High AHI with CPAP

[Rage]

Hi Gideon, thank you for your assistance.

I am a little perplexed about Positional Apnoea being caused by my pillow as I only use one pillow which is no deeper than 3in and allows me to lay quite flat with the top of the back of my head tilted slightly back, I even took it with me to the overnight sleep study, and they noted it was a good pillow. I think that when asleep I could well be pulling my chin down, so I will definitely purchase a cervical collar and drop my EPR to 1.

If this doesn't help, I will try another pillow and report back.

Thanks again to all that have replied, It is much appreciated.

[staceyburke]

The pillow may not cause positional Apnea but it is one thing to rule out. Positional apnea can happen in any sleep position. He was just trying to narrow it down. Sleeping on your back. Can cause it but sleeping on you side with a flat pillow you can chin tuck. That’s when a collar is needed.

[Rage]

My pillow is definitely still on the list of things to look into; I only sleep on my back as I have bad shoulders and as that is usually the worst position for dealing with Apnoea, I know that the pillow can often be the problem, I have bought a cervical collar which will be here Friday and I will be changing my EPR for tonight, so it will be interesting to see what happens.

[Gideon]

Just trying to get you going in the right direction. t least now you know the problem could have been the issue and depending on your specific anatomy, it still could be. You are going in the right direction so keep us informed.

[Rage]

Hello again, I received my Cervical Collar yesterday and used it last night, and I had two nights with the reduced EPR.

The last night of using 3 EPR, I had an AHI of 40.36

The first night with EPR 1:

   

The second:

   

And last night with the Cervical Collar:

   

Any help will be much appreciated.

[Gideon]

you still have a positional apnea/chin tucking issue and likely a too much EPR issue.
The timing is such that I suspect the positional apnea, or rather the recovery from it, put you in a cyclic flushing of too much CO2 from your system triggering the central apneas.

Set EPR=1 and concentrate on eliminating the chin tuck. It may take a different collar, a taller collar, or perhaps a bit tighter to prevent the chin tuck.
Collar recommendations guys?

[Rage]

Sorry for not responding sooner, I have been trying different things out and had a breakthrough night where I used no pillow, used the cervical collar and had EPR 1 and had an AHI of 16.

I have tried other combinations, but all make my AHI go above 40. I am going to repeat the best combination to see if I can get my AHI back down, and have ordered a different cervical collar, but I worry that when asleep when I pull my head down that the collar itself could be causing more positional Apnoea.

Trying to sleep without a pillow is incredibly uncomfortable thought as even though my pillow was quite thin, not having any pillow is having a detrimental effect on my back... It genuinely feels like it is always one step forward, two steps back.

[Gideon]

Post your. Current chart

It is likely that your centrals did not come down.  We need to see your chart to help you move forward

[Rage]

Hello Gideon, I had another bad night. I have tried everything I can, but nothing is working. Last night I had no pillow, used my Knightsbridge chin strap, Mouth tape, cervical collar, EPR at 1 and p10 nasal pillows.

I am exhausted... It's beginning to cause more problems than I already had before I started treatment. When I wake up I turn the machine off, grab my pillow back and go back to sleep and by looking at my heart rate stats for the night, the lowest range is after I stop using the CPAP.

Last night's report:

   

[Gideon]

I think you need to step up to an ASV.
This machine is very effective at stopping central apnea on the breath where it starts.
Can you talk to your doc about this or do you need to do it on your own?

Turn off EPR as we try to find comfort w your current system. Also can you try a different collar, this one isn't seeming to work for you.