Tobiathan therapy thread

[tobiathan]

If I'm reading this right, I had a 50-second OA. Yikes. Leak rate seems pretty low. Not sure what to make of it.

   

[Jay51]

That is what it looks like to me also.  It could be a 50 second CA, but it reports as an OA if the FOT interprets your airway as obstructed.  

This is positional apnea at its worst.  Do you use a soft cervical collar?  Try lowering your pillow height lower.  If you want, you can try side sleeping instead of back sleeping.  If those don't cut down on your OA's (especially the clustering together of them), then a soft cervical collar may help prevent these.  

Your SPO2 can drop significantly with long apneas like this.

[tobiathan]

I have not tried a soft cervical collar yet — sounds like I’d better… I try to side-sleep — sleeping on my back is my least preferred position… but I have shoulder/arm pain right now that makes it difficult to stay on my side.

[tobiathan]

Update — some trial and error going on with a couple of things. 

Active sleeper issues: P30i was not great, I hoped it'd be more stable than the P10 when I move around, but it wasn't.

Positional apnea:

• Definitely doing better with 1 pillow vs. 2, so that's a no-brainer. 
  
• Tried a soft cervical collar and it was a disaster. I used to have a problem with clenching my jaw at night and the collar put me right back there; I even managed to bite my tongue a couple times. Not going to happen. I think I need to either accept the ~3 AHI that I'm getting lately or get serious about losing a bunch of weight :/
  

[Jay51]

Great job putting in the effort to do all of your trial and error.  Probably how you feel in the mornings after sleep will be a big determinant of how to plan on proceeding from here.  

If your flow limitations ever become too much for you, a bilevel (bipap) machine can use pressure support larger than the current maximum of EPR 3 that you are using now.  Not saying that you need to do this, just something to consider in the future.  I hope you get optimized the best as possible and it works out for you.

[tobiathan]

Thanks Jay! I’ll file that BiPAP thought away for now; I’m waking up feeling fine. I’ll probably be looking for a new sleep doc at some point this year and I’ll bring my OSCAR data with me (that’ll be a litmus test, LOL… my old doc didn’t even know patients could go into clinical mode and make adjustments). 

I think my mask holy grail would be something as stable as my F20 but not a FFM since unfortunately those place pressure on my lower jaw. I seem to be doing ok with the P10 for now.

[tobiathan]

Update: sleeping on my stomach more now that my shoulder is improving somewhat. AHI now between 2.0 and 3.2 most nights. Feeling good in the mornings.