OSCAR screenshot: one night with new mask

[Chalkie]

    I am posting here an OSCAR screenshot of the first night with a new mask (the Respironics Wisp). It was rather forced on me as the mask I am familiar with, the Comfort Gel nasal, broke. 

What strikes me is that the lake rate was massively lower(<1%) - so why didn't I feel any better? If anything I felt more tired than usual although there was the "new mask" factor and I did not sleep as long as usual.

Does the data yield any useful insights? I felt the pressure may not be high enough - is there any way of knowing that from the data?

[Etirpsakdov]

It seems like your pressure isn’t high enough. You have mostly obstructive events. Maybe try using your machines auto mode if available. Otherwise I’d maybe increase your pressure by 1cm or even less.

Someone correct me if I’m wrong, but you might be able to reduce your centrals by raising the EPAP and lowering your PS. I think this would also help get rid of the hypopneas and apnea’s.

Maybe try posting another chart from that night that shows the flow limitations? What is your AHI on most nights with the old mask? 16 AHI would definitely leave anybody tired though.

It also looks like there were three times you had a big leak and might have woken up.

[Gideon]

There is no pressure that will be high enough. You are tucking your chin which is causing the clusters of obstructive events. The best fix we have seen for this is a soft cervical collar, see my signature for details and then post a new chart once you have used one and take it from there.

[Chalkie]

That's interesting, Bonjour. I have ordered a soft cervical collar as you suggest.

I will read the info in your sig ASAP but I curious as to how you know I am chin tucking?

[Gideon]

The tell-tale is the clustering of obstructive events in your daily charters

[Chalkie]

Aha, thankyou. 

It leaves me wondering why no sleep doctor has picked this up before. Incredible.

Could an excess fat around the neck be making this worse? 

PS I just woke from an afternoon nap short of air and noticed that my chin had tucked under.

[SarcasticDave94]

Excess fat around the neck will certainly make things worse, but people with normal levels of fat have apnea and chin tuck issues. All you have to do to test whether chin tucking will be a problem is to sit or stand upright and move your head and look down at your feet. Did that cause you to suffer from difficulty breathing? Yes then that is what we mean by chin tucking.

[Chalkie]

Hi Dave, yes it does. Thanks to Bolnjor for altering me to this. I will aim to report back after trying the neck brace.

[SarcasticDave94]

Pay attention to sizing attributes of a soft cervical collar. It's not meant to follow the guidelines of neck braces for injury. The goal is a support to reduce chin tuck only. Best to ya on a success. See the wiki regarding the collar if you've not already.

[Gideon]

Very, very few doctors will recognize cervical alignment as an issue, we call it chin tucking here.