109AHI, starting 2nd week on CPAP, have some questions

[DariaVader]

As I said before, my son had a similar AHI to yours... 102 on the home study, but if you simply subtract the ~ 1hr he was in the upright position and figure at the least he was not sleeping at that time (he said he wasnt) it was more like 120. whenever he was asleep it was a solid red line of events, and his desats were in the 60s. In his case, he couldn't even tolerate pressure below 10 - suffocating for him. His first weeks were like you describe, with AHI that was very much nowhere near the controlled range. He settled on a 12 to 20 pressure range, and within a couple mo went back for a Bilevel titration, which is what he has now. In his case, clear airway events are rare - it's all obstructive - and the Bilevel helps him to tolerate the higher pressures he needs --- but these days a typical night has an AHI between 1 and 2. At his pressures, the worst struggle is with leaks.

All this is to say - hang in there and be patient, with some analysis and some work, you too can be getting much better sleep. My son is (mostly, hehe) human again. In the months leading up to his sleep study things got really dicey for him! and even now, if things go south with his therapy, he is a sick puppy. He's been on therapy for almost 1 year now.

[DariaVader]

Last night's I haven't checked in Sleepyhead as of yet, but I do know the machine claimed about an 18AHI, which typically means I had a horrid first half of the night. When I can finally post plots, you'll see what the mountain ranges I've been dealing with look like.

one more and you will be able

sorry about the "hoops" but the spammer vehicle is relentless.

Do you see CA (Central Apnea or Clear Airway) events in your daily?

[toinewi]

one more and you will be able

sorry about the "hoops" but the spammer vehicle is relentless.

Do you see CA (Central Apnea or Clear Airway) events in your daily?

I'm in IT, I'm all good with any spam deterrents

I see CA events I believe.

Just got off the phone with the sleep study place, they are going to up the starting pressure, try getting me in for a followup ASAP (currently scheduled for 8/16, they want me in before if possible), and mentioned that chances are a titration study would be in my future.

Glad to hear your son has found something that works for him. I'm just at the starting gate, so I know it'll take some time and effort, but the data nerd/troubleshooter in me just wants to push forward

[DariaVader]

if it's truly CA you are seeing, upping the pressure will likely exacerbate the situation. you should be able to post now it is good that you are a nerd; I think we nerds tend to do better with this since we love the data, and since it is available for us!

ps - If there are CA events in any quantity make sure your titration includes the ASV machine

[Sleepster]

I do find myself currently waking up 1-2 times a night, usually right after a significant pressure jump.

Does the CPAP machine cause you any discomfort in any way other than waking you up? It may be that the low pressure of 8 is just not enough to keep your airway open.

[toinewi]

Does the CPAP machine cause you any discomfort in any way other than waking you up? It may be that the low pressure of 8 is just not enough to keep your airway open.

Not sure, but they are upping my pressure to 15-20 starting tomorrow it seems. I was also told to not sleep on my back, but rather to sleep on my side. Being a stomach sleeper until now, I'm guessing that will be easier than trying to back sleep, minus the mask and leaks.

Here are some charts, with the first being the best day I had, and the other two being more typical.


The one good day (day 3 of CPAP?):
https://drive.google.com/file/d/0B0SbFMF...sp=sharing

Typical Days:
https://drive.google.com/file/d/0B0SbFMF...sp=sharing

https://drive.google.com/file/d/0B0SbFMF...sp=sharing

https://drive.google.com/file/d/0B0SbFMF...sp=sharing

[justMongo]

My impression -- you do need more minimum pressure. And, seems so do the folks who are tracking you.
Frequently obstructive apnea is positional -- hence their recommendation to side sleep.

You may need a different machine. I *think* your Dreamstation has a max pressure of 20; and you may need higher.
Too soon to say, but there may be a bilevel machine in your future.

Let's see how you do on their recommended 20/15

[DariaVader]

my impression is that JM is spot-on

[Sleepster]

I was also told to not sleep on my back, but rather to sleep on my side. Being a stomach sleeper until now, I'm guessing that will be easier than trying to back sleep, minus the mask and leaks.

With the right pillow you should be able to sleep on either your side or your stomach. I do. Look at the Papillow. You need not get that brand, but it will give you an idea as to the size and shape you need. I recently typed Papillow into the Amazon search engine and the first hit was a very suitable substitute. You need a pillow that's thick, but has a small footprint. That way you can let your mask hang over the edge.

[toinewi]

Pretty crazy what a positional change can do. Just by sleeping on my side, I was able to get 8 hours on the machine with a 4.93AHI. Hopefully today when they up the pressure from 8-20 to 15-20, it'll help even more.

I did notice way too many leaks side sleeping, so I'm going to call my equipment provider and see about getting refitted, possibly even revisiting the nasal pillow as opposed to mask.

Side sleeping - a world of difference:
https://drive.google.com/file/d/0B0SbFMF...sp=sharing

Thanks all for the advice and support so far. I'll keep this updated.