Confused about CA's

[paulag1955]

You understand that a cervical collar will have no effect on CAs, correct?

[Sleeprider]

Your charts confirm that positional apnea is an issue for you and that a soft cervical collar should do wonders. The other thing is that your flow limits are also very high with a 95% flow limit of .34 to .48. This is an index of upper airway resistance, and we like to see that below 0.10 to minimize respiratory effort related arousals. As PeachLove above suggested, we treat flow limits with exhale pressure relief (EPR), but the setting only goes to 3, so set EPR full-time at setting 3. This will provide 3-cm of pressure relief during exhale, just like a bilevel. Another way to look at it is, it provides 3-cm of pressure support during inhale to help you overcome the airway resistance. Both the soft cervical collar and EPR are important to improving your therapy. Without the collar the lower pressure with EPR will increase OA events, but with the collar, you will not only tolerate the EPR, it will be much more comfortable and you will sleep better. A final note, your CA events are likely incomplete obstructive apnea. With very high flow limitation we see an open airway as the "victim" attempts to get a breath, but things are so restricted it shows up as an open-airway or clear airway apnea (CA). This is not neurological or even CPAP therapy onset, but an artifact of how the machine detects the type of apnea.

[UnicornRider]

I think that Pizza guy was on to something. Although EPR is limited to 3 cmH2O, Julia63 is already on EPR 3. However that AirCurve 10 Vauto is capable of Pressure Support. Therefore by changing mode to VPAPauto would she be able to utilize PS 4,  EPAP Min 12, IPAP Max 18. Let it run for a day or two and see what that brings?  Get some zoomed in views and then tweek and tune from there?

  I do agree a SCC is a needed addition to therapy, as well as a low loft pillow.


Please let me know if this is a viable solution.

I am still new to this ResMed world of wonders.

Thanks.