Complex sleep apnea, but can't tolerate ASV

[Pugsy]

Gottcha...I was confused and thought that you were actually trying to use ASV machine and it made things worse in terms of the aerophagia.
What are your current pressure settings? Using auto or fixed bipap mode?
What is your Pressure support settings?
What is the AHI breakdown for a typical night where you may have to settle for AHI of 6 or so?
Are you using BiFlex? If so, at what setting?

[arkis26]

I'm usually an observer here, but want to ask, Debbie, what mask configuration and sleep position you use? If you also treat GERD, do you elevate your head? Does your body habitus lead you to a "chin down" flexed neck position which opens the posterior pharynx and reduces the airway anteriorly? This can exacerbate aerophagia, particularly when post nasal drip swallowing is done with a full pharynx of air from the bipap. If so, you may benefit from a soft neck collar which elevates the jawbone and opens the airway and reduces the pressure requirement for effective bipap. Addition of this aid shifted me from "complex apnea" with an AHI stuck at 10-20, to occasional hypopneas with AHI <1. Good luck.

[needzzzzs]

I am using the Airfit P10 nasal pillows mask. I do not elevate my head (haven't really tried it, due to neck pain, which normally doesn't bother me if I use one of those Tempurpedic neck pillows. I do have a short neck. I normally start out sleeping on my left side, but find myself turning onto my back sometimes (or having turned onto my back), which I attribute to pain from trochanteric bursitis. I take acetaminophen for the pain, but it doesn't totally contain the pain after I've been on my side for a while. As you know, lying on the back worsens many peoples' sleep apnea, as it does mine. With regards to the body habitus question, I am do not knowingly flex my neck with the chin down, but who knows what I do while I'm sleeping? I certainly don't. I don't wake up in that position.

The neck collar idea interests me, and if I can figure out a way to elevate my head without making my neck hurt, I'll try that, too.

I appreciate your coming out of lurkerdom to comment and suggest a few things that might be useful!

Thanks!

Debbie

I'm usually an observer here, but want to ask, Debbie, what mask configuration and sleep position you use? If you also treat GERD, do you elevate your head? Does your body habitus lead you to a "chin down" flexed neck position which opens the posterior pharynx and reduces the airway anteriorly? This can exacerbate aerophagia, particularly when post nasal drip swallowing is done with a full pharynx of air from the bipap. If so, you may benefit from a soft neck collar which elevates the jawbone and opens the airway and reduces the pressure requirement for effective bipap. Addition of this aid shifted me from "complex apnea" with an AHI stuck at 10-20, to occasional hypopneas with AHI <1. Good luck.

[needzzzzs]

Hi Pugsy,

Still haven't gone into the machine's settings to get all the info you requested, but haven't forgotten, honest! Hope to do it tomorrow. Thanks for your patience...I appreciate (as always) all the help you give.

Debbie

Gottcha...I was confused and thought that you were actually trying to use ASV machine and it made things worse in terms of the aerophagia.
What are your current pressure settings? Using auto or fixed bipap mode?
What is your Pressure support settings?
What is the AHI breakdown for a typical night where you may have to settle for AHI of 6 or so?
Are you using BiFlex? If so, at what setting?