. Shall I rescan and resend or are they ok as is? Thanks