[Diagnosis] New CPAP User and Struggling

[BladedWedge]

I took PeaceLandP's recommendations and applied them to my ResMed device. I have attached the OSCAR readout for that night. It seems like I may have gone the wrong way according the readout. I am still in the process of buying a CPAP related pillow. 

I assumed the AutoSet on the ResMed machine is the APAP setting.

   

[PeaceLoveAndPizza]

That is how things go with CPAP at times. We have to try things to figure out what works.

Your issues still are positional. Have you tried a soft cervical collar and flatter pillow yet? 

Give this a read and it should help it make sense. The charts will look familiar.

https://www.apneaboard.com/wiki/index.ph...cal_Collar

In the meantime, we can try reducing pressure. Maybe something like:

Min pressure 6
Max pressure 20
EPR 2 full-time
No ramp

I expect the positional events will remain, but it is worth a go.

[BladedWedge]

I have purchased both a pillow and collar. Should receive them mid week. Not sure if I will try one at a time or both at the same time if possible. What is your opinion on that?

I will try your recommended settings tonight.

Thanks

[BladedWedge]

I tried Peace's recommendations again and got very similar results. Although I only lasted about 3 or 4 hours because of the high pressure. It was just uncomfortable and really enhanced my mouth breathing and dry mouth. 

Hopefully get the pillow and collar delivered today.

   

[PeaceLoveAndPizza]

That adds a very important piece of information. No matter what we do with pressure, it will not do anything to improve your flow limitations and positional apnoea.

If the SCC and pillow do not help, the next step is to talk to your doctor about getting an ASV. I’m not sure if that will do the trick, but others more familiar with it will chime in.

[BoxcarPete]

Your OSCAR charts are showing AHI numbers around or in excess of your initial sleep study, regardless of what settings you are trying. This tells me that the obstructions you have in your airway are not easily splinted open with some mildly compressed air and you need to look into other options. The collar and the pillow are still worth trying, to get the best chance of keeping everything in alignment, but if that doesn't work for you the next step is to find a sleep specialist ENT and get a camera up there. ASV can go to higher pressures than an APAP, but if you are at 16-20 already and seeing effectively no benefit, I don't think upping the cap a little higher will do anything for you. There's something blocking airflow that isn't pushed aside by PAP therapy and a good ENT will be able to identify it in less than a minute.