Need help and advice on Quality of sleep and AHI

[Sleeprider]

Check your sleeping position and make sure you are not having airway obstruction caused by a chin-tuck. If you can rule that out, try a minimum fixed pressure of 7.0 and we will see if that reduces H or increases CA. Technically your hypopnea should respond to a bit more pressure based on the flow limitation we observed in the detailed flows.

[ravik]

I am going to increase the pressure to 7 tonight and wait and see. On sleep position, I do sleep on left side mostly.

[Sleeprider]

Something I do for side sleeping is to pull a corner of the pillow over my lower shoulder. My chin tends to come to rest there, so it helps with comfort, breathing and leaks.

Good luck on the slightly higher pressure. As you know things are a bit unpredictable when complex apnea is afoot, so hopefully we see improvements. If not, we just fall-back.

[ravik]

I also use a small blanket rolled under my neck to give some extra support to neck and to avoid pinching/choking the mask silicon tubes.
Thanks for the tips.

[ravik]

Last night felt better and I feel rested this morning, no CAs so this strategy seems to be working. Please see the screenshot, please ignore the daytime charts, I did a test run with a full face mask between 6-7pm ET.

http://imgur.com/a/ZvvJr

[Sleeprider]

It's not ideal, but better. Glad you're feeling more rested. As you know, we will look to additional nights on this trial. We have learned that the problem with CA is not the result of minimum pressure but of variable pressure. Again, we're seeing more signs of complex apnea than simple obstructive. I am curious if a soft cervical collar might help, and it would be pretty cheap to find out. We don't know why you have periods of flow-limited breathing and hypopnea, but that would be one possibility.

[ravik]

Yes, it is not ideal yet. I am planning to get a cervical collar. Do you think I need more higher pressure? Surprisingly, I now see higher flow limitation (FL) at higher pressure. I did not see FL at min pressure of 5 at all in past.

[Sleeprider]

Ravik, take it 0.5 cm at a time and see what you end up with, and be prepared to back down when you reach a point where it's uncomfortable or less productive. The cervical collar is just to eliminate that as a possible cause. Your hypopnea tend to occur in cluster with many hours of no problem, which give me reason to think that may be positional.

[ravik]

Hi Sleeprider,
I will wait and see how I do with current pressure of 7 for few more days. Do you suggest I try using a cervical collar before increasing the pressure further?

[ravik]

Last night was OK but I do not feel fully rested this morning. Please see the screenshot.

http://imgur.com/a/V0W9H