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Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Excellent job experimenting and finding out what particular collar and set up works best for you personally. One member's collar was not working at all, and he turned the collar upside down and started getting zero AHI's.
There are many different brands, styles, firmness vs. softness, contours, etc. to collars. The objective seems to be finding the combination that works best and does no harm to the person (doesn't cause any injuries, pain, etc.) Not everyone used the same pap machine or mask or pressures either, but the general concepts are the same.
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
I think I placed the collar wrong. The upper side of the collar should be one straight line. The collar is designed for right handed people, so I close it with the right hand.
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Great job Jan. Your 95% flow limitations is 0.12 That could come down a little bit. You have EPR full time at 2, but you have some central apneas.
Possibly the central apneas could be treatment emergent; and go away in a few weeks or month or so. Increasing EPR to 3 full time would most likely decrease your flow limitations, but it very well could increase your CA's too.
Great job trying to optimize your therapy with your current machine. If in the future you have optimized it as best as you can, and you are still having a lot of CA's, there are machines with back up rates that can treat CA's. Your current machine does not have a back up rate to treat CA's. Hopefully you won't need a different machine.
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
In the Netherlands, insurance reimburses equipment prescribed by the treating physician. Another device may be required. The doctor and his OSAS nurse determine the settings of the CPAP and periodically read data.
I depend on that.
The last OSAS nurse said that they do nothing with airflow limitation and tidal volume.
On the one hand the CAs seem strange to me, on the other hand I wonder if they are of concern with AHI around or below 5.
I do not rule out that these CAs are the aftermath of medication (fluoxetine) that I stopped taking in November 2023. These medications also have the effect of reducing REM sleep. And according to my smartwatch, REM sleep is still too low. According to that same smartwatch, I am awake more than average. Last night, for example, that was 18% of the time.
My best results in terms of tidal volume and airflow limitation were with minimum pressure 5 and maximum pressure 9 with EPR 3.
The doctor does not go beyond pressure 8 and EPR 2.
The collar on the photo is size M. It is based on the circumference of my neck. According to the diagram you added my collar seems to me to short. I should need a XL. Please notice the pfoto I added.
Machine: Lowenstein Luisa Mask Type: Full face mask Mask Make & Model: Resmed Quattro FX Humidifier: separate F&P humidifier CPAP Pressure: Epap 4-20 PS 4-20; "auto" rate CPAP Software: Not using software
Other Comments: Using 45 degree angle upper body wedge (36"x36") and 4.5"soft cervical collar; 500 assured tidal vol
Thank you for all of that Jan. Yes, thank you PeaceLoveAndPizza for the excellent chart as to how to measure exactly for a soft cervical collar. I have about 5 or so of them total. You can try a XL. I use XL's also. It should not be so tight that it feels like it is strangling your neck either (that means it is probably too small). It should not feel so loose that it moves too much either (then it is too large). It should keep your chin in a normal position (like when you are awake and standing or sitting upright) also. Not too short or too tall either. Too short and the chin tucks some. Too tall and it tilts your head back too much.
You seem to have already figured out the plan to work with your insurance. If the CA's ever get too high for you, or you just feel that they are interfering with your nightly sleep to much, you can present these OSCAR charts to your Dr.'s, etc. How they will respond is unknown.
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.
Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
