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I am new to OSCAR/the Apnea Board.
I am not new to CPAP therapy (I have been struggling with mine for 2 1/2 years to get it controlled/good sleep).
My apnea has never been well controlled (untreated=severe, AHI 35). Lots of settings tried by my Sleep NP. A year ago it was determined a mandibular advancement device to use WITH my machine, could help, and it did, somewhat.
I am with a new doctor who increased my minimum and removed the max pressure settings to 10cm to 20cm, I am finally seeing some progress, BUT...
Even on my best nights, I frequently have large strings of apneas that my Dreamstation 2 seems to not respond to, and while the overall AHI is low, I can still feel tired/brain fog or even dizzy for half the following morning. Including total AHI in the OSCAR graph has been revelatory: a nightly 5.0 AHI score can include an hour or more at 30 AHI! I also see flow limitations, which seems to be significant according to discussions I read here. I very rarely have any large leaks (the ones that count on Dreamstation 2)
I have attached a few recent nights. Is there something I can do? At this time my NP scheduled me for another titration study.
Thank you
You have some pretty tight event clusters. That sometimes corresponds to a sleeping position which forms an airway obstruction that no amount of machine pressure can open up. Think like a kinked garden hose, the pressure can't overcome the restriction. The most common such position is chin tucking, which can be combated by changing your pillow to better support your neck and prevent your head from drooping, or a soft cervical collar like the ones used to stabilize your neck after an injury.
A collar can be found at your local drugstore or ordered online, sometimes you will need to try a couple to get a good fit based on the space between your chin and chest. It should be worn loosely, since it is only meant to support your chin and jaw to keep your airway straight.
Look, I'm an engineer, not a doctor! Please don't take my opinion as a substitute for medical advice.
And here is a zoomed view of the Dec 17 data showing what's going on with my flow rate while the Dreamstation 2 sits with pressure parked at 11.3 cm/H2O
Even though Respironics machines are slow to respond, there is no algorithm that can blast through clusters of apnea as shown on your graph during that time period.
Examine how you are sleeping.... are you on your back with head tucked to your chest? A too high of a pillow can cause your head to tilt forward, same as using more than one pillow. Think one flatter, thinner pillow would work better.
As described above, you are cutting off your air supply by "chin tucking", also called "Positional Apnea".
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Be sure to size it correctly. A collar that is too small will still leak and too large will be comfortable. Different brands use their own sizing, but this should help with the measurements. Remember the collar will compress a bit depending on its firmness, so if you go with a softer collar keep that in mind.
(12-18-2023, 07:57 PM)PeaceLoveAndPizza Wrote: Be sure to size it correctly. A collar that is too small will still leak and too large will be comfortable. Different brands use their own sizing, but this should help with the measurements. Remember the collar will compress a bit depending on its firmness, so if you go with a softer collar keep that in mind.
Be sure to size it correctly. Ok, I will read the sizing Chart.
A collar that is too small will still leak I don't want the leaky collar. AHH, perhaps he meant to say "Too small will not support the neck and chin, thus will not prevent obstructions".
and too large will be comfortable. I suffered miserably with a too large of a collar. I prefer the Goldilocks collar, not too big, not too small, not too soft, not too hard. [i]Just right![/i]
I will read the sizing chart. I will order from a place that has a very liberal return policy, just in case I order the wrong size.
I will order from a place that has very fast Free shipping. Because I want to try this out so very soon.
I also recognize that I have had three really great collars, but with age, weight loss and just wear and use, I have to replace or change collars every 3 to 4 years.
Thanks PL&P, we do not often get to jump in there and joust with the word master.
Now, I can not remember the names of collars to give a good reference.
12-19-2023, 09:38 AM (This post was last modified: 12-19-2023, 09:41 AM by eok361.)
RE: I'm new. Shouldn't my machine respond more
i'll add an anecdotal recommendation for a specific collar. i've tried a few and ended up with the caldera releaf. all the standard white ones are ok, but make sure that the one you get is comfortable.
i had some issues with a couple that were too tall, to the point that i couldn't even swallow for a day. the caldera works for me, and is somewhat adjustable with its folding bottom layer.
and i also ended up getting one of those u shaped contour/memory foam pillows. it helps, too.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
