[Pressure] Sudden elevated AHI. HELP!!!!

[JesseLee]

Sleep apnea has alot to do with genetics. You will share anatomical features of your parents. So yes. I am a prime example of hereditary sleep apnea.

[Sleeprider]

Arc0509, this is short-sweet story about how the collar can work http://www.apneaboard.com/forums/Thread-...-like-crap

I am continually amazed at the results so many members achieve by preventing the chin from tucking at night. I suspect if you have a short neck and sleep supine, your pillow can cause this, or perhaps prevent it with the right one. Let's just say it is one of the most common and easiest problems to solve.

[arc0509]

How does the Cervical collar works?

[Sleeprider]

Real simple. It supports the lower jaw and prevents you from tucking your chin. This stops leaks by keeping your mouth closed, and keeps the airway open. You probably know that in first-aid artificial respiration, the airway is opened by elevating the chin. You can experiment by sitting in a comfortable chair and relaxing and breathing normally, relax and let your chin drop. If you feel the upper airway respiratory restriction, this is the effect of positional apnea. Even positive air pressure can't overcome the blockage that can occur with some people. If during this exercise your relaxed posture caused a stoppage of breathing or a snore, you are the person this fix is targeted at.

[arc0509]

Hi,

I slept with the pressure settings you adjusted. Initially I had a little problem in exhaling. I felt as if I am inhaling even before I could complete the previous exhaling. Si i turned on C flex at setting 1. If you suggest otherwise i can turn it off. I am attaching the relevant screenshots for you to evaluate. Overall I slept for some 7 hours, but can't say feeling absolutely fresh. I want to sleep some more. I don't know if its due to the AHI or just a little less sleep. HAHAHAHAHA.


Please tell what you see in there brother. I had good amount of Clear Airway events but you told not to worry about them at the moment.

Also did you see my previous post where i posted screenshots of my sleep study done in august 2017. It shows breakup of events by the body position. You may draw some useful information from there since you suspect mine to be a case of positional apnea.

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My mother and eldest brother have sleep apnea too. All three find it hard to get up in the morning and tend to forget things.

[arc0509]

Getting good AHI is extremely important for me. I left my job at Deloitte to prepare for competitive exams. But this sleep apnea is severely affecting my memory , focus and ability to study. My whole career and life is at stake.

[Sleeprider]

In your last session I see a big monthly calendar blocking otherwise useful information...please click the triangle in the date line and minimize that calendar. In addition, I see mostly pretty good results with steady minimum pressure for the first 3-1/2 hours, then an obstructive cluster that rapidly elevated pressure and drove up the AHI. Your chin slipped under the collar or you had some other failure of the positional therapy. This repeated a couple times until 10:00. When you resumed therapy after 10:00 you had some sleep transition CA events, but mostly a quiet remainder of the morning. Your sleep hours are unusual to say the least, and if you are doing shift work, I suspect they are inconsistent. This is an additional challenge.

Comparing this result to what you posted at the beginning of the thread, your AHI is lower, pressure much more steady, leaks are significantly improved and snoring is mostly gone. Look at the difference in hypopnea! So while the AHI is not what I would target as an end result, this is a noticeable and important improvement. I don't think you need to do anything further with Flex, just try to find a way to get more comfortable and effective with the C-collar. Really, other than 5-6 minutes of time in here, this is good quality therapy. Don't be discouraged. Get rid of the monthly calendar.

[arc0509]

Actually my AHI has increase as compared to previous night. It was 4.35 previous night, and 7.09 after the settings you suggested.(Both screenshots attached with calendar collapsed )

However, you are better judge of the fact whether this night was better than the previous night in terms of the breakup of the events etc. After all, i suppose AHI number alone doesn't give the full picture.

This post is basically to let you compare the last two nights at different settings of pressure ans suggest me if i need to continue at 9-16 as suggested by you earlier or any other value. Also, between A-flex and C-Flex which one should i choose? Will keep the flex at 1 for now.

Also, posting the sleep study AHI breakup screenshot again just to be sure you saw that and derived any conclusion since the sleep study categorized the events according to my body positions.

I have a soft collar lying somewhere in the house and I am searching for it. I will sleep at the pressure range you suggest in this post's reply tonight. Also, if i fail to find the soft collar i will buy a new one and let you know the result. Just that its the extreme heat season right now and soft collar may make me sweat. But i am going to try it as you said without fail.

And what are transitional events? Do you mean the cpap machine mislabels them as Clear Airway/Central Apnea whey then in reality are not due to the inherent lack of diagnostic facility on a cpap machine as compared to a full blown sleep study. What I mean to ask is am I having episodes of Central Apnea or are they just nothing? I am worried since my sleep study did indicate an episode or two of Central apnea. If you suggest, I can consider another sleep study.


Also no night shifts, I just sleep late. Left my day job to prepare for competitive exams. Another poor sleep habit I am trying to change since long.

[arc0509]

I thought of attaching screenshots of airflow of all 22 Ca events I had. I am extremely sorry for the information overload. You could have gotten rich if you were charging me.

Jokes aside, I am desperate and to be honest you are more knowledgeable than the doctors i interfaced with so I am counting on you. I am not hopeful of getting a doctor more knowledgeable than you in this domain unless i travel 500 miles. I have some world class institutes in my city, but specialist for sleep apnea are just not have a mass appeal right now in my city. There are sleep labs for sleep studies throughout the studies, but doctors overseeing them are practitioners in respiratory departments and not sleep apnea specialists. I get to know more from this forum than them honestly. Sleep Apnea is still under explored domain here.

I figured by transition you meant there must be an OA/H events near a CA event. I maybe wrong. These shots are from the latest night when my AHI was 7.09.

Infact i uploaded the screenshots on my google drive and sharing the link with you so that you can see them in 1 go within 5 minutes.

the link is: 

https://drive.google.com/open?id=1Of8Cym...g--3vPiG7Q

[Sleeprider]

CA events are pauses in breathing of at least 10 seconds, and the machine detects an unobstructed airway. The manufacturer refers to that as clear airway because there is no way to know if they are central or not. They often occur in new users and light-sleepers during sleep stage transitions, arousals and physical movement as the person holds their breath as they turn. They occur all day long in normal individuals when we focus on a task, exert physical energy, etc. The erratic breathing patterns of an awake person are quite different from the normally smooth rhythmical patterns of a sleeper.

Considering the comparison of your charts, the AHI was higher in the more recent chart, and that was mostly due to CA events. What I notices was an improvement in tidal volume, more consistent breathing volume, less snores, and improvements in the leak rate. The cluster of OA as I said occurs all at once, so even though the numbers are "worse', the amount of sleep time potentially disrupted by all of that is less. Good luck with the collar.