Moved to a flatter pillow, do I still need a cervical collar?

[Phaleronic]

[gainerfull]

1. Your most glaring problem is your terrible leak rate for the entire night. How do you manage that with an F20?

2. Why are you using CPAP mode when your profile has bilevel settings listed? You'd probably benefit more from bilevel given how many hypopneas you're experiencing. Plus, you can adjust TiMax to accomodate your longer inspiration times which helps your breathing overall.

3. Could you use a soft cervical collar? Maybe? Your marked events don't suggest it but that last segment of REM is pretty ratty looking so it's worth a try. I recommend the $13 soft cervical collar from Walgreens but find which one works best for you and wear it loose.

4. Those obstructive events at the end of the night are suspect - would you mind zooming in on them? They could just be breath holds after position changes.

5. Are you a big dude like me? I'm 6'3" / 215lbs and my tidal volume is similar to yours.

[Phaleronic]

1. Your most glaring problem is your terrible leak rate for the entire night. How do you manage that with an F20?

2. Why are you using CPAP mode when your profile has bilevel settings listed? You'd probably benefit more from bilevel given how many hypopneas you're experiencing. Plus, you can adjust TiMax to accomodate your longer inspiration times which helps your breathing overall.

3. Could you use a soft cervical collar? Maybe? Your marked events don't suggest it but that last segment of REM is pretty ratty looking so it's worth a try. I recommend the $13 soft cervical collar from Walgreens but find which one works best for you and wear it loose.

4. Those obstructive events at the end of the night are suspect - would you mind zooming in on them? They could just be breath holds after position changes.

5. Are you a big dude like me? I'm 6'3" / 215lbs and my tidal volume is similar to yours.

Thanks for the reply, I couldn't sleep as well on autob, but I can give it another shot, I've since switched homes and am in a new bed so I am not nearly as comfortable and my leak rate went up quite a bit since moving.. 

I can zoom in and post it tonight, and yeah I'm 6'7" 320lbs, another big dude

[PeaceLoveAndPizza]

To your original question, given this one chart it does not appear an SCC would do much as the leaks are persistent, which would lead me to think they are not mouth leaks.

Did you try different mask sizes before settling in on the one you use? F20’s are finicky beasties, but once you get it dialed in they work well for many.

There is a possibility there could be a small leak from your hose or elsewhere. Easy to check by putting on “mask fit”, blocking the end and feeling for a leak. You can also fill it with water, but using pressure should work as well. I once had two tiny punctures from an overly investigative cat that took me a while to figure out.

[Sleeprider]

Looks like positional issues are resolved with a lower pillow. Therapy looks good. If the leaks are real you should be the first to know.

[Phaleronic]

Thanks everyone, I did try a medium cushion years ago and it seemed too small, I can try it again, I'll also try the mask fit test, I did also just break an elbow and put an old used on back on, I'll inspect everything tonight, thank you.

[Phaleronic]

Here is last nights chart, the mask seal is pretty good on my face, the high baseline leak I believe to be the venting of the elbow (which is constant).

[Sleeprider]

The Philips Dreamstation machine report total leak and unintentional leak separately. Your unintentional leaks (lower line) are actually very low and your large leaks are just 1/2% of the therapy time. That's pretty good in my book. AHI is excellent and no evidence of positional apnea in this chart.

[Phaleronic]

Thanks for checking Sleeprider.  I feel really good since moving off autobipap to straight cpap, also when I was using apap (before autobipap) I could never get my ahi down this low.