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BigSwell - Therapy Thread
#1
BigSwell - Therapy Thread
Hello all. I'm new here so sorry if I'm doing this wrong. I've been on cpap for about four years and have never had the proper help or guidance in getting quality sleep. I have Oscar and check my data once a week. I have a ResMed 11 and nasal pillows. I always have high large leak percentages so I've started using a cervical collar to help keep my mouth closed. It has helped bring leak rate down, but my OA's are higher. I never feel fully rested and just wish someone could help me understand how to dial this thing in. I don't really know how to interpret the data for my troubleshooting benefit. My Doctors are useless and disregard my pleas for help!

Attached two days data one with collar and one without


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#2
RE: Help with reading OSCAR data and adjusting
On may 4th your leaks were so bad it did not report all of your apnea.  If you mouth or mask is leaking the machine can NOT detect obstructions.  Yours were bad all night and no apnea was reported but I'm sure you had a lot.

On the 9th you showed many Oa events.  Many were postional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

You said you have a collar - it must not be the right size or it was not adjusted correctly.  The height of the collar is the distance between your chin and sternum.  You need to adjust the tightness so the chin can not slip to the sternum.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Help with reading OSCAR data and adjusting
Thank you so much for the pointers! I'm not really sure how to fit or adjust the collar, but when its on I don't feel that my mouth can fall open. Are you saying a flat pillow is best? I will try that. I sleep on both sides and my back. I can try to add mouth tape. I tried that before the collar and it always fell off from slobber. FFM has never worked due to facial hair, leaks, and bulkiness so I switched to pillows and have been able to sleep at least. Had UPPP surgery that didn't help much either. So frustrating!
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#4
RE: Help with reading OSCAR data and adjusting
https://www.apneaboard.com/wiki/index.ph...cal_Collar

This might help
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#5
RE: Help with reading OSCAR data and adjusting
Thanks. That is basically how I do it. Do you see anything on my data that offers any other insight? Ive tweaked settings here and there to see if it helps, but its all been a shot in the dark guessing game
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#6
RE: Help with reading OSCAR data and adjusting
Again the main problem is positional. You can not help positional apnea with pressure change!

You could chang EPR to full time 
EPR 3

That will make it more comfortable and limit flow limits.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#7
RE: Help with reading OSCAR data and adjusting
Ok. Thanks. Will try EPR adjustment and see if that helps. Thanks again!
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#8
RE: Help with reading OSCAR data and adjusting
Welcome  

On the 4th I see that you had no positional apnea but very high leaks, while on the 9th you had a lot of positional apnea and very mild leaks. You mention that you are already using a soft cervical collar, which you need, but it is maybe too short or too loose to help much. staceyburke may be able to advise you on that. When I used one I liked the Caldera Releaf Collar, but my positional apnea was not nearly as bad as yours.

For the leakage, it may be that you need wider or better tape.  I have to use strong 2-inch wide tape cut about 5-1/2 long to handle the leaks.  A lot of people like Cover Roll Stretch tape.  I prefer Theraband kinesiology tape, but it is more expensive.  Good luck with getting both of these problems under control!  When you do your therapy and comfort will both improve.  Smile
Machine:  ResMed AirCurve 10 Vauto
Mask:  Bleep DreamPort Sleep Solution
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#9
RE: Help with reading OSCAR data and adjusting
Changed EPR setting. Wearing collar as well. Last nights data still seems to show some issues and I'm feeling tired today. Next steps?


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#10
RE: Help with reading OSCAR data and adjusting
Look at your leak chart on each night. Spiked leaks are mask leaks while leaks, looking like plateau are mouth leaks. You have some of both.

Are you OK?Some people use mouth taping. I don’t know how you will solve the problem but it needs to be addressed. Maybe a different type of mask? Try searching mouth leak and see how others have fixed it.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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