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He has been using a Vive 4 inch collar (the same as I use and one of mine). His spouse (who I can trust) confirms that he is wearing it when he goes to bed. I don't think he is taking it off during the night; but I can't be sure. He could try the Eliminator Anti Snore pad tonight (it works for some on this site, but did not for me and I have one). How will a bi-level machine help? If that is what he needs, we will have another sleep study done. If his insurance will not cover it, we will find a way to pay for one.
I'm not a big fan of the Eliminator. It works on chin support and can hit the throat. Up to you, but I'm looking for better jaw support from behind. I would love to help you explore better options.. With a problem this serious, I would probably come up with a very serious solution, and one that neither you or I would be very happy. Your description of his weight makes me think a wrap-around solution is not going to work, and the severity of his apnea moves me to a more extreme solution. I know pressure alone is not going to work. There are many solutions and designs. This one is pretty radical, but if he can sleep in it, might give more relief. https://www.amazon.com/Orthomen-Neck-Bra...07VM4G2N3/ At the more conventional end of the spectrum, the Releaf Caldera neck collar has helped a lot of members. https://www.amazon.com/Caldera-Releaf-Ne...00CN97QMQ/ Do you have a neck circumference measurement?
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We decided to order the Caldera Releaf Neck Collar. It will arrive on Monday. In the meantime, we might try different pillows. Eric promised his wife and me that, if we can't resolve this issue, he will see his PCP (I will go along) and will get the requisite sleep study to consider if he needs a Bi-PAP. I'm ready to try anything. I really appreciate your insight and advice Sleeprider. It was you that resolved my initial issues and got me on the road to great night's sleep. Thank you for your patience. I will contact you again after we try the Caldera Collar.
We received the Caldera Releaf Collar today and Eric used it last night (11/20/23). He said it was more comfortable than the Vive Collar. The problem is his AHI shot up to 64.33. I have posted the Oscar report below. So, in summary, he wore the Vive Collar three nights (11/13, 11/14, 11/15) with AHI's of 26.21, 33.91 and 69.12 (all previously posted) and the Caldera Releaf Collar one night, all with AHI's way higher than he gets with out a collar. I guess we can assume collars will not work for him. I have posted two (11/18, 11/17) of the four nights with out a collar between the Vive Collar and the Caldera Releaf. November 18 is excellent with no clusters and an AHI of .31. November 19 (not posted because of three posting limit) was pretty good as well with an AHI of 1.34. It had two smaller clusters. November 17 remains somewhat problematic as while the AHI was 3.10, it had a large leak period preceding a major cluster in the latter part of the night. November 16 (not posted) was very similar to November 17 and had an AHI of 4.70.
The question now is where do we go from here to attain more consistent good nights. What do you advise?
I have posted the first three nights following the horrible night with the Caaldera Releaf Collar. November 21 returned to what I would describe as his typical less than satisfactory night. The AHI was 6.91 all due to one large cluster midway through the night. There were no large leaks and few events outside of the cluster. November 22 was a much better night as it had fewer and shorter clusters resulting in an AHI of 2.30. November 23 returned to another large cluster night with an AHI of 5.59. Since the collars did not work and increasing pressure does not seem to be answer to the problem, what else can we do? Should we keep changing pillows? Should we try a different mask? Should he have current sleep study and see a sleep specialist? What else can we consider to get him into an acceptable and consistent AHI range?
