AHI all over the map... Any thoughts?

[JPDTrek]

Hey guys -

So, just completed day four, so totally expecting anomalies as I get used to my therapy.... and I also know I'm not comfortable at all in my mask. (Hopefully I'll have the F&P Simplus Day after tomorrow... You'll see some leakage below, too). ALSO... I'm traveling right now, so I'm sure being in an unfamiliar place has something to do with it.

But --- was wondering if anyone had any thoughts or advice regarding my AHI patterns...?

Night 1: 4.53 (6-16cm)
Night 2: 8.40 (6-16cm)
Night 3: 6.19 (I adjusted sightly to 8.5c-16cm)
Night 3: 12.42 (I adjusted slightly to 9-15cm)

I made the pressure increases because it seemed as if there was a clear correlation between my pressure dropping, then immediate OA's and Hypopnea's... So I thought if I kept the pressure from going too low I'd be making an improvement. Not so. Any suggestions? Sleepyhead photos are below.










Also - I've developed this dry cough and irritation down near my bronchial tubes... Didn't have that before, and I don't feel dried out in my nose. Some places say it's just the adjustment that my lungs would be making to the pressure... But anyone else have any similar symptoms?

(Edit: Typo's).

[justMongo]

Stay at the initial pressure settings and give it some time. You have to become accustomed to the positive pressure before you can re-evaluate.
It's possible that you have some pressure induced central apnea that may abate with time. But, 4 days is too soon to be concerned.

It may be that it will turn out that you are not on the correct type of machine for your apnea.
If the centrals remain a significant contributor to your apnea, you may need to be put on a machine known as an ASV.

You appear to breathe rather shallow. Perhaps you are a small person; or you have other conditions.
Again, in the end, you may need the assist of an ASV.

For now, just stay the course. If you're working with a doctor, have him review in the near future.

[green wings]

I would have made the same increase in the lower pressure. The PR algorithm definitely does exactly what you've noted. It will go straight back to the minimum pressure, and then more OAs happen.

But...you definitely had increased CAs last night, plus PB showing up. I have no idea how to evaluate PB or to make recommendations about it.

Probably you can either leave your settings where they were last night or go back to your initial settings. There seems to be some "body getting used to breathing with CPAP" going on. In other words, the stuff that's happening for you right now, event-wise, may well be transient. It may be too early for you to try to pinpoint your optimal pressure settings. I don't know how to explain that in a way that makes any sense.

The cough sounds worrisome. My first impulse is to say "try more humidity". Do you have asthma, though? We had a new person to this forum just last month who had a history of mild asthma, but who developed problems with asthma when she began using CPAP, and ended up having to stop it for now. See forum member Kris the Crone's threads if you want to read about it.

I made the pressure increases because it seemed as if there was a clear correlation between my pressure dropping, then immediate OA's and Hypopnea's... So I thought if I kept the pressure from going too low I'd be making an improvement. Not so. Any suggestions?


Also - I've developed this dry cough and irritation down near my bronchial tubes... Didn't have that before, and I don't feel dried out in my nose. Some places say it's just the adjustment that my lungs would be making to the pressure... But anyone else have any similar symptoms?

[DariaVader]

with an AHI of 107, stopping pap is not a very good option....

Cough = get humidity to goldilocks. too much or too little causes issues.

wrt the changing AHI every night, you need to give it a couple of weeks. you have a lot of adjusting to do.

[eseedhouse]

As Paul Simon wrote "Slow down, you move too fast". Give yourself at least a week or so at each new setting. Your body and mind vary from night to night and you need a decent sized sample to even out the "noise" caused by these variations.

[toinewi]

I started about 2 months ago, was diagnosed at 109.6 AHI.

I'm still working back and forth with my doctor and sleep techs to get the settings dialed in. That said, your numbers are lower than mine were for the first week. Give it time. Also, isolate how you sleep if at all possible. I know sleeping on my back causes my AHI to skyrocket.

[Mike1953]

Give it and yourself some time to adjust to your new life with a hose at night.