UARS - Concerned about flow limitations - where to go from here??

[PeaceLoveAndPizza]

Keep all your therapy questions to a single thread. Makes it much easier to find past suggestions. Get a moderator to rename this thread "TryingToGetItRight's therapy thread" and keep everything here.

[Crimson Nape]

PeaceLoveAndPizza  -  Sorry, but the OP of this thread is, jekettex and not TryingToGetItRight.  No title renaming at this time.

- Red

[Sleeprider]

Hi, thanks for your message.

I've thought a lot about positional apnea though I can't quit crack it. My current theory is it happens when my jaw goes slack but I need to alternate between chinstrap/no chinstrap a few more times to be sure. I have noticed I sleep terribly when I use thicker pillows. Currently, I'm not using any pillow and doing a lot better that way. I would love to use a collar but my forward head posture is so bad it puts a lot of strain on my neck so I'm trying to correct that first. I'm not sure if you'd have any insight on this but I've found breathing to be way easier when my head is in alignment vs forward. When it's forward my breathing is really shallow and my nose feels congested. I adjusted my mask straps to keep my head in alignment last night and I do feel markedly more rested today. My FLs look a lot better (still not great) as well. This could be coz I've switched to the evora mask though. One day isn't really enough to make any claims. 

Currently I'm on 9 EPR 3. Do you still think I should go to 7? How come? Also while I still have a fair few centrals they are less than they were a few days prior which looks to be good news.

There are a lot of clues in this response that affirm a chronic positional apnea problem. To help you "crack" the problem, be sure to read the two wikis:
Positional apnea: https://www.apneaboard.com/wiki/index.ph...onal_Apnea and
Soft Cervical Collar https://www.apneaboard.com/wiki/index.ph...cal_Collar

A chronic chin-tuck, or head forward position, seems to be your problem, and some kind of aid that supports the jaw and/or chin to prevent that should resolve it.  If you sleep on your side, you might find pulling a thin, flexible pillow between you shoulder and jaw will resolve a lot of this. A soft cervical collar is ideal for individual that sleep supine, but size and fit matter a lot.  Note, positional apnea can occur in nearly any sleeping position, and you have to train yourself to keep the airway open...chin-up! This opens the airway and avoids airway restriction and obstruction. I suspect most of the CA events flagged in your results are just severe air restriction, leaving a severely restricted but open airway.  As far as CPAP settings, we want to increase pressure for obstruction and use EPR for flow limitation or airway restriction, but machine pressure will not resolve positional airway restriction/obstruction, and lower pressure can be very effective once the root problem is resolved.

[PeaceLoveAndPizza]

Thanks @CrimsonNape! I got lost in the thread. Much appreciated correction...