[Treatment] ivorpetkov (my wife) - Therapy Thread

[ivorpetkov]

Would appreciate feedback on OSCAR data and treatment, thanks.

My wife is on CPAP for 11 days.  She was diagnosed on 04 oct 2023 with heavy OSA (106 AHI).
The next day we started CPAP therapy.

I have been reading the forum extensively for several days.

The current situation is a huge step forward compared to the time before the start of therapy.
Gone are the headaches, getting up frequently at night and the constant need for sleep.

In addition, we have also been using a CPAP pillow for 2 days.

I am attaching photos for 2 consecutive days and statistics.

           

[ivorpetkov]

I am adding the summary view for the past days.
In the beginning, we used a test "ResMed for Her" from the supplier, which did not have an SD card.

   

[ivorpetkov]

Several 3 min views of Flow Rate:
               

[gainerfull]

1. Your wife is sleeping in a way that is closing off or limiting her airway at night. The simplest solution is to buy a soft cervical collar that prevents her chin from tucking. This is called "positional apnea". You may also consider a thinner pillow if she sleeps on her back.

https://www.apneaboard.com/wiki/index.ph...onal_Apnea

2. Once you solve the positional apnea we can look at increasing pressure. Since her flow limits and snore data are so high this suggests the minimum pressure is too low in combination with EPR 3 which is subtractive, not additive.

3. Mask leak could use some fine tuning although it's relatively low.

[ivorpetkov]

Тhank you for the advice gainerfull.
I was hoping to solve the positional apnea problem with the CPAP pillow, but as described in the article, the likelihood is less.
I'm going to try to get her to try on a collar.

[ivorpetkov]

I tried "Response Soft" but got an additional increase of Flow limit.
After I changed it back to Standard ,  Flow limit went back to its previous values.

So far she doesn't want to wear a collar. 
Meanwhile, we reduced the height of the CPAP pillow. The effect was positive.

I plan to gradually increase the minimum pressure.

[gainerfull]

Other things you can try is asking her to sleep on a wedge pillow, a mandibular advancement device, and breathe right strips.

As you increase minimum pressure you'll know you're making progress when snore goes to zero and the light blue "obstructive events" disappear.

[ivorpetkov]

I'm waiting for some time to pass since the last change in the settings - a gradual increase in the minimum pressure. 
So far nothing special is happening.

In the meantime, I carefully read everything that is posted here on the forum.

I was intrigued by some discussions about inspiratory flow shape.

Following our graphs in OSCAR, I noticed some specific shapes in different stages of sleep.

I would like to know more about the different shapes.

1:     2:     3:    


Thanks in advance and apologies to native English speakers

[ivorpetkov]

I'm also posting the last flow-limit photo that's been discussed more often here.

4:     

[ivorpetkov]

I increased the minimum pressure. 
First until 9 for a week and then until 11. 
I did it because of the "2 below median" rule.
I didn't expect a result, because due to the flow restrictions, the automatic algorithm always holds a higher pressure.

But I'm not sure if the algorithm is not affected by min pressure and max pressure even if it doesn't reach them.

For the week with "min pressure 9" there was an improvement, but surprisingly for the week with "min pressure 11" there was a deterioration in the score.
I explain it to some external factors.

Starting today, I will adjust the "min  pressure 9" to see if that worked.
Otherwise, my wife feels fine, only I am surprised by the results.