AHI Help

[jmedley]

        Switched to Dreamwear FFM bc of mouth leaks with Dreamwear nasal even after taping and chin strap, and the FFM is more comfortable but still is not lowering my AHI. Am I chin tucking, or do I just need to raise the pressure again? I had a titration study, which started me at a constant 9 cmH20, but I have since raised the pressure to 10 for the last two nights. Attached are views of the last two nights. Also, the leak rate on the 27th was due to a mouth leak, where may jaw dropped so that my mouth fell out of the mask. I corrected the issue last night with a chin strap. Should I just buy a cervical collar? Should I just raise the pressure again? Should I set the machine to APAP instead of CPAP and then reevaluate my pressure?

Thank you in advance for any advice!

[Sleeprider]

It sounds like you are already familiar with our wiki articles on positional apnea and the soft cervical collar. OA events in your charts are characteristically clustered in the pattern consistent with chin-tucking. Let's change your settings a bit:

Mode: Autoset Standard
Minimum Pressure: 10.0
Maximum Pressure 15.0
EPR: On, Full-Time
EPR setting: 3

[jmedley]

Thank you so much for your help! I have been using a cervical collar and have set my machine to APAP with a range of 9–11.6 cmH2O based on further OSCAR analysis. I still am struggling to get my AHI down consistently, though, with last night being my worst performance ever at AHI = 20. Attached is a screenshot of last night's OSCAR data, as well as comparative screenshots of the previous two nights.

It seems like my apneas correlate to my pressure fluctuations. Should I change the machine back to CPAP and set the pressure as ~ 10.6? I noticed that it was my P95 two nights ago, when I recorded zero OAs. For what it's worth, the cervical collar also seemed to be helping with OAs, apparently until last night.

Thanks, again, for any follow-up advice.