Retrying with BiPAP

[Takeout Neutron]

I did a home sleep study about a year ago which noted an AHI of 39 and severe sleep apnea. It took about 7 months to get the CPAP approved and delivered.

The doctor prescribed a max pressure of 20 cmH2O. It was difficult to tolerate the pressure. By the end of the second month I was so tired I needed to skip nights to get a reasonable amount of sleep. My AHI numbers were still high and all over the place. The doctor said we needed to increase the pressure even higher. At that point I fell out of compliance with the insurance compliance returned the machine.

The doctor suggested an attended sleep study and titration test for BiPAP. That showed an AHI of 39 again with pressure of 15/10 cmH2O reducing the AHI to 0.

I received an Aircurve 10 VAuto about a week ago and have been trying to make a real effort this second time. It's much more comfortable on BiPAP, but my initial AHI are still high and ranging rom 8 to 14. I'm concerned the doctor is just going to increase the pressure again and I'll be setting myself up for a second failure.

I was fortunate enough to find Oscar and this forum and hope that graphs might give me clue to getting my numbers in line. 

Thanks in advance for any suggestions.

[Gideon]

The problem here with the BiLevel, and I'll guess with the APAP, is that most of your obstructive events are positional. By this Iean you are most likely tucking your chin. Try using 1 pillow vs 2, a softer/less firm pillow so your neck is straighter when you are sleeping. You may need to use a soft cervical collar. Read the link in my signature. I don't think it will surprise you to know that no amount of pressure will overcome this. There is a real good chance that when all is said and done that we will suggest a lower pressure and pressure support, well at least to try them.

For now with either the pillow management or the use of a SCC you need to manage this positional aspect of your therapy.

The tell? Well it's the fact that the events are clustered.

[Takeout Neutron]

Thank you for the feedback!

I tried a different flatter pillow last night. My numbers were a little worse on the MyAir app, but I didn’t have time to load it into OSCAR before work.

I did order a SCC and will report back when I get some data.

Thanks again.

[Takeout Neutron]

I tried the Caldera Relief Neck Rest pillow last night. It was a little uncomfortable, but I did manage to sleep. The AHI was slightly worse than previous.

[Takeout Neutron]

I tried the Caldera Relief Neck Rest pillow last night. It was a little uncomfortable, but I did manage to sleep. The AHI was slightly worse than previous.

[Takeout Neutron]

The second night with the SCC and the AHI increased to 27.8. Almost constant events every minute.

[Takeout Neutron]

The second night with the SCC and the AHI increased to 27.8. Almost constant events every minute.