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Flucuating AHI even with no leaks. Longtime Cpap user.
Hello Apneaboard
This is my first ever thread on this forum, and i've been roaming here for around 1 week now, learning a lot more about why im still tired even tho im sleeping with a CPAP machine.
Lately i've learned a lot about OSCAR, and general AHI scores, and i've came to notice that my AHI score is rarely under 5, and is mostly hovering around 7-11 range.7
i have then started to fiddle with some of the settings myself to see if i can fix my issues with AHI fluctuating so much, leaving me tired all day with no motivation or energy. (almost losing my job even tho my AHI is mild, its enough to make me super tired in long term (years))
I'm a 28 year old male with good activity level, but weighting 93 kgs at 176 cm tall. (5.9 i believe...)
I wake up with headache and sometimes dry throat and mouth, and im just so desperate to get more knowledge on what settings i might be able to improve? i've seen the amount of help some of you people on this forum is providing and i think its an amazing community.
That said im from denmark where we have really good medical support from the state, but with long queue times speaking with doctors etc.
I've attached some pictures of my last 2 nights with OSCAR.
Best regards. Jacob.
RE: Flucuating AHI even with no leaks. Longtime Cpap user.
Welcome to the board. If you look at your charts you can see almost all of your O events are cluster. That shows positional apnea. No pap machine can help, the only way is to stay out of that position that is causing your blockage.
It is also called chin tucking wher your chin drops to your Sternum cutting off your own airway.
Please look at the link I have at the bottom of the post on collars. It shows people that have collars and the same people without collars - huge difference.
RE: Flucuating AHI even with no leaks. Longtime Cpap user.
First and foremost, NO DIAL WINGING, no changes without a purpose.
Oh and welcome to the forum.
As Stacey said this is an obvious case of "chin tucking", a cervical alignment issue with thje signature being clusters of obstructive events. These events cannot be fixed/treated with pressure (technically they could BUT no CPAP can produce that amount of pressure and enough pressure to do that would cause some VERY serious issues. (No amoount CPAP pressure will hurt you).
Two solutions exist
1. Pillow modification or change, 1 vs. 2 pillows, less firm flatter. This may work but if not
2. A soft cervical collar, look at the wiki that Stacey refered you to,it will provide more detail.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
RE: Flucuating AHI even with no leaks. Longtime Cpap user.
(01-27-2022, 11:48 AM)staceyburke Wrote: Welcome to the board. If you look at your charts you can see almost all of your O events are cluster. That shows positional apnea. No pap machine can help, the only way is to stay out of that position that is causing your blockage.
It is also called chin tucking wher your chin drops to your Sternum cutting off your own airway.
Please look at the link I have at the bottom of the post on collars. It shows people that have collars and the same people without collars - huge difference.
I've actually done some homework and reading other people having similary scores as mine, and with clustered OA's.
I've seen u earlier posts about using a small flat pillow, which i changed to on the picture with 7 AHI.
I've also ordered a neck collar to try see if that can help, but theres no setting i can change to help? its all postitional?
RE: Flucuating AHI even with no leaks. Longtime Cpap user.
Hi Jacob, Welcome to Apnea Board!
Most of your problem stems from what we call "positional apnea."
Look at the Obstructives on your event graph. See how they are clumped together?
This is positional apnea.
This happens when sleeping in a way that causes your head to tilt forward into chest, which cuts off your air. This can occur regardless of sleeping on back or side.
Your pillow may be too high and that in turn can tilt your head forward into your chest. (Chin tucking) Consider using a thinner or flatter pillow.
Another alternative that has helped many here is to use a "soft" cervical collar. This helps keep the head and neck aligned and stops the "chin tucking."
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Flucuating AHI even with no leaks. Longtime Cpap user.
at this time yes, all positional. Resolving the positional may show issues that can be addressed with settings, but the positional must be fixed, as a guess at least 90% positional, with the other 10% possibily hiding under the positional.
Gideon - Project Manager Emeritus for OSCAR - Open Source CPAP Analysis Reporter
RE: Flucuating AHI even with no leaks. Longtime Cpap user.
Okay, my girlfriend video recorded me sleeping and it always seem to struggle to exhaling out, where i would fight my own throat, never thought i was chin tucking that hard. so good to know i hope the collar can help...
RE: Flucuating AHI even with no leaks. Longtime Cpap user.
Hello again.
It's been some time since i last wrote here about my AHI flucuating even with no leaks on my mask.
Since then i've done some of the things u recommended, and i even got to speak with my Sleep specialist/doctor in Denmark.
What you guys recommended and what i've done.
1. Change from 2 pillows to 1 pillow to minimize chin tucking, noted the 1 pillow was flat. (this was one of the biggest help, it made me reach avg. AHI around 5-6 more consistenly than 2 pillows.
2. Try a Soft cervical Collar for my neck, and here i had to different sizes that i tried. one was 2.4 inch while the other was 4 inches., Neither did help on my OSA/positional apnea/chin tuck. It actually made it worse, i woke up nights with both of them with high AHI. I dont know if i should give them more time, but maybe im misunderstanding why my AHI is higher than lower using them. (maybe chin tuck is not my problem?)
The Doctor at the hospital told me, that he wanted to try put me on an ASV machine instead of my Dreamstation machine(APAP). I have no clue if the reason why my breath patteren is the way it is (see attachments). I know that certain positions can cause these clustered events, but EVEN with a neck collar, and 1 pillow i still get the exact same Clusters?
I am DESPERATE for help, as i'm extremely sensitive with bad sleep, even tho my AHI is on the lower end i can tell for sure the difference with nights on AHI of 3~ and under...
Do you guys have any idea if ASV would help? (note its free in Denmark to try other machines/masks.)
Returning after tried positional solutions on OSA clusters.
Hello again.
It's been some time since i last wrote here about my AHI flucuating even with no leaks on my mask.
Since then i've done some of the things u recommended, and i even got to speak with my Sleep specialist/doctor in Denmark.
What you guys recommended and what i've done.
1. Change from 2 pillows to 1 pillow to minimize chin tucking, noted the 1 pillow was flat. (this was one of the biggest help, it made me reach avg. AHI around 5-6 more consistenly than 2 pillows.
2. Try a Soft cervical Collar for my neck, and here i had to different sizes that i tried. one was 2.4 inch while the other was 4 inches., Neither did help on my OSA/positional apnea/chin tuck. It actually made it worse, i woke up nights with both of them with high AHI. I dont know if i should give them more time, but maybe im misunderstanding why my AHI is higher than lower using them. (maybe chin tuck is not my problem?)
The Doctor at the hospital told me, that he wanted to try put me on an ASV machine instead of my Dreamstation machine(APAP). I have no clue if the reason why my breath patteren is the way it is (see attachments). I know that certain positions can cause these clustered events, but EVEN with a neck collar, and 1 pillow i still get the exact same Clusters?
I am DESPERATE for help, as i'm extremely sensitive with bad sleep, even tho my AHI is on the lower end i can tell for sure the difference with nights on AHI of 3~ and under...
Do you guys have any idea if ASV would help? (note its free in Denmark to try other machines/masks.)
The attachment with AHI of 7.77 is with 2.4 Inch Collar.
the other attachment(AHI 8.74) is with the 4 inch collar. ence why i bought 2.4 inch, reading it helped others.
