[CPAP] AHI 7-10, desperate and leaking!

[flabberjabber]

I have an update for you guys.

So I had an Evora Full F&P silicone mask that my clinic sent to me previously. I figured, despite the silicone, it would be useful to try and get to sleep with it on. It was a little claustrophobic as before, but I managed to fall asleep with it on last night. The markings I will deal with for the moment with a dab of barrier cream applied prior to fitting the mask. I'll look to get a cover for it soon as this isn't a long term solution.

I also turned on AutoPAP.

Interestingly, my Hypopneas/OAs aren't as frequent but are still present. My AHI has dropped, and I feel better this afternoon. I'm still getting some leaks, but no where near as much as before. I also felt refreshed after 10 hours, when 11-12 would be my normal.

Do you still see the clusters for positional apnea in the the data? I don't think they're there... but would love to hear your thoughts.

Interestingly the machine seems to think I need up to level 13! The highest I'd gone previously was 9.

Anyways, any further thoughts you guys might have would be super appreciated. Hope you're well and best wishes from across the pond .

[SarcasticDave94]

Not knowing your machine leak values well, but this still looks high enough to adjust the mask. You want the pattern closer to the first segment before 04:00 than after. Zero leaks isn't expected.

I have the same Evora full. The top of head strap affects height on your face. Center the lower edge between your mouth and chin. The 2 sets of side straps needs adjusted to be slightly snug, but not tight. The mask needs room to inflate. And over tight will distort the silicone seal, creating more leaks.

The higher the leaks, the lower the accuracy of the report on OSCAR. This is due to how the leak rate affects how accurately the machine will self report events and pressure needs. Lower leaks, higher accuracy.

Last thing, turn off calendar on OSCAR for next time. It should be the down arrow between August and 2024 in the blue banner. It's hiding important info.

[flabberjabber]

Thanks Dave, I'll readjust the mask tonight and let you know how I get on.

I've contacted the clinic today and ordered a larger one as I have quite a big nose and am a bigger guy yet the clinic sent me out the s/m rather than the m/l. The main issue I had this morning was a sore nose from the side of the mask compressing my nostrils. But hopefully that plus a readjustment will lower the AHI even more.

I also have a cervical collar in the post, just waiting on that to arrive. Will let you know if things change/improve, and will endeavour to remember to remove the calendar next time. I've attached last nights report below with the calendar removed incase that's helpful.

Thanks again .

[flabberjabber]

Just realise not all the data was shown on that last image. So have attached an updated image with full chart below:

[flabberjabber]

Update for you guys again.

As you can see my AHI is no longer increasing past around 6 on the regular, which is progress, but not ideal either.

Last night was my first night with the cervical collar. It's a standard soft collar I bought from a healthcare company. To my eyes, there appears to be no difference to the previous night. AHI is very similar. Perhaps clusters continuing to show positional apnea?

One thing that I figured might be worth mentioning is that I have suspected issue with my neck. Not diagnosed, however I have a background in physiotherapy, and suspect that I have tendonopathy in either the superior heads of sternocleidomastoid, trapezius or levator scapular. It's a very old tendonopathy though, so without surgery, there's not much I can do as I suspect parts of the head of has calcified. I've tried exercises and stretches to no avail.

It causes my face to swell slightly, and come and goes. I also get blurry vision out of my left eye that comes and goes (which would seem to suggest a restriction in blood flow due to the swelling perhaps). And, it really effects my ability to think - with my left brain internal monologue having become particularly diminished in the past few years. I also had an experience during the pandemic where I collapsed and had temporary loss of vision in my left eye. But the hospital put it down to a panic attakc without any investigations and sent me on my way. Perhaps, if the swelling is restricting blood flow, it could also be restricting air flow at night? Just a thought.

I would really appreciate any insight anyone might have as to why I can't get the AHI to go any lower. Was so hoping the cervical collar would make a difference last night! I've still yet to buy a pillow that properly supports my neck whilst side sleeping. So perhaps that will make the difference. I'll be doing that next week.

Look forward to hearing your thoughts and thank you again for your time and energy .

[Deborah K.]

Yes, you still have positional apnea.  Is your collar high enough that it holds your chin up?  My guess is that it's not.  If so, you need one that is higher.

If the collar is making your neck problem worse, there is another alternative.  I just didn't like using a collar, so I bought a child-size pillow (they are always smaller and flatter) that has a raised front and back edge.  This keeps my head tipped slightly back and completely solves my positional apnea.  My pillow is no longer made, but I've seen some on Amazon that look like they might work.  In case you are interested, here's a link to one:

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

[Jay51]

Here is some reading from our Wiki also:      

• 5.3Positional Apnea
  

[flabberjabber]

Thanks for your response Deborah.

I'm actually a side sleeper rather than a back sleeper. But I do toss and turn quite a bit in bed apparently, but even then usually remain on my side. If what I have is positional apnea, it's from side sleeping, I rarely endly up on my back. I might wake up once a fortnight on my back. The collar I have makes it impossible for me to chin tuck. Yet, I'm still getting positional apnea clusters consistently every night despite having the collar for about five days now.

Is it possible the clusters are representing the time I'm on my back whilst asleep even with the cervical collar blocking chin tucking? If so I don't know how to resolve this. I can only fall asleep on my side. I need a thick-ish pillow to support my neck whilst side-lying and I can't exactly swap the pillows over whilst I'm asleep and have rolled over. I'm not sure there's a solution to this?

Can side flexion of the neck rather than chin tucking cause similar issues to chin tucking I wonder? As that's the other possibility, I've not been particular cognisant of a adopting a neutral position for my neck and probably don't have the best pillows for this.

Last nights leak rate was excellently low which is good! I've attached the OSCAR chart as I thought this might be useful to see one with basically no leaks. The random extreme leak at 7.30 was due to a rain out (happens whenever I wash the tube and don't have time to dry it fully - so ignore that).

Thanks for your continued guidance, so appreciating having somewhere to go with this . You guys are amazing.

[flabberjabber]

Sorry, realised I posted the chart with calendar up. Here's it with calendar removed .

[Zombie on my Lawn]

I had a problem with sensitive skin with the Resmed P10 (nasal pillow) and a silicone nasal cushion mask that went around my nose, but when switching to the AirTouch N20 memory foam mask, the irritation was significantly reduced. It also helped with leaks. Using a cheap soft cervical collar also helped immensely.