Recommendations on treatment

[sauerkraut]

       
Good Morning;
     I would appreciate an opinion on My present Resmed 11 autoset settings ..
I was diagnosised end of 11/2022 issued a Resmed 11 12/02/2022 by the V.A.
I've used the initial setting until 02/18/2023 ..  After researching in the forum 
for a couple weeks I changed the Min. Pressure to 7 CM H2O the EPR was 
already at 3 .. This seemed to be a standard starting place .. I presently am 
sleeping better then before therapy .. I had no trouble adapting to the mask 
(Resmed F20 medium) sleeping thru the first night no trips to the bathroom .. 
This suprised Me as I had been waking 2-3 times a night previously .. 
     I'm no tech guru hopefully You will find My sleep study and last nights
OSCAR report attached .. I couldn't post the sleep study report/graphs they're
in a PDF format the site won't except it .. 
     The sleepstudy AHI was 48.7 ..
     Thanks in advance for any help You can give ..
Steve

[sauerkraut]

   
     Sorry I reposted the first screen shot to show the top of the left hand column ..
Thanks ..   Steve

[Dormeo]

Your apnea is being treated beautifully! And the change in night-time urination is a side-benefit; more here:

https://www.sleepapnea.org/sleep-health/...eep-apnea/

You might consider turning off the ramp, though if you like being at 4 with no EPR while you're falling asleep, leave it on.

Your flow limitations are fairly heavy, though this may not be affecting the quality of your sleep. FLs occur when there's a restriction in the airway that is short of an obstructive apnea or an hypopnea. The source of your FLs could be in your nose, in which case your machine probably can't do anything about them. Or the source may be further down, in your pharynx. In that case, EPR can help, but you're already using maximum EPR. You could try increasing your minimum a bit, but honestly, if you're sleeping well, I'd leave your settings alone.

With numbers this good, your main data point should be your subjective sense of sleeping well and feeling rested.

[sauerkraut]

Dormeo;
     I guess I'm pretty lucky the V.A. doctor seems to have hit the sweet spot !!
     Do You think a cervical collar would help ??
I do have one ..
     Thanks ..   Steve

[Dormeo]

Conceivably a soft cervical collar could help, if your FLs are exacerbated by chin-tucking. You can't possibly hurt yourself by giving a try and seeing what happens. Because sleep is highly variable from one night to the next, give it a couple of nights before you draw conclusions. Exception: if sleeping with the collar is uncomfortable and keeps you awake, stop using it.

[sauerkraut]

Dormeo;
     Thank You for the help.. I will try wearing the collar for a couple nights and compare graphs ..
     Thanks again You and the rest of the Members provide a very valuable service !!
It is greatly appreciated !!
     Steve

[sauerkraut]

       

Well I tried a cervical collar 2 nights .. I don't see any improvement, I feel no different 
with or without it .. It seems the flow limitations are worse with the collar ..
AHI is higher too .. I think I'm reading the charts correctly ??
I think the collar is going back to the closet ..
Any recommendations ??
Thanks Steve

[Dormeo]

Yup, back in the closet.

A different kind of machine (one like mine) could offer you more EPR (called "pressure support," just to keep things complicated), and that might address the FLs. But those FLs might not be interfering with your sleep, and you'd have trouble getting the VA to provide you with a more expensive machine, especially when your AHI is below 5.

Conceivably with a higher minimum pressure your FLs might diminish. But I wouldn't recommend that, since the odds that it would help are not high, and higher pressure could cause you more discomfort, which would be counterproductive.

So I'd say stick with your current settings and keep track of your AHI and your subjective feeling of being rested during the day. You're doing very well! Keep us posted, would you?

[sauerkraut]

Dormeo;
     Thank You for the support and recommendations ..
     I will check in and update this thread periodically .. 
     Lurking around this site and the information avaliable here
is a resource I will continue to use ..
    Thanks again !!
Steve

[sauerkraut]

Well I tried the soft cervical collar again didn't work out very well !!



       



I think I will go back to min. 7  max 15 EPR 3 ..