bonjour

Ruby, you are in the US and you seem like someone who takes charge of their own care. You do not "need" a Sleep Doctor unless you discover some specific issue where you need a specialist and then you likely need a specialist sleep doctor covering a specific issue. Your family doctor, even your dentist can cover you for the basics easily, just ask them.

Fred

The medical community tends to discount consumer add-ons. That said the general rule that a CPAP doesn't need an oximeter. That assumes that your sleep lab studies, in particular your titration study, did not show significant Desats. Medicare's rule for Oxygen supplementation is at or less than 88% Oxygen saturation for 5 minutes overnight. Some Oximeters are compatible with Sleepyhead. If your symptoms are such that they indicate that you may be suffering from hypoxia I would want to monitor that stat. I have recommended individuals do so to demonstrate an issue to raise with their doctor.

I would suggest cleaning with dilute dawn before sanitization. That would ensure any film is gone giving the sanitization a better shot at the interior surface of the tubing. I would have no problem with the dawn after sanitizing.

FYI what we do to our CPAP equipment is no where near what it takes to sterilize, but provides adequate sanitization for use.

Fred

Based on your charts you do not have enough Central Apnea to be diagnosed as Central Apnea.

Dr. Dakota Snore Eliminator (Flat back and technically not a cervical collar) and the Caldera have proven to be both successful and popular. Many use other brands.

What CPAP machine do you have. Phillips Respironics are known to react slower than ResMed.

In either case speed of reaction can be improved by narrowing the range sol that less increase is needed to resolve events. With a fixed Pressure you need to raise the pressure to prevent the events.

Definitely a soft collar. I have recommended it many times to use with a CPAP and most can visualize the difference on their SleepyHead charts by the loss of clusters with their Obstructive Apnea.

Top be clear I am not saying this is a cure or that this will replace a CPAP.

One question. Is your issue on inspiration or expiration? Expiration implies a different problem.

I guess at this point it doesn't so much matter what exactly is happening as long as I can identify and the machine helps. What I think happens is when I lay down and go into a deeper sleep stage, my soft pallet relaxes and becomes sort of flappy-like. As best as I can tell, I feel a little better when I sleep more on my stomach and turn my head to the side compared to just on my back. There have been a lot of times when I woke up and my brain was awake and alert enough to think it was my upper throat closing over and yet my body was still asleep and relaxed to the point where I could simply lay there and recreate it within seconds by letting my throat relax. At that point, it feels like the soft palate closes over my airway in what seems like a flap-like fashion. I'm not sure, maybe everyone has that ability...but it seems like I have an odd ability to move my soft palate open and closed just by thinking about it. For instance, sitting up in my computer chair right now...I can sort of control my soft palate and make it flap over and close the airway voluntarily.

I think that you may have some positional apnea because of your description above. I haven't seen any of your Sleepyhead charts so I can't look for any confirming evidence. The common way I explain it is that your chin is tucking. If you would try a loose fitting soft cervical collar (we do not want on the front of your throat, we are not trying to immobilize your neck, only to stop your chin from dropping. If I am right you should feel remarkably better.

Fred

Thanks Sierra, that is a good point. You reminded me that I did not address that the first night is just a trial and the real treatment would start after the adjustments from that. My only thought on your studies was that 10 cm may be low, then that was OK because either of us would adjust that based on the data from the first night.

The Dreamstation is cheaper for the DME to provide, that means more profit for them. If you want the ResMed have you doctor modify the Rx for that and state DAW (Dispense as Written) Note that you will likely have this machine for 5+ years and NOW is your chance to get the machine of your choice. Your insurance pays the same for both and there is enough markup for the DME to make money either way.