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I have made some improvements in the last month. But still super tired. I have tried p10 nose pillow. N20 mask foam and non foam version, different chin straps, and cervical collar. I have tried epr of 1, 2, and 3. Also several different pressure changes. I have used cpap for more than 6 years. My numbers used to be very good for years. Than in the last six months with no changes to machine or mask my numbers went very bad. I knew something was wrong because I now wake up very tired. Here is attached a newer chart with better numbers. I am stilling working on problem. I just ordered the new ResMed N30i with foam headgear. I will see if that helps.
I could not read anything in SQ. The OSCAR told me a lot. You have 2 major problems.
first you have positional apnea. You can see positional apnea where either H or Oa events are clustered together. Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…
IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.
second. You have very high flow limits and that is why your pressures are going up to the max. EPR is about the only way we have to stop flow limits. I would try EPR3 to see if that helps a little. Other machines like the ResMed AirCurve VAUTO allow more EPR (called PS on the AirCurve) but I think if the Flow Limits continue high we need to go to straight cpap with a limiting high to stop the runaway pressure...
