Are these flow limits my problem?

[k888]

Good advice Dormeo.  I do plan on staying at these settings for a while.  This was more a long term goal kind of question, k888

[Dormeo]

Ah, a longer-term plan. Well, I don't think there's anything inherently good or bad about a wide range, a narrow range, or no range at all. It all depends on what your body wants and needs. In general, you'll want settings that are as comfortable as possible, give you good numbers, and leave you feeling refreshed in the morning.

[k888]

Here is an interesting chart demonstrating very clearly my need for a “perfect” SCC.  Although I was wearing a 3.5” Corflex all night, I started out with a somewhat used collar (a few weeks at most) and then switched.  My neck was never bent, nor was my chin stuck inside the collar.  Is there some other anatomical factor that could be in play?

On the chart you will see:
1)  I had trouble going to sleep with a stuffed-up nose.
2)  I went to sleep but woke sometime before midnight with AHI at 6+.   At that point, I tried removing one pillow, even though previous pillow removals have had worse AHI results.
3)  When I awoke around midnight, the AHI was over 7, and GERD was evident with a big burp tasting of dinner.  So, I replaced the pillow, and switched to a brand new 3½” Corflex collar used in its standard position – chin placed in collar dip.
4)  It was soon evident this was not working,  lots of air and numbers worse. (though I note looking at OSCAR that FL dropped.) So I flipped the collar over (which effectively makes it a little higher) and slept the rest of the night:  no events,  no FL, no pressure fluctuations,  all for a tiny fraction of foam!?  

I don’t see how a "kink in the hose" can possibly develop with a 3.5” collar correctly in place, but that extra fraction of foam makes a huge difference.  All thoughts would be much appreciated,
k888
   

[Dormeo]

What a dramatic difference! I wish I knew exactly why that fraction of an inch was so critical. Possibly there's just some little tug it exerts on the soft tissues lining your airway, or maybe it induces you to assume a slightly different overall sleep posture.

I hope you can get the same results consistently -- and that this will leave you feeling rested and refreshed during the day.

[TechieHippie]

I find this very interesting, also, and look forward to more data points. It could have also been slightly different in tightness, that seems to make a lot of difference for me. Or maybe you really need a 3.7" collar...

My experience is that wearing a collar has been very helpful sleeping on my side, even when I'm pretty sure I'm not tucking my chin, but does nothing for sleeping on my back so far (meaning my tongue is probably the problem there). I think that the collar does more than just preventing dropping the chin to the chest, I think it supports the jaw and helps my chin not jut forward (because of the support in back of neck, which has to slump for my chin to jut out forward). I also know my teeth are misaligned and my palate is smaller than it should be. Sometimes my teeth hurt a little bit in the morning; I think it's because I'm keeping my jaw closed with the collar. I think it's not a bad thing for me because I want my palate to expand, and my TMJ is improving.

[Macka]

Wow thats crazy! Understandable though, very small changes in palate or nasal cavity like with EASE surgery can make night and day difference. It must be that the first few millimeters of your tuck induces the limitations, not your last.

[k888]

Thank you Dormeo and Macka.  Duplication of experience (in the good direction) is indeed the challenge.
TechieHippie:  I always sleep on my back - can’t sleep on my sides for various reasons.  But your comments really made me think about body mechanics and the collar function.  I know I have read other comments on the role of the collar for jaw support.  My collar supports my chin, but no collar can support my jaws, they simply recede too much.  Any collar that actually provided "jaw support" would be choking me.  Using my fingers, I can see that jaw support really keeps the mouth shut, but chin support seems a bit weaker.  Maybe the collar supporting my chin has to be really higher in order to accomplish the same thing?  Something to think about.
k888

[TechieHippie]

On your back, it makes sense that a slight difference in height from being upside down could have an impact.

As far as the jaw, the jaw can move in all different directions, so the support might not be obvious. I certainly think it helps on my side because my jaw doesn't fall sideways the same way. Good discussion!

[Deborah K.]

K888, I wore several different neck collars to control positional apnea.  My favorite was the Caldera Releaf collar.  It was comfortable and worked well.  I see that you wear your collars out very quickly.  I did not have that problem but I decided to try something else.  I bought a small, child-sized bed pillow that has a raised ridge at the front that causes my head to tip back slightly.  This has worked better for me than the collars, and it is way more comfortable.  I too sleep on my back because of lower back pain.  My AHIs are very low, usually 0.something, fairly often 0.0.

The pillow I use is no longer made, but there are others on Amazon that I think would work the same way.  Here are two:

https://www.amazon.com/MLILY-Adjustable-...r=8-5&th=1

https://www.amazon.com/Hcore-Adjustable-...r=8-6&th=1

These both come in three layers, so you can lower the pillow as much as you like.  I like Amazon because returns are easy, and for Prime members they are almost always free.

[k888]

Thanks Deborah!  I tried the Caldera.  t was super comfortable, but so soft that it failed very quickly.  They even have a version that is theoretically stiffer, but that was the same problem.  I had previously read your comments about the baby pillow but had not pursued the idea because I need to sleep raised up (GERD).  However, it occurs to me that if I stack other pillows, so maybe I can do the same with this?  What do you think?  I will check out your links.  k888