help with optimizing AHI--positional apnea?!?

[jdougc]

Are you still sleeping on the couch for several hours?
If so, consider using the CPAP there.

Can you provide several zoomed in charts of about 3 minute duration before your obstructive events?
It would be helpful to see the breathe shapes since your flow limits are high and causing many of your pressure increases.

[Tsukuyomi]

Here's a blow-up where there was a cluster of OA, CA, and LL.

   

[Tsukuyomi]

not having the same luck I had the first week I had the SCC. maybe it's already becoming too pliable?

   

[jdougc]

Make sure that the collar is tall enough.
When I loosen my collar to be comfy, I have to test it to see if I can tuck my chin.

Except for the positional apnea, not a bad night.
When your pressure gets to 12,the leaks come.

[Tsukuyomi]

yeah, like I said, I wonder if the collar is already becoming more compressible or if I've just started fighting it more. it seems like there's more "give" now.

[Tsukuyomi]

Those scores I got the first week I used the SCC have been elusive.

   

[ejbpesca]

I see some familiar details in your most recent OSCAR report. 

The APAP pressure is often pegging out at the top.  The max is too low to allow it to rise.  Perhaps somewhere in this thread, you explained why you cannot allow it to go above 14cm.

Clusters of apneas are often called positional apneas as if it is a trend.   Some think positional apneas cannot be helped by pressure when it is higher pressure that is the answer.   In my case, increased pressure, not a collar was the answer.  My AHI raising position is supine.  By raising my min. pressure the clusters stopped.  It was not chin tucking as so many will claim that was causing the apneas.  It was gravity plus airway tissues which is a very common cause of apneas and the very reason PAP therapy is needed.  A collar did nothing to stop the clusters and was ineffective at keeping my chin up.  A collar can be a pain in the neck figuratively and literally.  I tried 3 models.  The only way they would prevent my chin from lowering was to cinch them too tight.  Then I found it was not chin tucking after all that was my problem.

I feel advocates of collar-wearing should realize the clusters they see may not be due to chin tucking.
Possibly you have reasons you cannot try pressure over 10cm.  Maybe you know for certain you are chin-tucking.  Some have suggested an all-night video of sleep to discover chin-tucking.  

I raised my min. pressure until the clusters stopped. I went from min 8 to 11 by increasing the min less than 1 cm per day.  I raised my max until the pressure stopped pegging out (red line).   

I had to find a full face mask that could handle the higher pressure.  The F40 is working but I have to tighten straps a bit more than what some would consider tolerable.

[Tsukuyomi]

Good points and perspective. I suspect that it's true that pressure cannot overcome some positional events, but can improve others.

In any case, I increased my max pressure to 15 right after I posted my latest update. I'll continue to tweak.

[Tsukuyomi]

So frustrating... two terrible scores in a row despite the CSS and despite increasing the pressure. Will increase max back to 16 again.