Help Lowering a Varying AHI for a Newbie

[rtkierke]

I was wondering if anyone could help me understand what is going on with this specific event as well as why I can't get my ahi closer to 1 or below consistently (as I feel much better when I do).

   

Here is the full night as well as the previous night. For reference, I am using P10 with mouth tape and a cervical roll pillow. 

   

   

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And here are the previous two nights before that. 

   

   

I will note that last night (first two attachments above) is the one that has me feeling bad.

[rtkierke]

Is there any way to get this lower? I'm not quite sure why I can get .5 every once in a while then I get this most nights:

   

[Jay51]

I agree with Red.  Not bad therapy IMO.  Charts look pretty clean and good.  You do have a couple of OA's spread out and not too clustered (but maybe 3 kind of close at times.).  Your pressures look ok. 

You might be suffering from a little bit of positional apnea.  Try lowering your pillow height, possibly side sleeping instead of back sleeping if you sleep supine; and that last resort would be purchasing a soft cervical collar to keep your chin from tucking into your chest and cutting off your airway.  Your machine responds with higher pressure to the OA's.  

Here is some more reading to do on positional apnea:  

• 5.3Positional Apnea
  

[rtkierke]

Thanks! I only use a cervical roll. Is it possible that the issue could be going the other way? Could my head be too far back?

[Jay51]

That would be very rare.  I have only heard of one instance of a member's head leaning back too far and causing problems with the airway.  The member was an older gentleman with serious neck problems (severe kyphosis I remember and something else). 

Most of the time the head (and chin) tuck forward into the chest and can cut off the airway.  It can happen sleeping on your back, on either side, and even sleeping on your stomach.  A neck that bends too far to one side could possibly kink the airway like a garden hose somewhat, too.  

Try a test.  Sit upright and let your chin fall to your chest.  Any difficulty breathing?

[rtkierke]

It reduces but doesn't shut down airflow. That can't happen with my cervical roll, at least not towards my chest or neck. The only direction my head can really move is left and right.

[Jay51]

Great that you took the chin tuck test.  Since it "reduces" airflow, you can be affected by it then.  Make sure the collar is the correct height (measure from your chin to your chest (sternum) in a relaxed, normal position.  In inches and 1/2 inches.  A few times, a member's collar has been too short or didn't fit correctly, and replacing it helped.  Also, one member turned his collar upside down and started getting 0 AHI.  Experiment a little if you want to here.

[rtkierke]

It seems to be about 5.5 inches. I had already ordered the releaf collar from the wiki. One issue is I couldn't find any without a back portion, which is kind of important as my pillow is a cervical roll that supports directly under my neck.

[Jay51]

I went through the same things with my collars.  I use xl around 5.0"   I would recommend only xl and jumbo sizes if you are 5.5" measurement.  If the collar is too short, you still could be tucking your chin somewhat at night.  

2 other brands I know of with the back cut out:  Dr. Dakota's collar (or something like that) and The Eliminator collar.  I have several eliminator collars.  They are only 2.5", but I stack 2 on top of each other and it pretty much immobilizes my neck.  The problem:  it is difficult to find them since I haven't seen any new ones in a few years.  A used one or open package might show up on ebay every once in awhile.  

I have cut out the back of a 5.0" collar and used velcro around the cut out back end to secure it.  Comfortable.