Plmnb's Never Ending OSA Journey (Data)

[70sSanO]

I’ve used a soft cervical collar since 2014. Started out with a Walgreen’s/CVS one. Eventually found one on eBay that worked better and was cheaper. It doesn’t have to be snug around your neck. You are only trying to keep your chin from tucking down.

Bed pillows can also be an important part of sleep therapy. You might find the higher pillows with the collar to he the perfect combination.

John

Edit Added: Don’t worry about people not knowing about chin tucking. I first heard it a couple months ago. I started using a collar based on the advice from another forum years ago that recommended someone to use one while waiting to get a CPAP machine as it might help to keep the airway open. It made sense, so I figured I would try one to help with my obstructive clusters that had popped up from no where.

[Plmnb]

Second night worse with changes. Help with new data?

Hello forum.

So, the second night of data collection is in.  I am interested in what the reports from last night show and the comparison to the previous night data.  The AHI is higher than yesterday.

As I mentioned in the Software section, I changed the starting pressure to 8 from the original starting pressure of 6.  I used a different mask last night.  I sort of liked that it did not have the little soft pillow area of the full face Dreamwear mask under my nose.  I believed that the hard plastic full face part of the ResMed Full Face would work better.  I also found the need in the middle of the night to reduce the humidifier setting from 8 to 7.  Following suggestions that I might have a "chin tucking" issue, I fashioned a towel into a soft cervical collar.  I wanted to try this before buying an actual collar.  It had been mentioned that I should try to get more hours of sleep.  So I laid down at around 9:00pm I think.  (Btw, my sleep hours are messed up because my husband generally gets home from work around midnight to 1am.  I get awake to spend time with him.  I usually pass out around 2-3 am.)

Anyway, last night was tough.  I felt like I awoke more times than I did the night before.

Insight highly welcomed.  If I need to repost previous night's data for assistance, please let me know.  Thanks!

   

[sheepless]

reinforcing previous suggestions to try the soft cervical collar. $20 usd at walgreens & other similar stores. different designs for more $ that some folks find less uncomfortable can be found online. you're still showing clusters of events that can be avoided by fewer pillows, lower pillow height & a collar. maybe a wedge would help. I don't like my collar much but can't pap without it due to clusters & lip leaks otherwise. may not be the total solution but you should see a respectable reduction in obstructive events.

[Sleeprider]

Please read the soft cervical collar wiki (link in my signature). As I said before, your clusters of apnea are a classic warning your airway is being shut down due to head/neck alignment. Until that is resolved, you will continue to experience high pressure and disrupted unsatisfying sleep.

[Plmnb]

Regarding the soft cervical collar.  I did read up on it on the link.

This is why I thought I should try it.  I really thought this would be a good thing for me so I fashioned a collar out of a towel last night.  It felt very good, fit comfortably and I liked the feeling of support it gave my head.  It seemed like my chin would not drop to my chest.  I figured I would go buy an actual one this morning.

However, I did not feel like I got a good night sleep.  So, I'm not SURE about the soft cervical collar.  Taking everything else I mentioned into consideration y'all think I should try again, this time with a real collar?  

Pillow wise, mine is very soft and squishy.  So much so, that my husband does not like his at all.

[sheepless]

if you can tolerate it, the collar is usually the best solution to clusters of events. there are other means; we have to experiment to see what combination of things work best for us individually. the collar isn't the most comfortable thing in the world at the outset, but hardly noticeable after a while. usually a large improvement for not much $.

[SarcasticDave94]

IMO yes the real collar of the sort described would give best results.

The head pillow choice may need addressed too. Some here on AB like the brand My Pillow and some others like results from a buckwheat filled pillow. My Pillow is fairly expensive as I recall. I'm going to try buckwheat style soon. Best to ya.

[Plmnb]

Good evening .

I was browsing the forum and came across the thread about positional sleeping.  I have some questions regarding this subject.

It has been suggested by many members that have seen my OSCAR reports that I may benefit from a soft cervical collar and I am actively investigating this idea.  It has also been suggested that I look into the pillow that I use.  I will do this too.

But after reading the posts in the thread, it got me to thinking about what the meaning of certain things in my sleep study report mean.

I am at work at the moment so I would have difficulty posting the picture of this page, so I am typing it out:

RESPIRATORY SUMMARY BY BODY POSITION

By Body Position|  BACK  |  LEFT  |  RIGHT  |  PRONE  |  TOTAL  |

Apn Index, REM       30.6       72.4                                            51.4

Apn Index, NREM    40.3       65.8                                            46.2

Apn Index, Total      40.4       67.1                                            47.2

Hyp Index, REM        0.0          0.0                                             0.0

Hyp Index, NREM     1.3          0.9                                             1.2 

Hyp Index, Total       1.2          0.7                                             1.1

Duration (min)         334.6      94.5                                           451.3

AHI, REM                   36.6        72.4                                           51.4

AHI, NREM                41.6         66.7                                           47.4

AHI, Total                  41.6         67.8                                           48.3

RDI, REM                   36.6         72.4                                            51.4

RDI, NREM                 41.6         66.7                                            47.4

RDI, Total                  41.6          67.8                                            48.3

TST (min)                  249.6         84.9                                           334.5

What in the world does everything mean?  Does this section of the sleep study report indicate I am having a particularly hard time with sleeping on my back and/or side?  Does this back up the need for soft cervical collar and something to keep me sleeping in a particular position?

I look forward to the explanations.

Plmnb

[Gideon]

That means that you sleep with fewer events per hour when you sleep on your back. This data doesn't tell me anything about you tucking your chin. It is the clustering that says you are tucking your chin, not the number of events. An argument could be made that there is sufficient events to meet the definition of clustering but honestly, I have not seen a specific frequency that would indicate clustering. It would take manual evaluation because an hourly count is just too coarse to be effective.

[Sleeprider]

The data in your chart apparently came from two sleep tests where body position was monitored.  Both the first and second test have similar results, and the fist (top) test measures apnea, hypopnea separately, while the second (bottom) test measures AHI and RDI.  Both tests show you are inclined to have apnea rather than hypopnea.  

Focusing on the top half of the chart, this summarizes the apnea and hypopnea events per hour (Apn Index and Hyp Index).  It's worth noting you slept on your back 334.6  minutes (5.58 hours) and on your left side 94.5 minutes (1.54  hours), but the event rate per hour was much greater on your left side compared to supine.  Your total AHI of 48.3 events per hour is your baseline without treatment, so no matter how bad your events look on CPAP, you have had a remarkable improvement.  We just want to make it better. This data is telling you that without CPAP, you have 67 events per hour on your left side vs 40 events per hour on your back. That's severe in any of your sleep positions, so keep using CPAP.

Based on my read of your CPAP charts and the clustering of events I saw there, you tuck your chin a bit when you sleep on your back, but when you sleep on your side, you go full-fetal and without CPAP would have more than one event every minute.  You tried a rolled towel as a positional aid, but it probably didn't travel with you when you moved at night.  It's hard to correlate these sleep study results to your CPAP results because we can't record your sleep position when the events occur, but if I was inclined to make a bet, I'd probably gamble your husband sleeps on your left side and when you roll toward him, your apnea flares because the neck support was lost and you are inclined to have more apnea on your left side.  That's 100% speculation on my part, you'll have to let me know if I'm completely off.  Even if that is wrong, the results are interesting because as I said in the Positional Apnea Wiki, the idea that back-sleeping is responsible for positional apnea is a myth, it is the chin tucking. You're not the first member I have known that had much higher rates of apnea and respiratory events on their side vs supine.