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03-11-2024, 12:13 PM (This post was last modified: 03-11-2024, 12:15 PM by SleepyLlama.
Edit Reason: Add more details
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SleepyLlama therapy thread
Hi all,
First, I have been a CPAP user since May of 2023 and benefited immensely from the wealth of knowledge in this community, so thank you to all who contribute and share their advice, issues and success stories.
I've made positive changes in my own therapy but am having some issues that I seem to be unable to resolve myself.
First, I am 40 years old, male, and in relatively good shape physically with no medical issues besides apnea. My sleep study showed an AHI of 23 with no centrals. It was a pretty terrible night of sleep.
I am using a ResMed AirSense 11 Autoset with a Philips Dreamwear mask with a nasal cushion. I tend to sleep on my side using a buckwheat pillow and then switch to sleeping on my stomach. I currently use a chin strap to help with mouth breathing/leaks which seems to work.
I'm posting because lately, I am consistently hovering around an AHI of 5-7 and I'd like to see if there is any room for improvement. I feel a marked improvement in my sleep quality since before CPAP, but the AHI nags at me. I'm attaching graphs from a recent night. I'd greatly appreciate any advice or suggestions.
Here is another recent report, just for some variety.
I often show a decent number of centrals but they look/feel like periodic breathing or sleep-wake-junk from what I understand. I do a lot of meditative and box breathing breathing during the day and I suspect this is just carrying over into my sleep patterns to some degree.
Would still greatly appreciate any advice to tweak therapy!
You have high flow limits. To treat these I suggest that you turn on EPR full-time to a setting of 3. This should improve your comfort and therapy.
You seem to have some positional apnea too. That shows up when you see clusters of apneas (not including centrals). No setting change will help. Positional apnea is caused by your chin tucking toward your chest. It's kind of like a kink in a hose which makes it difficult for the water to flow through. You need to keep your chin up to prevent this. Since you are a side and stomach sleeper you would probably benefit from sleeping with a soft cervical collar. When I used them I tried a bunch. I liked the Caldera Releaf Collar (available on Amazon) the best.
DeborahK, thanks for the advice! I'll try EPR out for a week or so. What kind of changes in flow limit should I be looking for to know if it is helping?
I have tried soft cervical collars before and I did not feel that they improved my AHI or perceived restfulness meaningfully, but I'm happy to try it again for a bit to get some data. I'll try that after I get a week or so with EPR.
I have tried using EPR set to 3 and found it to be extremely uncomfortable, and my score was much higher. I decided to set at EPR 1 for a bit and haven't found significantly improved results. I have also used a cervical collar and have not seen much change. I'm posting data from a recent night.
I got to exploring the statistics screen in OSCAR and noticed a period where I was seeing consistently good (for me) scores. Looking at this data, I noticed my pressure settings were actually significantly lower at the time. The only other significant different I see is that I had the humidifier disabled (I've since re-enabled it because I'm concerned about drying my mouth out and causing dental issues). I'm posting screenshots of both the statistics screen and the older night in question.
I'm wondering a few things:
Are there any indicators in my data that lower pressure settings might be preferable? If not, is there any other reason why that period of time might have given me better results?
Can the humidifier increase apnea events?
Are there any other potential changes I might explore to continue improving results?
03-20-2024, 03:30 PM (This post was last modified: 03-20-2024, 03:32 PM by jcp519.)
RE: SleepyLlama therapy thread
Like Deborah said, those apneas seem to be positional related. Some sort of cervical collar should solve this. Is it possible that the buckwheat pillow is a factor? I know when I tried out the buckwheat pillow it caused my positional apneas to be worse because the pillow was a lot higher and it made my chin tuck towards my chest.
The humidifier shouldn't really be a factor in increasing apneas. Your humidifier level is actually quite low, most of the time I see it up in the 4-6 range
Edit: missed the part that you tried the collar. Are you sure its on correctly? It needs to keep your chin from dropping too much.
