Epark - Therapy Thread

[Epark617]

Hello everyone, I'm back again, and decided to create a thread so I can ask ongoing questions and make changes. 

I must admit I'm feeling quite confused as to why some things appear to work, and others not. I supposed the fact that I am unconscious while these things are happening doesn't help. I am now using the F&P Brevida, which I do enjoy wearing much more, and feel more comfortable rolling around in. It took a couple nights to get the leaks under control, and I've found 2 things that have worked for leaks but my AHIs seem a bit more out of control? When I was previously using the P30i, my AHI was typically 2-3, though I was having large leaks. With the Brevida, it's been closer to 4-5, with last night being 11. I've attached pictures of the last 2 night. Curious what everyone's thoughts are about the data and what suggestions there might be

Nov 14, Mouth Taping with ergonomic pillow (lower in the center)
   

Nov 15, Cervical Collar with regular memory foam pillow not too high 
   

I did sleep more deeply last night, in that I didn't wake at all on Nov 15, whereas on Nov 14, I remember waking multiple times throughout the night, and so perhaps that's why there aren't such big OA clusters? Are these clusters on Nov 15 still PA even though I was wearing a soft cervical collar? It seemed to prevent mouth leaks, but doesn't seem to have made a difference with OA clusters.

[Old Steve]

I would suggest that you try adjusting your minimum pressure to at least 9cm, perhaps 10cm as you are almost averaging this pressure anyway.   Your second chart is showing what appears to be Positional Apneas (clusters of apneas). I too have the same problem, I was never able to get my cervical collar to help much, I had to start sleeping on my side all the time. See below for more info on Positiona Apneas.  You are already aware that you leeks are higher than they should be.  What you may or may not know is that your leeks, even a small one can cause an arousal, so keep working on them.  Try the new settings for a few days and post some more charts.  Good luck

[Epark617]

Interesting I wonder why the cervical collar seems to not work for some people's positional apnea

[staceyburke]

Your collar needs to be the right size.  The height is the distance from your chin to your sternum.  The second measurement is your neck size.  It has to be tight enough to stop your chin from slipping under the collar.

[Epark617]

Yes, I did read the wiki passages, measured my chin to chest and confirmed it wasn't too loose so my chin wouldn't slip under. For some reason, it seems to make my OA clusters worse whenever I'm wearing it..

[Deborah K.]

You did much better with the ergonomic pillow than with the memory foam pillow.  Stick with the ergonomic one.

[Epark617]

Yes I was hoping I could avoid the mouth taping with the collar, but it seems my apnea disagrees haha

[Epark617]

   
First full night with my Philips Dreamwear mask! I can definitely understand why many people have trouble with compliance. Pretty much every time I tried it (prior to last night), I had to switch back to my F&P Brevida in the middle of the night, and if I didn't have a mask I was already comfortable with, I definitely would have preferred to have just slept without the machine. I finally realized last night that I was wearing the mask too low the whole time, and that was causing leakage from my nose, and then at high pressures, it was leaking out everywhere. 

Any feedback based on my oscar data? Should I be worried about the RE and H events? I don't seem to get these when I'm using the Brevida. Here's a close up of one such sequence of events 
   

[Deborah K.]

You need to change your pressure settings to 11 to 16. You are zooming up to higher pressure, your median pressure is over 11, and you are bumping up too much against the 13 you have set. Try these settings and see how it goes.

Your flow limits have risen quite a lot. Are you using EPR? If not I suggest you set EPR full time at a setting of 3.