Palatal prolapse?

[melody]

I posted once before about the flow limitation I'm seeing. Since then, I've been increasing the pressure incrementally to see if that helps. The changes I've made over time are:

• I started with a pressure range of 4-15
  
• I was having a lot of Clear Airway events so I turned off the EPR
  
• After turning off the EPR I was having more aerophagia, turned the EPR back on and gradually bumped it back up to 3
  
• I haven't been having as many clear airways but it seems mask dependent and I keep changing masks out of frustration with leaks and noise - Dreamwear (very noisy, fewest leaks), n30 (comfortable but leaks), F&P Brevida (leaks after a couple of uses)
  
• I'm having a lot of flow limitation every night
  
• After posting here, I got some advice to increase the min and max pressure and I have been doing that
  
• I noticed what looks like a palatal prolapse pattern, which I hadn't recognized before but seems to have been present for some time, if not the whole time
  
• I continue to have issues with aerophagia but less with the Dreamwear mask. I use a cervical collar to keep my mouth closed. Have used chin strap and mouth tape in the past.
  
• I often have low event counts and higher event counts with the same settings, same mask
  
• Even with low events I wake up a lot, am often awake for around 90 minutes, feel terrible the next day
  

After reading about Palatal Prolapse, I understand the airway is collapsing after I inhale. So I thought that I should reduce or turn off the EPR. But I need the EPR to help with the aerophagia. One of the moderators previously suggested I might need a Bipap because of the flow limitation that I am consistently having. Does bipap make sense for palatal prolapse? Any suggestions of what I should do next? Is there anything else I should glean from these charts?

I don't have an appointment with my doctor for another month. Every appointment is 3 months out so I want to go in with as much info as possible. Any help is appreciated.

           

Thanks!
Melody

[Sleeprider]

Melody, please do not take the lack of response on this thread to be a lack of interest. Palatal prolapse is a complicated issue and adjustments to CPAP settings have unpredictable results. There are several members we have worked with that have similar issues, and you can find Related Threads are now linked below this post. Some of the most effective therapy has actually been to stent the upper airway with an Alaxo Stent. The thread by SleepyCPAP is probably most complete documentation of personal experience of any I know of. You have a high level of inspiratory flow limitation, even when EPR is at 3. The need for positive air pressure pressure support seems to be beneficial for improved inspiratory volume and flow. The expiratory cutoff looks like it could be PP, and unfortunately I don't know of good CPAP/BPAP strategies to resolve that.

[melody]

Sleeprider,
Thank you for your response and for providing links. I'm dismayed to hear that CPAP/BIPAP may not be able to resolve my issues. I will read everything you provided and go from there.

Thanks again,
Melody