soft cervical collar from Amazon. It was cheaper when including the shipping, and much easier to find . I just have to wait until the beginning of may to get it.

(04-22-2018, 02:47 AM)Kristin Wrote: Just thought I would give an update. 
I ordered a soft cervical collar from Amazon. It was cheaper when including the shipping, and much easier to find . I just have to wait until the beginning of may to get it.
I have for a few days used the same settings. My sleep has become more fragmented, and I have had major leaks. I am a bit tired after getting too little sleep, so I am considering as follows: Go back to EPR at 2, and perhaps reduce the min pressure to 9 again (the same settings as the 17th).


As far as I can see, it seems like the flow inhale and exhale was better when EPR was set at 2 on the 17th.


My thought is that it might be better to try to use EPR 2 and gradually encrease the min pressure from 9 to 10 while trying to avoid the major leaks. Or I can stay at EPR 3 and just settle with min pressure at 9. I don't know what would be the best.

I am posting thumbnails from the last nights, and hope for some advice on the matter.

Thanks!

(04-19-2018, 07:45 AM)Walla Walla Wrote: I think once you start using a cervical collar you'll see the those small clusters of events go away. As far as EPR setting I'd go with the one you slept best with. Either 2 or 3.
Just my opinion.

(04-18-2018, 09:13 AM)Melman Wrote:

(04-17-2018, 09:46 AM)Kristin Wrote: I haven,t been able to get a soft collar yet, but it is a priority. I have to find out where to buy one. Any suggestions? 

Most pharmacies sell soft cervical collars. A good choice is the OTC soft cervical collar from Amazon for $12. It comes in three different heights and a good selection of neck sizes. There is a sizing guide to help you select the right size.

(04-18-2018, 09:48 AM)Sleeprider Wrote:

(04-18-2018, 12:31 AM)Kristin Wrote: I have had the best night in a very long time!  I would like comments on the development. Any further adustments? How is the flow and exhale? 
I seems that SleepyHead doesn't register the changes I have made lately, and it seems I can't make any changes to the settings on this forum either?

So to be clear. Last night the settings was as follows:

Mode: Autoset
Min pressure: 9
Max pressure: 18
EPR: On
EPR settings: 2


Kristin

Kristin, I didn't catch up with your last post where you posted the closeups of the flow rate.  Great shot, and this really explains why turning on the EPR worked so well for you last night.  In this graph we see extremely flow-limited breathing.  You can see that your inhale gets a good start, but then falls apart in that downward sloping and irregular peak.  This shows that as your breath proceeded airflow became increasingly restricted, and that rough top may even be snoring.  

When you added EPR, you gave yourself more inspiratory pressure support and that probably felt great and likely resolved a lot of what we see in this earlier graph.  Your inspiration/expiration time went from 2.3/1.4 to 2.06/2.96. That is almost equal and much more normal. I think with this progress, we might even want to try EPR at 3 and see if we can resolve that last bit of flow limit.  The best part of this is that your sleep has only one break compared to the fragmentation we see in the earlier session before EPR. This means you are more comfortable and sleeping better.

Your progress is very encouraging. Keep up the good work.  

(05-22-2018, 05:06 PM)Sleeprider Wrote: Hard to believe this is the same person with the huge obstructive apnea clusters and very high flow limitation.  I think flow limits are still and issue, but are considerably lower, and the apnea events are nearly gone.   This is so much better, but your sleep and comfort has not improved.  You respond to EPR in a positive way, but this is a case where I think bilevel (Resmed Aircurve 10 Vauto) is really likely to make a difference.  With the bilevel you can get real pressure support, and we can alter parameters like time of inspiration, cycle and trigger sensitivity, as well as provide true pressure support.  I think your best CPAP settings are going to be  10 to 14 cm with EPR at 3.  This will somewhat limit the range but will remain effective and keep EPR lower.  If you really thing EPR is a problem, you can try EPR at 2 and judge whether that  is better.

If you were able to pursue bilevel, I would keep you at 8.4 to 14 with PS 4 to start and consider opportunities for adjusting some of the trigger and cycle settings.  Your CPAP is working well, and I really think you need to continue on the same path you have followed in this thread, and consider a narrower range of pressure as suggested above.  Give it time, and it should become better.  I still think flow limitation is present and the kind of pressure support that would be needed to fully remedy the problem may require consideration of bilevel.