[Pressure] Advice on pressure adjustments

[akarifur]

I hope you are aware that while an AHI of zero can happen occasionally, it is not the standard to expect.
- Red

Good to know!

[akarifur]

Hello everyone, firstly thanks for the adjustments suggested here so far. Overall i've been under the <5 AHI goal this whole time. I even had two nights under 1ahi!! However, it looks now that my AHI is creeping back up a bit, still under the 5 AHI so maybe i'm overthinking things but I figured i'd post graphs here and see if you have any followup adjustment suggestions etc.

Great night 0.51 AHI
[attachment=59637]

Great night 0.36 AHI
[attachment=59638]

Tuesday Night
[attachment=59639]

I'd post last nights but i forgot to put the sd card back in Oops

[Sleeprider]

Are you using the soft cervical collar yet? Tuesday has a number of positional obstructive clusters. It's not bad, but not on par with the others. There will be nights like this, but even on the good nights, your median pressure is 10 to 11 cm. Increasing minimum pressure to 10.0 seems like a reasonable step in view of your median pressure on both good and bad nights.

[Deborah K.]

If your doctor tells you not to use a cervical collar, there is one other solution.  I bought a child-sized pillow that has a ridge in front which holds my head tipped slightly back.  This solved my positional apnea completely.  My pillow is no longer made but there are others on Amazon that I think would work in the same way.  Here are two:

https://www.amazon.com/MLILY-Adjustable-...r=8-5&th=1

https://www.amazon.com/Hcore-Adjustable-...r=8-6&th=1

Both of these are made of three layers, so you can make them flatter if you want.  I like Amazon because returns are easy and are most are free for Prime members.

[akarifur]

[attachment=59692]

I'll take a look at the links you provided, I am turns out more of a stomache sleeper than side sleeper like i thought, i tend to switch between the two. I've posted last night's graph after adjusting minimum up to 10

[Sleeprider]

Prone sleeping presents a difficult problem with positional apnea. The cervical and airway misalignment occurs as the head is turned to the side in the prone position. There aren't many solutions that allow prone sleeping face down with a CPAP mask. I'm sure if you were to use a night camera to record sleep you could correlate the clusters of apnea with a particular sleep position.

[Deborah K.]

I was a natural side sleeper for most of my life.  Roughly ten years ago I trained myself to sleep on my back with a special pillow under my knees because of low back spasms and ongoing pain.  Now back sleeping is entirely natural to me, and when I learned I had apnea and about positional apnea I tried cervical collars, then discovered the child-sized pillow.

My point is that you can train yourself to sleep in what will feel like an unnatural position at first.  It's worth it.

[akarifur]

Long time no chat everybody, I thought I'd post an update and ask for some advice on dealing with my sleep nurse. First of all things have been going well but could be better I was noticing alot of variability in sleep and decided to get a consultation from axg sleep diagnostics which was really really helpful and educational to learn how to identify things in OSCAR (i hope no one takes this as any disrespect towards the advice here, in fact the progress made from advice here was really great) Jason was able though to identify that i need a high pressure value 15 +, I am trying 15 with epr 3 for the last two nights and tonight then trying 16 for 3 nights but he also said that I should get a bilevel machine after reviewing that i am still waking up alot at night and it should benefit me.

The problem is that I need a doctors note from my sleep nurse or PCP for lofta my provider to send me my new machine. Now my PCP is rather good but she is in territories she has never dealt with before and is feeling naturally a bit uncomfortable. I called my sleep doctors office and boy were they extremely disrespectful and rude. Claiming that "Well we don't have your data, so we can't make a decision on that" (They apparently haven't had it since the beginning of my therapy over a month ago now and haven't cared till now). "Your sleep doctor (she's not a doctor but a ARNP with no creditation certificates or actual specialty, she is actually only a general medicine nurse) is in charge of your health" "You need a sleep study from one of our Tech's" Now I am paying pretty much entirely out of pocket because the insurance will only deal with the scammy DME who good news sent me a letter last week for me to call them to setup an appointment to discuss Maybe ordering a machine.

Any advice you can give would be great, I am trying to provide data and backup to my PCP, i've sent an email to axg as well to see if he can help provide my PCP with data to make her feel more confident in the decision. But man I knew going into it that sleep clinics can be horrid but holly cow is this a nightmare just to get a note to get my new machine

[Uzupan]

Long time no chat everybody, I thought I'd post an update and ask for some advice on dealing with my sleep nurse. First of all things have been going well but could be better I was noticing alot of variability in sleep and decided to get a consultation from axg sleep diagnostics which was really really helpful and educational to learn how to identify things in OSCAR (i hope no one takes this as any disrespect towards the advice here, in fact the progress made from advice here was really great) Jason was able though to identify that i need a high pressure value 15 +, I am trying 15 with epr 3 for the last two nights and tonight then trying 16 for 3 nights but he also said that I should get a bilevel machine after reviewing that i am still waking up alot at night and it should benefit me.

The problem is that I need a doctors note from my sleep nurse or PCP for lofta my provider to send me my new machine. Now my PCP is rather good but she is in territories she has never dealt with before and is feeling naturally a bit uncomfortable. I called my sleep doctors office and boy were they extremely disrespectful and rude. Claiming that "Well we don't have your data, so we can't make a decision on that" (They apparently haven't had it since the beginning of my therapy over a month ago now and haven't cared till now). "Your sleep doctor (she's not a doctor but a ARNP with no creditation certificates or actual specialty, she is actually only a general medicine nurse) is in charge of your health" "You need a sleep study from one of our Tech's" Now I am paying pretty much entirely out of pocket because the insurance will only deal with the scammy DME who good news sent me a letter last week for me to call them to setup an appointment to discuss Maybe ordering a machine.

Any advice you can give would be great, I am trying to provide data and backup to my PCP, i've sent an email to axg as well to see if he can help provide my PCP with data to make her feel more confident in the decision. But man I knew going into it that sleep clinics can be horrid but holly cow is this a nightmare just to get a note to get my new machine

I just purchased my bipap out
Of pocket. Since I could not find my prescription I did an online prescription renewal through the company that sold me my machine.

[akarifur]

Oh nice, I wonder if that would work for switching from APAP to Bilevel? My current prescription is alright according to lofta but i need a doctors note saying "Ok to switch to bilevel" before they'll send it to me