poor results [Please Advise]

[Commodore]

two sessions last night, the second a train wreck

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second session

[Sleeprider]

Keeping your therapy thread in one place really helps those of us that are trying to form a cohesive idea of what is going on, and how you respond to changes we might suggest.  In your other thread on Respiration Rate http://www.apneaboard.com/forums/Thread-...ion-levels  where you posted results, there was a pattern that suggested a potential problem with chin tucking.  This pattern continues in your most recent results. 

Please read our wiki on positional apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea  Look at the examples of data there and how similar that data is to your own results.  I think you would benefit from finding and using a soft cervical collar that is comfortable and supportive of your jaw to prevent chin-tucking.  Your events are all obstructive or end-of-night CA from sleep transition and disruption.  They are associated with flow limitation, and events are clustered.  You will have to decide for yourself if you want to resolve this and try out a C-collar.  I can only say that many members thought a collar is the worst idea ever, but benefited with very low AHI and comfortable sleep when they used one.  The only other tool you have is pressure.  You should increase minimum pressure to 9.0 and consider allowing maximum pressure of 20.  If this does not open your airway, then you would have a good argument to return to your doctor with these poor results and ask him to consider a bilevel like the Aircurve 10 Vauto. 

Please use this thread for future updates rather than starting new threads.  This will help both you and us to see the progress and help you more efficiently. 

[Commodore]

I apologize , I’ll familiarize myself better with protocol.

And thank you for suggestions.

[Melman]

I second Sleeprider's recommendation of a soft cervical collar. I was one who thought it would be very uncomfortable but I've used one for almost 2 years and barely notice it.

[Commodore]

I’m now scheduled for overnight titration study

End of month 

Seems wise at this point 

Thanks, all

[Sleeprider]

I won't argue with an overnight study, but take your own pillow and try to simulate your home environment as closely as possible. The problem with clinical studies is they are a one-off evaluation, and the closer they are to your normal sleep conditions, th e better. Good luck, and keep us advised of how it goes.

[Commodore]

I really want to commit to this.  The nasal pillow produced good AHI but leaks.  The mask is seemingly random on AHI but better leak values. 

I wonder if the mask , because of the full strap, exaggerates my chin tucking?

I will certainly stay in contact with this helpful group.  I’m reading the wiki pages too.

[Sleeprider]

What mask are you using. Your profile says nasal prongs, but I'm sure that is wrong. Your leaks are actually pretty good in the last couple charts. That is not the problem. We are not very aware of our posture during sleep, and the purpose of a soft cervical collar is to train you to avoid a fetal position or chin-tucking that is a problem. Many users find they eventually don't need it. It's not just laying on your back. Some of the worst positional apnea we have seen has been seen when the sleeper is on their side, or using an ergonomic pillow. The collar works because it moves with you.

[Commodore]

Dreamwear full mask last week or so

Phillips dreamwear nasal pillow in periods prior

[Commodore]

Do cervical collars assist with mouth breathing?  Seems like they might.