AHI and OA's sudden increase. Any ideas/suggestions?

[TexasCPAP]

       
Just completed my 72nd night of CPAP,  and have changed no settings since starting this
journey.   Still at a pressure of 9 with no ramp, etc.  on my resmed machine.

I had taken the suggestions of exclusive side sleeping, and the soft neck collar.   I was happy that
my AHI's had consistently been sub 5 after doing that for a period of time.

All during this time my number of CA's had almost always been higher than my number of OA's,
sometimes 50-100% more.    I remember one of you kind gents commenting that the pesky CA's
sometimes are present during the first couple of months,  and then not so much later.

Well,  that was the case at about the 2 month mark.  My CA's have almost gone, but about every
other night I am now having this huge number of OA's,  sometimes 60 or so.  And they seem
to be clustered in one or two short periods of time during the night.  I have attached the graph
if of interest (accidental duplicate.  Sorry).  Any comments or setting modification suggestions
are appreciated!

[Canuck 2]

Just observing your charts looks like you could be chin tucking which is indicated by grouping of clusters of OA & H apnea's. I will leave a link to a thread that explains it very clearly. Some folks use a Soft Cervical Collar to remedy that issue.
http://www.apneaboard.com/wiki/index.php...cal_Collar

[staceyburke]

Yes it does look like it is positional apnea. Use my link in my signature for collar.

[TexasCPAP]

Yep,   I'm using a collar as indicated in my post.   These OA's have just started out
of the blue.    I'm thinking I need to make some adjustments to the settings,  and
am looking for some suggestions.

[staceyburke]

If it is positional it cannot be controlled by pressure. I would look to adjust the collar. Is it high enough, tight enough so your chin cannot go under?

[sheepless]

could be a collar adjustment problem. I find they soften & curl after a while. I seem to be replacing them annually & that's probably a couple months longer than best practice.

[Melman]

You mention using s soft collar. Is it the type described in the links you've been given? If yes, you may have it too loose. You don't want it super tight but it should be tight enough so your chin cannot tuck behind it. You may also do better with autoset mode so the machine can adjust the pressure to your needs. Since you seem to do well at 9 I suggest a range of 9-16 for starters. Also, I believe you machine has EPR which lowers the exhale pressure. Although this is billed as a comfort feature it will also reduce flow limitations. Try EPR full time at 2 to start. It's possible these changes may increase your centrals so you will want to watch that. Please post more data after making changes. Here is a link to access the clinical settings https://www.apneaboard.com/resmed-s9-cpap-setup
You can order a manual by using the link for CPAP Setup Manuals at the top of the page.

[Melman]

Yep,   I'm using a collar as indicated in my post.   These OA's have just started out
of the blue.    I'm thinking I need to make some adjustments to the settings,  and
am looking for some suggestions.

Changing pressure settings will not correct the clustered OAS you are seeing. They can only be corrected by eliminating thepositional issue.

[TexasCPAP]

Thanks to everyone for replies/suggestions.   I think the collar is ok,  but I will try wearing it a bit tighter perhaps.  And perhaps trying the EPR.  Thanks.