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+--- Thread: Well, I thought I had AHI under control... (/Thread-Well-I-thought-I-had-AHI-under-control)
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RE: Well, I thought I had AHI under control... - LookingForACleverHandle - 03-12-2024
UnicornRider - thank you for your explanation and links. I will endeavor to increase my proficiency with OSCAR.
Sleeprider - Also thanks - and now, the rest of the story...
Since our last correspondence, and against the scientific method of change one, note results, etc, I have made the following changes:
1. Cervical pillow.
2. EPR set to 2
3. Reduced max pressure from 14 to 13.5
First night - I have not included the chart, as there were multiple user problems. First, the collar was too loose, and my chin found a way to squeeze in there and ruin the therapy. As you may have noticed, my sleep pattern is usually broken into two sessions. The first was about 1.48 hours, with AHI around 48. The night's balance of six hours was 24.6.
Second night - Collar was put on tight enough that the chin could not slip down behind the collar. In my dreams, it seemed I was in a straitjacket. Every time I moved my head left, right, forward, the movement was very restricted (as it should be).
I was surprised to feel just how much my head moves. First session 3:53 had an AHI of 15.71; second session 17.29; total 16.61. A significant improvement since my pulmonary edema a couple weeks ago, but not the single digits I was achieving in the fall and early winter.
[attachment=61073]
Blowing up the graph, it is showing nearly constant periodic breathing -
[attachment=61074]
In the hazy world between sleep and wake, I felt the periodic breathing occur. Kind of surprising. This is the scary part of the graph with long inspiration times - I wonder if I'll start breathing again and wake up in the morning. Per the trace, lots of opportunities.
Also note, Large Leaks amount to 0.19%
Which begs the question about large leaks: Note the exhaust pressure/flow of the Mirage Activa mask:
[attachment=61075]
The exhaust pressure/flow rate for roughly my pressure settings is between 20 and 40 l/m. OSCAR allows me to set LeakRate Upper Threshold which is a static value. Should it be set to MIN, MAX, or whatever. It does not seem to change the LL calculations. The Total Leaks, in this chart, are roughly equivalent to the MAX leak rate of the mask.
RE: Well, I thought I had AHI under control... - LookingForACleverHandle - 03-18-2024
Finally, two days in a row under AHI of 5.
[attachment=61404]
New problem - it has taken about a week to adjust to the cervical collar. Now that I'm comfortable using it, my wife has deserted me for the guest room because of loud, constant SNORING! I actually woke myself last night, saw she was gone, and took the collar off. She's always up before me and found me sans collar, and quiet as I used to be.
So, a quick compare of the session 1 charts (with collar) with the session 2 (short break about 5:30 seen in the pressure chart) (without collar) charts shows roughly the same AHI.
The collar is tight enough to not leave room for the chin to drop, but not apparently too tight - seems "comfortable".
What can I do now about the SNORING?
RE: Well, I thought I had AHI under control... - Sleeprider - 03-18-2024
Best I have is to put on the collar and fully relax, then try to find how snoring emerges. Is there a pressure point behind your chin that triggers it? If the collar keeps your chin up, but causes pressure in the soft tissue behind the chin, that could be the problem. The solution to that may be modifications to the collar, the way you wear it, or a different collar. There is no way I can troubleshoot this from my seat in the bleachers, so you'll have to do some detective work. I originally got CPAP because I value sharing a bed with my wife, so don't let that happen!
RE: Well, I thought I had AHI under control... - LookingForACleverHandle - 03-18-2024
Sleeprider,
Thanks for the reply. I do understand very little can be done from the bleachers.
What you did share gives me a direction - I'm going to have to work out the geometry.
A thought - this collar has a slight dip for the chin - maybe put the dipped-side down - might give me a little extra clearance at the neck-jaw junction.
See what tonight brings.
RE: Well, I thought I had AHI under control... - Sleeprider - 03-18-2024
Lots of members have modified collars, to the point of digging out extra room to wearing them backwards. I am an observer that says, do whatever it takes.
RE: Well, I thought I had AHI under control... - LookingForACleverHandle - 03-18-2024
I'll just drag out my electric turkey carving knife and have at it!
