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I'm a longtime cpap user (2009). Orginally well controlled with fixed pressure machine (12cm). Over time, required pressures increased but AHI scores remained ~5-7 on an average night. Recently went for repeat sleep study and was told I'd need Bipap machine (Aircurve Vauto) set to 16/22 in s mode. Sleep tech said I had 0 AHI's during sleep study at that pressure. Increased pressure initially caused massive mask leaks. Took a month to find a mask that would take that pressure (F&P Vitera FFM). Went for compliance visit with doc, 5 minutes, said my average AHI of 7.68 was just fine. Told me that when my aircurve reported 10 AHI, his lab equipment would score that as 0 AHI. Never heard such a claim before.
I'm averaging about 13 AHI per night at these settings (16 EPAP - 22 IPAP). Don't feel terrible, but definitely don't feel well rested. I'm attaching some OSCAR charts and would appreciate any feedback. Thanks, in advance.
You are having positional apnea. You can see positional apnea where either H or Oa events are clustered together. Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.
I don't think you need a Vauto, I'm sure that if you take care of the Positional Apnea you will feel much better.
Thank you. That gives me an idea what to work on. I think my problem was exacerbated by a shoulder injury (a fall) preventing me from laying on one side. Did PT and it’s getting better. I tried collar but it’ll take some getting used to. Hot and uncomfortable on back of neck.
Tried a soft cervical collar last night. Results worsened. Spent restless night tossing and turning. I was wondering if one of those dental devices that are used to advance the lower jaw might be another way to avoid chin recession and tucking that are obstructing airway?
The collar is what works but that doesn’t mean you can’t try a device The main measurement you need is the distance between your chin and sternum. That distance is given for the size you need. I would try a new collar of the right height.
It will take you time to get a dental device and the cost is much lower than trying a collar the correct size.
Thank you for your patience and advice. I’ll keep experimenting with the soft cervical collar. I appreciate that there are people out there willing to share their hard earned lessons. Happy New Year.
