CPAP therapy not working anymore!

[DZee]

Hello all,

I’ve been reading the great threads here for some time but this is my first post.

I started CPAP therapy about 18 months ago and after reading about soft cervical collars here, I had very good results for over a year - mostly back sleeping. After the initial home overnight apnea test, I’ve been self treating and using OSCAR.

A few months ago I started to have health anxiety issues and my CPAP therapy started to go downhill. I stopped using CPAP and slept on my side more often since my apnea is positional. Recent back pain has meant I’m now sleeping on my back again and I’ve tried using CPAP but the results weren’t good - see attached. I tried adjusting max. pressure and EPR settings but I’m not really sure where to go with that. I tried an AirFit F20 full mask but had better results with my previous AirFit F30i.

Some of the ideas that I have for the poor CPAP results are:

- I’m using a different soft cervical collar (although it seems to feel similar)
- somehow my apnea has become more complex (requiring BiPAP?)
- the anxiety is making the apnea worse
- occasional use of sedatives for sleep and anxiety (a few times a week - although there doesn’t seem to be a difference in results on nights I take something vs. nights I don’t)

I’m wondering if anyone has any comments, advice or recommended settings to try.

Thanks for reading!

[Big Guy]

I took a two year or so break from my CPAP Therapy. I felt that it wasn't doing anything for me. But recently, I've been diagnosed with some AFIB issues and my doctor wanted me back on CPAP. 

There's a very good chance that I'll have a Catheter Ablation in the near future to treat my AFIB, hopefully, once and for all. I had a Cardio Version a few years ago, to get my heart back to a normal rhythm. It went well, was easy, but it didn't hold long enough, obviously. 

It sounds as if you need to take some control over your anxiety issue(s). Once you accomplish that, you might be amazed at the difference. I take OTC sleep aids every night, and have for a long time. If I don't, I lay there awake in bed for way too long. 

Anyways, I guess what I'm trying to say, is give it some more time. Some seem to take longer than others to experience a change. Nothing wrong with that! 

I have a new mindset, so to speak, I'm going to keep at it and stick with it. 

[DZee]

Thanks Big Guy!

Hope your AFIB treatment is a success.
I'm working on the anxiety but it's a process that takes time.

[staceyburke]

You are having positional apnea.  Your new collar is not correct for you or you are not putting it on right.  Almost all of your events are positional in nature.

[Big Guy]

Thanks Big Guy!

Hope your AFIB treatment is a success.
I'm working on the anxiety but it's a process that takes time.

I was a career cop for 30 years. I had occupational anxiety, but was able to rationalize it and keep in in control.

I've been retired now for over 14 years. I still have some anxiety issues that I deal with, but I can't seem to identify it's source. Mine is low and doesn't interfere with my daily doings. 

But, it's always there. I think it's just a part of the aging process. I turn 70 in late October.

[DZee]

My current cervical collar is a modified Corflex ULTRA. I cut back the foam so that it only wraps about half way around my neck and then extended the velcro. I never liked the feeling of the foam collar being behind my neck and resting on the pillow. Otherwise it’s the same width as the old collar. I wear it loose but sometimes it sits against my neck in the front so maybe that’s not ideal. I’ll try adjusting the position.

Thanks staceyburke.

[Deborah K.]

DZee,

When I had positional apnea I used a variety of soft cervical collars, but found the Caldera Releaf Collar the most comfortable, and it worked as well as any other.  Eventually, I decided to try something else to see if it would work.  I bought a child-size pillow (they are flatter than other pillows) that had a raised front and back on the pillow top.  This holds my head tipped slightly back and has solved my positional apnea altogether.  My pillow is no longer made, but I found one on Amazon that looks as though it might work in the same way.  Here's a link in case you are interested:

https://www.amazon.com/MLILY-Adjustable-...r=8-4&th=1

One nice thing about this pillow is that it contains three inner layers, so one could make it flatter yet if one wanted to.

Whatever you decide, best of luck with finding a good solution!  

[DZee]

Thanks for the recommendations Deborah K.

I tried adjusting my collar last night and sleeping with my head slightly tilted back on a flattish pillow. The results were worse than before.
I'll try a different collar and maybe a large wedge pillow for some incline.

[staceyburke]

The main measurement on a cellar is the distance between the chin and sternum- that is the height of the collar you need.

[Deborah K.]

A large wedge pillow usually causes more CAs, not less. I suggest you don't get one. It won't help.