ejbpesca - (Therapy Thread) Aerophagia and other questions.

[Brazen]

What about chin-tucking? That can occur even if you aren't on your back.

[ejbpesca]

What about chin-tucking? That can occur even if you aren't on your back.

I very well could chin tuck.  I have no way to tell.

[Brazen]

Read the optimizing therapy wiki again about positional apnea.
Suggestions are a soft c-collar or even a travel pillow or bunching blankets up by your chin to keep it from falling forward.
Making sure your pillow isn't too fluffy is also important. 
If you sleep curled up on your side you could very well be tucking your chin.

I'm not an expert so that might not be your issue but it's something to pay attention to.  If you tuck your chin it closes your wind pipe and no pressure changes will make any difference.

[ejbpesca]

[attachment=45151]

Well this is different.  I have never seen a daily report as good as this one.  I believe I did not move from one side position all night.  Sometimes I feel I've been in a wrestling match all night.  EPR at 3 made breathing much easier.  No detectable aerophagia today.

[Brazen]

Glad you had a good night!!
How have the last few been?
Can you post some screenshots?

FYI, with your min pressure set to 6.6 you are not getting the full benefit of EPR 3.

EPR 3 lowers your expiratory pressure 3cmw but since the machine can only go as low as 4cmw you are really only getting EPR 2.6.

Maybe not a big deal.
Maybe increasing your min to 7 would make your expirations more comfortable. 
I don't believe that change would affect aerophagia.

[ejbpesca]

A question about the pressure graph:

The max level of ten is reached quite a bit.  Does this indicate the max level should be raised as the APAP hits the set limit so much?

Another question:

Is having a bad nigh on occasion with AHI 10 to 15, a reason to increase max pressure?  



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[Crimson Nape]

Your flow limit could be driving up your pressure. I would set the pressure min to 9.6 and the max to 12. I'm trying to avoid large pressure differences. Having the pressure range set too wide can cause arousals. Let's see if it hits the maximum with the new settings. Two other possible sources for the bad nights are sleeping on your back or chin tucking.

- Red

[ejbpesca]

Thank you for the advice.  My daily reports range from 0 AHI to 18 AHI.  I am attempting to find a happy medium of pressure settings that will not induce aerophagia that came on a couple of months ago after a long illness and weight loss.  No easy task.

Thanks.

[ejbpesca]

Days without good sleep = all day in bed, exhausted.  I seem to be getting therapy for AHIs but at the cost of aerophagia, high acid, and headache.  The aerophagia/acid woke me around 4am today. 

[attachment=45271]

[attachment=45272]

I will reduce the max to 9.6. Hard to believe I had min/max 12-20 for years. This aerophagia is making me quite sick.

Sleeping on left side, no chin tuck apparent. My left arm remains under my chin acting like a cervical collar. I may cannot handle APAP treatment anymore. Like so many other therapies, many years of it may have taken a toll.

[Brazen]

Red recommended MIN 9.6, MAX 12. 
Try that for a few nights.

Post some of your high AHI nights. 

Seems obvious something has changed for you after years but I don't believe APAP treatment itself "takes a toll".

Have you had a full medical workup for the reflux?

Can you get a continuous o2 monitor?
The headache could be low o2 sats during the night but it could be unrelated.

Have you tried different types of masks?