New to CPAP with mixed results and need help

[torrej12]

            I'm a 24 year old male new to CPAP and have been getting mixed results so far. As of now I have been using my dads machine (DreamStation) since he gave up on his therapy and a nasal pillow. I'm in the process of getting my own machine right now but the process takes weeks to get approval etc so as of right now im making due with what I have. I've been tinkering with my pressure settings for about a month and a half now and have had nights where my AHI is less than 5 and nights where my AHI is higher and wake up feeling tired with little sleep. From my experimentation, I have noticed that lower pressure ranges have resulted in lower AHI and higher pressure ranges resulted in higher AHI for me. The best nights of sleep my pressure ranges were 6.5-10.5 and the pressures where my AHI was higher were when i set my max pressures to anything over 10. This makes sense with what my sleep tech said when i went to get fitted for a mask and did the titration study that my case is mild and won't need that high of a pressure however when the results came back a few days ago my doctor said my prescribed pressure was 14 over 10. Anyways, tonight ill be trying out sleeping with a soft cervical collar and the pressure settings 6.5-10.5. Below ill be posting screenshots of some of my best nights and worst nights of OSCAR data for you guys to look at and give thoughts and recommendations. Any help is appreciated and I can add more screenshots as needed.

[staceyburke]

The day with high AHI did not have anything to do with pressure. You were sleeping in a position that cut off your own airway. It is called positional apnea or chin tucking. It happens when you drop your chin down to your Sternum cutting off your own airway.

It happens maNy times sleeping on your back or to high of a pillow.

It did not happen the other 2 nights. Be aware that you have a good chance of more nights like that if you can not find out why it happened.

You can see positional apnea when there are groups of either O and H events.

[torrej12]

        The pillow I have been sleeping on is actually a thick one so i can see how that may be causing me to have positional apnea because it does tuck my chin. Tonight ill be sleeping with the lower pressure settings as that's what I have had the best AHI with and also will be switching to a flatter pillow and using the soft cervical collar i got on amazon. I'll let you know how it goes. I appreciate the input greatly and ill post some other screenshots of high AHI to see if this positional apnea is a consistent problem.

[staceyburke]

Feb 28th is positional apnea. The. CA (central are generally not positional apnea)

[torrej12]

    tonight ill be switching to a flatter pillow and ill try to sleep on my side with the soft cervical collar. However the reason why I was using the thicker pillow was because I actually thought it was supposed to help with sleep apnea as supposedly sleeping in an elevated angled position actually opens the airways from what I have read online. But from what I have read here about positional apnea its actually the opposite? Sleeping with an elevated head is like bending a garden hose to your throat, it restricts the flow. Do you have any idea what might be causing the Central Apneas?

[staceyburke]

Centrals are caused by lack of CO2 and the body just does not breathe. All other apnea O, H and flow limits all are obstructive apnea where there is something blocking your airway. A pap machine is used to keep the airway open using air pressure. 

If you have many true centrals (and I don’t have any experience with them) you will need a special pap machine that is more expensive than normal Cpap machine.  This type of machine actually helps you take a breath when a central is detected. It is an ASV.

[SarcasticDave94]

An elevated pillow might help but your head would need to tilt backwards or you'll get these positional events. Think tilting head back like in a CPR need. But for most a too thick pillow causes more negatives than positives.

As for the Centrals, it is likely due to the newness of CPAP usage. We call the treatment emergent Central Apnea. You can minimize them if they become a nuisance. Do not use Ramp and lower the Flex setting, if required. All CA will have a consistently inconsistent factor meaning counts are up or down nightly. Of any CA, you possibly have these treatment emergent ones. They should diminish in a few weeks, maybe at the absolute worst 2-3 months.

[torrej12]

    These are my results with the collar and sleeping on a flatter pillow. First few hours were a bit uncomfortable and also my sleep schedule has been way off lately but I would say that the collar definitely made a difference and a few more nights are needed to make a determination as to what adjustments I may make.

[torrej12]

Just wanted to give a quick update. After a bit of experimentation I have been able to get my 
AHI under 3.0 the past 2 days by switching to sleeping on my side and also using a chin strap and taping my mouth shut method. I feel significantly better now. I appreciate the input a lot.

[SarcasticDave94]

OK that's good news. Keep at it.