ResMed S9 to A10 "upgrade" - Huge jump in AHI, CA, H, OA events - battling machine

[SleeplessInPHX]

The soft cervical collar wiki http://www.apneaboard.com/wiki/index.php...cal_Collar
Positional Apnea wiki http://www.apneaboard.com/wiki/index.php...onal_Apnea

The patterns in your recent chart are pretty classic for what we see with chin tucking, so somehow you are finding your way under or around the Eliminator.  The effectiveness and comfort of any given collar varies from person to person, and wedges have been less effective for some, depending on favored sleep position, especially side sleepers.

the 20th looks pretty good cluster wise
the 19th is bad, that is what we are trying to avoid with the collar.

Thank you @Sleeprider, I've read through the cervical collar wiki a few times, the Positional Apnea wiki is a new one to me (yep, in your sig line   ). I'm strictly a back sleeper. I think I may have figured out the cervical collar last night.

Thank you @bonjour, I agree the 19th was bad, but what do you feel makes the 20th look good? I had 21 Hypopnea events and 26 Obstructive events. I read that as bad. No?    I'm still learning. 

Last night was much better. I'll post my Oscar result chart in a moment.

[SleeplessInPHX]

Well, well, well. What a difference a new mask and a tight cervical collar can make!


I've been using a ResMed AirTouch F20 full-face mask system since starting again with my sleep apnea therapy this past December. It was a big reason why I started again and my personal "compliance" has been so easy: the mask fit better, but it's been far from perfect. Despite using the Large mask, it just doesn't quite fit in both height and width (ResMed needs to make an extra large, but that is a different discussion): I have a big nose and a big mouth (as many that know me can agree! (laugh!)) so it's been a struggle to the extent that I've had to ratchet the headgear down causing the foam to roll over at the bridge of my nose (and the corners of my mouth), setting the base of the mask on the bridge of my nose which has cut my skin (I was putting a band-aid on nightly for a week) so it hasn't been ideal. Also, it's 'touchy' with the fit so I find myself waking up to leaks and having to adjust it frequently. The foam split at the nose bridge a week ago which has drastically increased mask leak, discomfort, and my sleep events have risen as a result. 

I ordered a ResMed AirFit F20 mask because it fits the headgear of the AirTouch F20, thinking that I could try it for $24 and if that didn't work, start researching other manufacturers' full face systems.

Put it on last night and WOW that thing seals to my face like it's made of glue! Best (lowest) AHI and event numbers since my ResMed S9 CPAP. 

I'm going to wait a few days to settle in with the new mask and then I plan to start increasing the minimum pressure on my A10 APAP machine. I got way better numbers with my S9 CPAP being set at a constant 12 cmH2O than I have had in the three weeks since switching to the AirSense 10 Autoset (A10 for short).

Also, after another miserable night two nights ago and obvious clusters of events, and at the prodding of @Sleeprider to re-evaluate the cervical collar, I tightened it substantially and my clusters disappeared for a night. I'm hoping that this combination is going to be the "hardware" solution and it'll be "software" (machine settings) tweaking from here forward.

Late night of work so I got to bed at 2:00am, but I feel pretty good!


   

Cliff's Notes: See bolded text

[DaveL]

That's good news! I'm pleased for you.
I tried the F20; I never tried the memory-foam version. the F20 was a loaner.

[Dormeo]

Fantastic news, and your post is packed with information that may be very helpful to other people—thanks!

[SleeplessInPHX]

That's good news! I'm pleased for you.
I tried the F20; I never tried the memory-foam version. the F20 was a loaner.

I hope the good news continues! Thank you @DaveL !

I think the AirTouch F20 is a good mask, I just wish they'd make it a little larger. It seems that all the ResMed FF masks top out at "Large" which on my giant melon is a SmMeduim.  

Fantastic news, and your post is packed with information that may be very helpful to other people—thanks!

Thanks @Dormeo, and thank you for your input the other day. I'm going to start tweaking the EPR once I've seen what a rise in minimum pressure produces. 

The more info we post, the more everyone learns, right? 

[Gideon]

The difference between the 19th and 20th from the collar was all I was talking about there.

[SleeplessInPHX]

The difference between the 19th and 20th from the collar was all I was talking about there.

Ah! Understood! The 19th was terrible and the 20th was slightly less  terrible!  

[Gideon]

No the 19th was disastrous, the 20th workable, Until the chin tuck has been resolved nothing will really work.

[SleeplessInPHX]

No the 19th was disastrous, the 20th workable,  Until the chin tuck has been resolved nothing will really work.

Understood, thank you for clarifying.

Well, slightly higher amounts of events last night. Not getting much sleep because of a project I'm working on so I'm getting to bed after 2:00am.


My Flow Limit. is all over the place, can someone explain that to me please?

   

[Gideon]

My Flow Limit. is all over the place, can someone explain that to me please?

The simple answer is that you have restrictions.  This is the case in most of the charts that you have posted.  The usual solution is to increase epr or pressure support.  Try EPR=3 but I'm not sure that will be enough.