ac123 Treatment Thoughts/Help

[SarcasticDave94]

I wonder if this area before 01:05 is a Positional Apnea episode. Certainly, it's clustered events. Try reading up on the subject in our wiki HERE.

Check how thick the pillow is you're using. Multiple pillows will promote airway kinking. Airway kink is what happens during Positional Apnea. Think about the scene, Grandpa fell asleep in the recliner watching TV. His head is flopped over into his chest, snoring a forest of logs. His chin tuck is creating an airway restriction.

If this applies to you, then you need to externally prevent the chin tuck. Either a thin pillow or a soft cervical collar may be needed.

My opinion, even at 3.x CA, given certain circumstances, isn't too high to oppose the treatment of other events. Some of the CA you present might be simple breath holds.

[ac123]

Thank you, I will check that out!

I purchased a CPAP pillow (this one https://www.amazon.com/gp/product/B084R7...UTF8&psc=1) thinking it would help me prevent knocking off the mask when I toss and turn (I also ended up switching masks to one that attaches on top of the head). I'm using the thinner option on the pillow. I have occasionally found myself laying on the hose which could be an issue here. I am a very active sleeper (have been my whole life) so basically no matter what I do I have to be able to compensate for tossing and turning.

My sleep study actually didn't have much difference between positions (not saying that isn't it) but did have a huge jump during REM sleep compared to non-REM.

[ac123]

Hmm, so I've been doing much, much better recently in terms of both OA and CA events and a lot lower flow limits as well. I'm not sure what disturbed it so badly for a few weeks, but I guess things happen! Even though EPR is more comfortable for me, turning it off greatly decreased both types of events and didn't seem to increase flow limit, so I guess I leave it off.

What I'm suddenly struggling with is leaks again. I was down to near-zero leaks for huge portions of the night, and maybe 8-10 l/m average on a bad night. Now, I'm suddenly way, way up and I've had this happen several times. The attached from last night is the most obvious one that it's a sudden start and sudden stop.

I've already:
1. replaced the mask cushion (the first time this was the issue)
2. replaced the headgear (no significant change, although it's more comfortable, i think the elastic had worn out)
3. Tried adjusting the straps every which way (I'm using dreamwear full face mask) including through pressure test. 
4. I already have a CPAP pillow, but I've found I move around too much at night to effectively use it - I'll position myself properly when I fall asleep but it's anyone's guess what position I wake up in! I've also pulled the CPAP off the nightstand quite a few times as well (moving too far away from it) although thankfully I have not done that recently. 

The issue is it is low to no leak when I go to bed, but they develop over the course of the night, including large jumps at certain times that usually resolve themselves. Although I do remember waking up at times briefly, I don't remember waking up to fix obvious leaks and thus I can't say for sure what position I was in for any of these. 

I'm guessing this is positional, but I'm not sure what to do about it. Anyone had any success with anything? Or at least figuring out what position causes the issue? Especially if you're an active sleeper like me?

[G. Szabo]

Perhaps you turned your face down, which moved the FF mask, causing leaks. I had used the FF Dreamweaver and then switched to under-the-nose masks (both from Philips and Respironics) with mouth taping. It was a good choice. If you need a high-moisture setting, then I suggest the Phillips. At low moisture, the Respironics is better.

[super7pilot]

ac123, sounds strange. But i have heard the suggestion of sewing a ball (racket or hand ball) to the waist of one’s PJ’s or gym shorts to keep you off your back.

I was able to train myself many years ago to not sleep on my back. I’m an active sleeper from restless legs but go from side to side and 3/4 belly.

[ac123]

I've heard of the ball thing as well, but I think I have the opposite problem - I am pretty sure my big leaks are happening when I turn to my side while asleep. Although I know back is typically worse for apnea, it's more comfortable and I didn't have a significant difference on my sleep study by position (it was hugely different per sleep stage, especially REM sleep). Every once in a while I turn to my front but it's pretty rare (at least that I remember). Thanks for the idea though!