[CPAP] flow limitation in cpap

[CanberrySleeper]

                                    Hi

I have been using Resmed S9 and F20 mask. I started using Knight bridge chin strap to reduce leaks.
It appears there are lot of flow limitations.

Also, there are residual hypopnea and apnea events occuring regularly.

Is there any advice that you could suggest.
do I increase the pressure to20 ?
Is there a machine with greater than20 pressure ?
what can be done to reduce flow limitations further ?
how can we reduce AHIs further ?

Any other advice 

thanks
Canberry Sleeper

[Gideon]

Welcome to the forum.

Could you start with enabling your AutoSets best tool to treat hypopnoea, flow limitations, RERAS, and UARS, Expiratory Pressure Relief.

Set EPR = 3, Fulltime

Typically you would set your exhale or Expiratory Pressure at a level that would resolve most of your OA events and then increase the differential between the inhale, inspiratory, pressure to treat hypopnoea, flow limits and RERAS, UARS. This difference is commonly capped pressure support, in the AutoSets it is called EPR.
.

I wouldn't be surprised if you also could lower your pressure settings but let's see how this does first.

Is there a better device, yes it is called a BiLevel and for you the proper model would be the ResMed AirCurve 10 VAuto. It can go up to a max pressure of 25 and a pressure support much higher than the 3 that EPR and an AutoSet can provide. But first let's try the EPR and see what can be done

[CanberrySleeper]

Thanks for your feedback yesterday. I set it to EPR 3 Full time yesterday but reduced the pressure to 15.
There are large number of Apneas during the night.

Can you please have a look and advice.

Is this positional apnea ?

S9/F20 Full Face mask/Knightbridge chin strap.

thanks
Canberry Sleeper

[Gideon]

Yes, I think this is positional. Typically enabling EPR at a level of 3 helps a lot, and it did. But the clustering is now more evident in your flow limitations so work on pillow modifications, 1 vs 2 pillows, less firm, flatter. I suspect that you will need a soft cervical collar, see the link in my signature for a deeper dive into this.

[CanberrySleeper]

Thank you. I will try and get back to you soon

[CanberrySleeper]

Thanks for your feedback yesterday. I corrected the pillow usage (used a flat single pillow) with the recommended CPAP settings. It has gone worse from yesterday. 

Can you please review the data and advise. 

Thanks
Canberry Sleeper

[Gideon]

Very strongly positional.
Now try a soft cervical collar as the pillow mod is obviously not working.

[CanberrySleeper]

Very strongly positional.  
Now try a soft cervical collar as the pillow mod is obviously not working.

Hi 

Thanks for your advice. 

Just wanted to inform you that cervical pillow, like the one shown in the link below, addressed the positional sleep apnea.

Not sure why and how, it reduced the clusters and has even reduced the ahi below 1.

Thanks for your help and advice.

https://www.amazon.in/dp/B07VRRXGRP/ref=...6J91NJ7QYA

[OpalRose]

That was a rather expensive fix! But if it worked and you're ok with spending that much...

Gideon was suggesting a Cervical Collar for positional apnea.

http://www.apneaboard.com/wiki/index.php...cal_Collar

[Crimson Nape]

Note for anyone viewing the Amazon link above: This is an Indian website and the currency in listed in Indian rupees. The price is 1499 rupees = $19.33 USD.