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Sounds like you have REM clusters. Might be related to the way your body relaxes completely during REM sleep, which may be causing you to tuck your chin and kink your airway. I don't think any doctors will tell you this, but using a soft cervical collar to keep your neck reasonably straight (doesn't have to be tight, just to keep your chin away from your chest) has helped many members here clear up the last of their obstructive events that no amount of pressure can beat.
It appears that some of your problem is positional apnea as BoxCarPete said. If you sleep on your back, sometimes all you need to do is sleep on your side. I would also suggest that if you can, turn the ramp off as it doesn't treat your apnea when it is on. Also, you might try setting your minimum pressure to 8cm.
I see that recommendation all the time, to turn off ramp because it "doesn't treat apnea" while it's on. Bull. It's providing you pressure just like it does the rest of the night. People used dumb CPAPs to successfully treat OSA for decades. What it doesn't do is record events or automatically boost pressure if things are going wrong, but this chart shows practically no disordered breathing for the first two hours until we drop into REM for the first time. I do see a mask off awakening, so that would be the only risk, that we drop into REM within the first few minutes after a mask off awakening in the middle of the night. Your call, if a 5-10 minute ramp helps you fall asleep, you aren't in the penalty box very long, so there's little risk of having a dumb machine for those few minutes. Someone who sees trouble knocking on their door as soon as their eyes close would do well to consider disabling ramp, but according to my opinion there's no reason for you to worry about it. Everyone is a little different.
On Ramp, your chart says you don't need it. If you do choose to use it set it to 7.
The clustered pattern typically says positional apnea, chin tucking. Tuck your chin to your chest. Does that make it harder to breathe? If so the soft cervical collar should work, or possibly a pillow modification. Think 1 instead of 2 pillows or flatter, less firm pillows.
I'm not seeing a significant increase in your flow limits during those clusters. That means these could possibly be an awake period. But then we would typically see (false)CA events but they are not there.
Please post a couple of 3 minute views covering the start of these clusters so we can better see what is going on.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
12-02-2023, 07:44 AM (This post was last modified: 12-02-2023, 07:45 AM by muhaddib.)
RE: AHI Help - First call to help
(12-01-2023, 11:29 AM)Gideon Wrote: On Ramp, your chart says you don't need it. If you do choose to use it set it to 7.
The clustered pattern typically says positional apnea, chin tucking. Tuck your chin to your chest. Does that make it harder to breathe? If so the soft cervical collar should work, or possibly a pillow modification. Think 1 instead of 2 pillows or flatter, less firm pillows.
I'm not seeing a significant increase in your flow limits during those clusters. That means these could possibly be an awake period. But then we would typically see (false)CA events but they are not there.
Please post a couple of 3 minute views covering the start of these clusters so we can better see what is going on.
Thank you for your reply.
I've setted the ramp to 7 and will try the cervical collar also.
Here are 2 screenshots of some of the clusters.
Cheers
(12-01-2023, 08:51 AM)BoxcarPete Wrote: Sounds like you have REM clusters. Might be related to the way your body relaxes completely during REM sleep, which may be causing you to tuck your chin and kink your airway. I don't think any doctors will tell you this, but using a soft cervical collar to keep your neck reasonably straight (doesn't have to be tight, just to keep your chin away from your chest) has helped many members here clear up the last of their obstructive events that no amount of pressure can beat.
Thank you for the reply. It makes sense and I will try the neck collar.
