Jakespeare65 - Therapy Help

[jakespeare65]

And here is Saturday and Sunday. Saturday's score was higher but I felt markedly better Sunday morning than today.

       

[PeaceLoveAndPizza]

Glad you are feeling better. The 3/10/24 chart looks quite good. Things are moving in the right direction, though there are still some tweaks to be made.

You are still experiencing quite a few flow limitations and have some positional apnoea’s occurring. The FL’s can be addressed with more pressure support with EPR=3 or possibly needing a bilevel to get more pressure support, but the positional events require possibly a flatter pillow and more neck support to keep from tucking. 

If you want to experiment a bit, try the following:

Min pressure 11
Max pressure 15
EPR 3 full-time

What make, model, and size collar are you using? Have you or are you using a flat or CPAP pillow? I was amazed at the difference a CPAP pillow made.

[jakespeare65]

I'm using the 3M Futuro cervical collar. It's adjustable for both height and width. "Moderate support." Seems to be large enough for my giant neck. One size fits all.

I am not using a CPAP pillow. Which one(s) do you like/recommend?

Last night I had a bit of a "get all this stuff off my face" moment and took the collar off at a certain point. Nose was also pretty congested last night. Increased AHI seems to indicate the collar is helping. I think it was also just one of those off nights.I will try adjusting the height tonight.

I'm still trying to understand the data - what indicates positional events?


Thanks!

   

[PeaceLoveAndPizza]

It does not have to be a specific “CPAP” pillow. I use a Contour CPAPmax 2.0 pillow, but any flatter pillow may work.

For the positional apnoea, look around 05:30 at the cluster of rapid hypopnoea’s. That is typically indicative of chin-tucking occluding the airway. You can see the change in your charts from pre-collar to post-collar, which shows a reduction in the clusters indicating it is the likely culprit.

[jakespeare65]

Thanks for explaining. I forgot to make the setting changes you suggested, but this looks like I'm going in the right direction. Higher AHI but less clusters/flow limitations and a looooooong session (100 on MyAir haha). I remember getting up to go to the bathroom a few times - I think the high leak rate events are mask off pee breaks, but the system didn't catch it? Does that matter?

I feel almost human today!
   

[PeaceLoveAndPizza]

I would not worry about the leaks since as you noted they are related to loo breaks. 

I think bumping up pressure by 1 cmH2O may help with the pressure swings. A simple experiment to try if you wish.

[jakespeare65]

Good to know.

I have adjusted my settings as suggested:
Min pressure 11
Max pressure 15
EPR 3 full-time

I'll have the CPAP pillow in a few days.


Thanks!

[jakespeare65]

Last night seems to have been a regression - wore the collar, but clusters are back. CPAP pillow should arrive Friday. Like anything else new, it takes some practice and fine tuning. I'll keep at it.

   

[jakespeare65]

Going in the right direction, but still seeing clusters. Pillow should arrive today.
   

[jakespeare65]

And last night's data. OSCAR isn't seeing the bathroom breaks as mask-offs but every time you see a leakage spike, I woke up and used the loo. It was like the bad old days. Even old MyAir (100) only captured 2 mask-offs, but it was more like 7. I was miserable waking up every hour or so. I noticed that the UA events almost always occur right when the mask goes back on - Is that a glitch? I would be awake and have just reconnected the hose - I tend not to take the mask off for bathroom breaks, especially with the collar. I like the pillow. Great for side sleeping. I was also at a different location, spent the night at GF's place. Her dog was taking up too much room and it was colder than I like, so that may partly explain the 7 wake-ups. I will try and get everything right tonight, hoping to see a score under 3 tonight.