[Pressure] Help for a newbie: titration failed

[sheepless]

I'm not 100% sure about this so I'll be interested to see if someone corrects me.

I think your pressure increases against obstructive events including flow limitations. higher pressure can produce more leaks.

I think flow increases to maintain pressure in the presence of leaks. ironically, I'd think increased flow would also contribute to leaks.

[lilymaebelle]

Thanks for the feedback. Should I be making more of a concerted effort to sleep on my side? I am a habitual side sleeper, but since getting the BIPAP I have switched to sleeping in an almost sitting-up position, partially to deal with aerophagia and partially because that's the only position in which the mask doesn't start leaking loudly. Even then I have to crank the straps down almost painfully tight.

My oh-so-helpful DME gave me no choice of mask, sending me a fit pack and leaving me to my own devices. I called them this week and talked them into sending me a DreamWear nasal cushion mask. I am a little apprehensive about it because my first experience with PAP therapy was when somebody woke me up at 2 a.m. and shoved nasal cushions up my nose and I almost suffocated. I'm hoping now that I'm used to air blowing in my face I'll handle it better.

[Sleeprider]

I think the sitting up position is causing chin-tucking. Read these articles

Positional apnea wiki http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft cervical collar wiki http://www.apneaboard.com/wiki/index.php...cal_Collar

By using the wedge or pillows to elevate your upper body, you have become more prone to positional apnea. As a result your pressures are much higher. If you can resolve this, either by reducing this elevation or using a soft cervical collar, then I think you can move pressure down to EPAP min 8.0, PS 4.0 and max pressure 15.0

[lilymaebelle]

Dave, this was WITH a soft cervical collar, strapped as tight as I could make it. I am using the Releaf Neck Rest. Is there another brand that people have found better results with?

[SarcasticDave94]

I've not used any collar yet, but there's a member on Apnea Board that likes his Corflex Ultra Cervical Collar. I think that the sitting up, or nearly so, position may be voiding some of the positive affects the collar is doing.