SleepHQ data for someone struggling with CPAP

[therhile]

This was last nights data. I changed the minimum to 9 but kept the EPR at 3 because my flow limits are high and I think that's what is waking me up at night. I don't know if my flow limitations would still be considered high here. I feel "decent" right now, well rested but I was really hoping a cervical collar was going to really bring my AHI down to 1 or something like I see with other people. I'm wondering if my collar isn't wide enough as I went with the 2" collar instead of the 3. I did not sleep on one flat pillow however, because I thought I could sleep inclined and comfortable with the collar. Any ideas what to do next?

[PeaceLoveAndPizza]

Two things stand out…

1. The CA”s are the current challenge. Whilst positional apnoea does not directly affect CA’s, you do have a few OA’s that still appear positional. 
2. Even with an EPR of 3, you still have more flow limitations than we like to see. 

Next steps…

1. Follow Phaleronic’s advise and make the following changes so we can see if EPR affects your CA’s. Try it for a night or two and let us know how it goes. Depending on the result we will either tweak things or try something completely different.

Mode APAP
Min pressure 8
Max pressure 14
EPR 2 full-time
No ramp

2. Continue working on avoiding chin-tucking through whatever means work for you.

One thing to consider is you may be one of the lucky ones (like many of us) and require a bilevel to manage the CA’s and flow limitations. A bilevel with pressure support of 4 and trigger set to high or very high will likely remove almost all of the CA’s. Whether that gives you a better nights rest or not remains to be seen.

[therhile]

Okay. I will try those settings tonight. This was last nights data, still seem to be getting positional apneas, which is strange because I am wearing a cervical collar. I wonder if I don't have it on tight enough?

[therhile]

Here is last night with your settings you suggested. This was also with a bigger cervical collar.

[quiescence at last]

Those past two night's plots were really good looking to me. I know I mentioned not being overly concerned about the CAs, since these are reactions to the extra help the APAP is giving. I note that the CA score has really gone down the past couple of nights, and partly due to dialing back the EPR to 2. When you are after the low scores, I would just say the pressure is supposed to help reduce the OAs and Hs to a minimum, not the CAs although there is a relationship you can see. That is why I made the statement that you should count only the OAs and Hs, and take the WIN when the OAs plus Hs combine to less than 1. You arrived at almost 1 on Sunday night, and under 1 last night.

Congrats,

QAL

[therhile]

Thank you very much for the reply. I’m glad it looks good, I am noticing a difference most nights it seems. I’ve actually been noticing some dreaming lately, which is rare for me as I didn’t dream for years. Do my flow limitations look within normal range? Or is that something I still need to figure out. Thanks again.

[quiescence at last]

I like 95% flow limitation values under 0.10, so would almost you got there on last night's post, getting 95% flow limitations as 0.11.

QAL