Therapy less effective for no obvious reason

[Chalkie]

The images below give a flavour of what is happening with my therapy.  Despite broadly similar leak rates in the two charts and no other obvious changes in the variables - including the same mask - there has been a consistent decline in the past couple of months in the quality of my therapy. 

I have changed the filter and already I see there is a slight amount of gumming up with fresh dust. The force of the jet of air is marginally lower with the filter than when I take it out, as an experiment...is that normal? But the pressure shooting out of the machine seems OK, much better than a previous occasion, for example, when the filter was really blocked and there was hardly any pressure being pumped out. But is this slight reduction in pressure when inserting the filter to be expected?

   

   

My sleep nurse is talking about trialing a new mask,  but I am not sure I should ditch the existing Resmed AirFit F20 full-face mask.   In the past, the leak has been down to a few %. So maybe it di down to me to make sure I fit it better.

I have also changed the hose again in case there was a leak there. Last night AHI was 8 so there has been some improvement. 

Any insights, however, into why my generally effective therapy (AHI around 5 or less most nights) has gone downhill so much would be much appreciated.

[staceyburke]

You are having a lot of positional apnea.  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 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.

[Chalkie]

Thank you. I have started using a collar again and have switched to a flatter pillow. I will see how I get on with this pillow.