[Treatment] Help with therapy

[KPink]

Thanks...

Maybe it's time to suck it up and do a titration study.  I've been avoiding it but prolly should just git'r done.   KP

[OpalRose]

So the Snore Eliminator collar didn't work too well?

This is all Positional Apnea. As much as we don't like to use collars, flatter pillows, and trying to sleep on our side, most of us have found that we have no choice to make necessary changes if we want this to work.

Again, what is happening when your "chin tuck" is that you are cutting off your air supply, like a kink in a hose. The machine tries to compensate by raising pressure, but it can't blast through a closed airway.

FL is high too, but probably is caused from the chin tucking.

I doubt using Flex has much to do with it, but turn it off if it's not comfortable.

Do you feel your pressure is too high? It may be better to switch to Cpap mode to stop the pressure swings.

[KPink]

Hey there OpalRose.  Actually I didn't use the eliminator last night.  The only thing I did different was to set the flex to 2 as you suggested and spent a large part of the time without any pillow at all.

I do know that how I sleep does need a few tweeks and I'm giving it all I've got.  So, time and continued effort will tell.

No, the pressure doesn't seem too high but the flex on 2 does seem to feel like I'm not getting enough air.

Back when I was experimenting with a ton of different settings it seemed that I actually did best (if you want to call it best) at:

Auto CPAP Min: 12.0 cmH2O Max: 14.0 cmH2O Flex 1

However, even though my AHI's averaged 5'ish and below, it was inconsistent.  There were an average of 2+ days a week when the AHI would jump up to 7,8,9-11.  Hence the reason I would like to solve this issue.

So, tonight I will change the flex to 1 and wear the Eliminator and see what happens.

Thanks for your input and I'll let you know what the report looks like tomorrow.  KP

[KPink]

Well.
I spoke too soon.  I thought that AHI 13.4 with 64 OA's was bad.  Last night my AHI was 15.4 with 93 OA's.  Yet the CA, FL, H and RERA's are not exactly horrible.  Obviously zero would be best but they are better than the OA numbers.  They are CA 11, FL 12, H 7 and RERA 7.

Unbelievable how my OA's are going south fast.

I did use the Eliminator neck pillow thing but somehow still ended up with clusters on top of clusters.  So, I must be seriously doing something wrong as it relates to my positioning.  The report is so ugly that I'm not even going to show it.

So, final comment is this.  I'm going to continue working on trying to figure this out.  My next sleep clinic meeting is next month so when she sees these results I'm sure that she will freak out.  Oh well it is what it is.

Thanks again for trying to help.  More to follow at some point.

KP

[Jay51]

KP, I use 2 eliminator soft cervical collars (they are each 2.5" so they total 5" in height).  Just mentioned that because 2.5" is usually a bit small for even the most petite person.  If you shop online you could find a different collar for not much $.  Measure from your chin to the top of your chest.  I suspect the measurement will be larger than 2.5".  Probably closer to 3.5" or 4" or even more.  Look at the design of it also to see if it will be comfortable enough.  Like OpalRose (Rose) said, "This is all postional apnea."  No amount of pressure can get high enough to open up a postional apnea "clog".  The collar should not be too tight or too snug, but it functions by keeping your chin from tucking down towards your chest.  You should be able to fit a couple of fingers in it also to make sure it is not too tight.  I encourage you to at least give this a try when you can.  It is your decision of course.  There don't seem to be many more options.  I am sorry about that.  
Have you tried switching to cpap mode like OpapRose suggested?  That would make for less pressure swings.

[KPink]

Hello Jay thanks for the encouragement.  I may need to buy another cervical collar to try since the first one was gleefully thrown in the trash after its failed maiden voyage.

The thing about my jaw/chin drop is pretty interesting.  Last night I made a point to notice whether my jaw or chin was even able to drop with the eliminator and it did not drop.  At all.  At least in the position that I was in at the time (on my back). 

What does happen when I completely relax my mouth, throat and jaw (as when on the verge of falling asleep) is that I feel my tongue or back of the throat or maybe tonsils flap and cause a momentary blockage.  This causes me to choke, startle and swallow to reopen the passage until the next time it happens.  Therefore, while sleeping this must be happening constantly.  Thereby never getting enough good sleep even when I've slept all night.  I felt better before being diagnosed the sleep apnea.  Sure I always felt sleepy but at least I didn't look like hell warmed over.

OK enough rambling.  I need to run some errands.  Take care.  KP