Heracles - Therapy Thread

[Gideon]

Pure obstructive, you need a collar

[Heracles]

Hi,

Thanks for the reply.

Well... She --always-- sleeps on her back, every night, because she is still not used to the mask when on her side. She is working on that but we are not there yet. That night was the only catastrophic one.

Here is the overview of her data since that incident. Aug 24 is the "nightmare" while everything else is good or at least, acceptable. 

   

As for the pressure, since I increased it to 16, it never happened again. The machine used that extra pressure a few times but not every night either. Should it be strictly related to position, extra pressure being of no use and her being always on her back, should not the problem be more global ?

Can it be something else ?

Thanks again,

[clownbell]

Heracles - Gideon is right of course. Let me try to explain. Positional apnea is when your neck is bent so that the chin goes toward the chest. This is like a 100%-kinked garden hose. If you turn up the water, the kinked garden hose remains kinked. Same thing here. NO AMOUNT OF PRESSURE will solve a positional apnea problem. The answer is to get the chin up, which is what the collar does. If you turned up pressure and positional apnea improved, that means that coincidentally something ELSE happend; perhaps gf simply didn't drop chin as much on the night when you just so happened to increase pressure. Coincidence is not the same as causeation. Get a collar.

[Gideon]

The only way that chin tucking apnea doesn't occur is if, for whatever reason she didn't tuck her chin. It seems likely to be what has happened since. That high of an AHI is rarely fixed without a collar. It seems she may have. The Only Way to be sure is to review the daily charts. At the least she should watch her head position.

[Heracles]

Thanks again for the info.

I will grab more data from her past sessions to illustrate how that pattern started but was quickly fixed (not sure how...). I will also keep watching her new data to detect if such a series of event ever happen again.

She already has a mouth piece, plus the head gear for the mask. We hope she will not have to use yet another accessorie but if it happens again, we will know where to look...

[Heracles]

Hi again,

It just happened again last night :

The pattern started, the machine reacted by increasing the pressure, only a few cycles (without more apnea) and she is back to regular breathing...

   

In the same way, insufficient pressure created that pattern in the past before that terrible night I posted already. Here, the machine did not increased because it was using the For Her algorithm which does not increase over 12 unless some extra conditions are present.

   

   

So the overall situation is :

--My girlfriend is having episodes of CSR / Periodic Breathing / I Don't Know, as visible on the posted data (and much more evidence is available)
--I am trying to understand what is happening here
--According to your opinion, it would be related to her position and a situation for which pressure is of no use, only a collar would do it
--That root cause (position) is always present but does not always create such catastrophic pattern
--Enough pressure always fixed it (bad cases are when pressure was maxed).
--She never used a collar so far, so all the other good results were in the same position, without a collar

So would it be more probable that her situation is still related to position but pressure does fix it ?

Or would it be more probable that, because pressure fixes it, position is always the same without the same impact and no collar, that it is not position related ?

As always, thanks for your input

[Crimson Nape]

Heracles - Since the thread name seems to have worn out its use, I have taken the liberty to rename your thread, Heracles - Therapy Thread.  If you wish a different or more catchy name, just let me know.

- Red