[Treatment] Can a Sleep Number bed change my treatment?

[doickle]

I am hoping to get some help sorting out my pressure/machine settings and hopefully getting some feedback on how a Sleep Number adjustable bed can affect my treatment.
I have been on treatment now for about three weeks. I started out with a brick then quickly went back to the DME to get an Auto after reading the posts here.
I started out messing around with pressures and then decided to just pick my current settings (7-15) and be patient before making any changes.

This is a screenshot of one of my first Auto sessions where I had the pressure set a 6-14:



As the pressure seemed to be maxed out at 14 most of the night I bumped it up a bit to 15 max, see the following screenshot:



The results seem to be ok but it still seemed I was maxing out at 15.
I decided after reading some posts here that I would keep things like this for a bit and see what would happen.
Everything still seemed to go ok. I had one or two days with AHI above 5 so I thought something else may need to be tweaked but I wasn't sure what.
Then I bought a Sleep Number adjustable bed and started using the slightly raised head or "Snore" feature.
This is what my data looked like in the new bed:



Significantly lower pressure than I had seen but not much change in AHI.

Then last night I started having a huge leak problem:



Has anyone else experienced a change like this with the change in a bed or raising the head a few degrees?
I would also appreciate any advice on the data posted on how I can tweak things to be more consistent, or am I still too early into therapy to expect perfection?

Thanks for your help. (Sorry for the long post)

[Gideon]

A sleep number bed could affect your sleep several ways. First your comfort and changing head and neck positions can definitely impact your therapy.

My mother slept in a recliner to keep her head raised when she refused other treatments.

To evaluate leaks it helps if we can see the leak graph. You median leak was 6 so I don't think you leaks were that bad.

There will always be a fluctuation in your results. The first question is how do you feel.

I would boost your minimum to provide better and quicker reaction to the few events you are having. Try it for a few nights knowing you can change it back. 1 cmH2O is plenty of change.

Keep looking at how you feel and let us know

[doickle]

Thanks for the input.
I will try an increase of my lower limit tonight.
Below is a shot of my data from last night including the leak graphs.
There was a significant amount of leakage but it didn't seem to have an effect on the amount of apneas as my AHI was pretty low for the night.
I did not have this leak issue until a few nights ago when I switched beds and am now sleeping with my head raised.

Any input is helpful.

Thanks

[justMongo]

Check your flow limitation graph. I see you have some in the stats. Plus, your machine is bumping up pressure when there are no event flags.
I infer that you need more min pressure to suppress flow limitation. Something closer to median EPAP.

Did you have a sleep study -- what pressure was recommended?

Can you specify the exact full-face mask you are using. You need to control those leaks.
I would turn off the ramp and adjust the mask straps at pressure to get a better fit.

[doickle]

Thanks for the help.

I have a couple of questions from a newbie,

What exactly does it mean by Flow Limitation in the realm of Sleep Apnea?
Are there specific things that could be causing Flow Limitation?
I have a Full Face MasK (ResMed F20), could a deviated septum and a closed mouth be the cause?

My sleep study gave me a CPAP Rx of 10. My Median EPAP is just over 9. Should I increase my lower limit to 9 to reduce the range and improve the machines response?

Thanks

[Gideon]

You have good control now, your AHI is under 2.  Make your changes slowly and see what the impact is.  Set it to 8 for now,  you may get to 9, but there is no need to hurry.  Make small changes and see how it works over time.

[Hydrangea]

I can tell you that the angle a chin is toward the chest can very much affect the fit of a mask.

I tried the Amara View, and it fit great, unless my pillow elevates my head much. The more my chin tilts toward my chest, the more leaks I have with it.

[Homerec130]

I would say it depends on which Sleep Number bed you are talking about. Sleep Number beds do provide a more comfortable bed to sleep in. If it is too hard, you can deflate it, too soft, inflate it. We have had a couple over the years and currently have a king size. The cats have our old queen size in their room and it is a little on the soft side so they can have their burrowing pockets. One thing we have found is they tend to be a little warmer in the summer months as they contour to your body more than a traditional bed.

If you are talking about the new adjustable sleep number beds (read a real expensive adjustable bed) raising the head can affect sleep apnea as you can get into a less horizontal position. Remember the old lofts that were sold to raise the head of the bed? We were looking at one of the newer beds until we saw the price. They ain't cheap even for the basic adjustable bed and they also require special sheets although we have been told twin fitted sheets work quite well.

Homer

[PaytonA]

Exactly! The lower your chin is to your chest, the less tension there is in the lower straps which can cause leaks.

A Flow Limitation is a reduction in breath volume that is less than a hypopnea and is considered a precursor to obstructive apnea. Could be caused by chin lowering toward your chest which narrows your airway. The same as what might be causing your leaks.

The F20 mask seals well at even high pressure. Mine seals up to 20 cm no problem. Of course, this can depend on your facial features

Best Regards,

PaytonA

[doickle]

I appreciate all of the responses and help.
I have adjusted my settings slightly as was suggested and I think (after one night) that it has worked good.
However, the leak issue is getting worse. The strange thing is, from my rookie perception, that the leaks are having no effect on the therapy. My AHI is still pretty low.

I have attached two screenshots below, any insight is welcome.