Suggestions?

[TinySteve]

Hi folks, I'm about three weeks into CPAP, and I could use a little help interpreting these numbers....
Also, I've just switched to a full face mask.

[G. Szabo]

You have positional apneas because your events are clustered. You should change your sleeping position, avoid chin tucking (use a collar and thin pillow), and try side sleeping.
Turn the ramp off. 
EPR=3
Standard mode.

Your pressure should be determined after you control your leaks. As long as they are so high, you cannot get realistic treatment.

[TinySteve]

Thanks for the input!

I will try a thinner pillow, and the machine changes. Will also use my chin strap.

I am a back sleeper, doubt that I can make a switch now.

[staceyburke]

You are having positional apnea.  You can see positional apnea where either H or Oa events are clustered together.  Getting rid of as many as you can will lower your AHI.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow or sleeping on your side helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.
 

[TinySteve]

Thanks for the input....

I'm sharing a screenshot from last Monday.... Big thick pillow, used my chin strap with ResMed N30i Nasal Pillows

2nd screenshot is last night.... Thin pillow, ramp turned off, chin strap, Philips DreamWare full face mask

[G. Szabo]

Your leaks are so high that the instrument cannot provide adequate treatment, tainting your AHI and event numbers. 
Are you on EPR=3?  It would be best if you were in that setting.

[TinySteve]

Unsure about where to find that setting on my machine?

[G. Szabo]

Unsure about where to find that setting on my machine?

You enter into the Clinical Menu by, pushing the two knobs on the front of the instrument simultaneously and holding them for about 5 seconds—scrolling down and changing the EPR setting. You should also turn off the ramp there.

[Expat31]

It is early days, but your leaks and positional apneas are stubbornly present. 

I would like to expand on these points, and hopefully suggest some possibilities l. 

- True about leaks, your graphs at best, are of limited use. Reading mask leaking solutions  may help, as well as the mask primer. 

Full face masks have many plus points, but with a large surface to seal, seal, can be problematic. It can depends on each person's facial characteristics. 

A pillows mask, which is of minimalistic design, and of a small surface area can achieve good results 

For mouth breathers however, not always quite so easy, but  good results can be achieved with mouth taping, or a chin strap.


- Regarding positional apnea, on this forum, most of the discussion revolves around "chin tuck" and the excellent metaphor clearly describing the "garden hose" effect of  impedeing air flow through the oesophagus, with the corrective benefits of using a soft cervical collar. This seems to efficient for the majority of members. 

But for back, sleepers, there can be another cause, not of the oesophagus being out of alignment, as the the previous paragraph above, but the tongue, under the force of gravity, can falling back against the phalanx wall, blocking the airways. See attached diagrams below. 

This is known to happen in the deep sleep phase, especially REM or paradoxical sleep when there is a a semi paralysis of the muscles and consequent loss in muscle tone.

This supine positional apnea (video) I think is pretty demonstrative. 

This may be useful also:- Sleeping positions & pillow adjustments (video). 

What was indicated in your sleep study, iethe break down of apnea events between supine, and side sleeping. 

There is a possibility you may have to get off your back. I have always been a stubborn back sleeper, and had to train myself over a period of 6-8 months with 3 tennis balls sown into a chest brace to solve problem. Bit uncomfortable though, but worked 100%. Now hardly ever needed. Nothing else worked. 

Sorry, lots to digest in the beginning, just to work through step by step.. 

Hopefully the SCC should work fine for you. 

[TinySteve]

Thanks very much for all the info!

Here's my screenshot from last night, I think these numbers are more accurate.
For the very first time, my leak was under control.
As suggested by G. Szabo, I had changed my machine to EPR 3, and I used my chin strap with the full face mask.