AHI always under 4

[Deweym]

If my AHI is always under 4 regardless of my pressure settings and I feel good the next day, why shouldn’t I just use the lowest pressure?

[Gideon]

Welcome to the forum.
Your question also begs to ask can you pressure realistically be lowered.

1. pressure going up alerts you that something is happening
2. what non-AHI 'events' do you have happening
3. goes with 2. what are your flow limits doing
4. comfort.

[mesenteria]

If my AHI is always under 4 regardless of my pressure settings and I feel good the next day, why shouldn’t I just use the lowest pressure?

Perfectly reasonable question.  Have you been experimenting by lowering your pressures, EPR, and raising the upper limit for inspiration?  I would wonder why you thought of doing so in the first place.  What led you to try doing this?  Just curious.

As Fred wonders, your question isn't easily answered, not helpfully anyway, unless we know more about your diagnosis, treatment, response of several kinds, and maybe even other health conditions that might make too much variation a problem over time...if you keep fiddling.

[Deweym]

5 years ago I needed a pressure of 12-16 to get below an AHI of 4. An less pressure resulted in AHI of 6+.
Recently I have been testing lower settings and find that even with the lower pressure my AHI is not over 1.00 on average. 
My flow limits have always been in the .30-.40 range regardless of the pressure. Epr is set at 3.

[mesenteria]

Thanks!  You must be getting alerts. 

Okay, so you have been on PAP therapy of a kind as yet undefined, and you must have had a diagnosis of some kind.  What else has taken place in the interim?  Have you gained/lost more than 15 pounds?  Have you become/ceased being a diabetic?  Have your sleep habits changed (what you sleep on, when you sleep, position, with or without a partner....any of those things are likely to have some kind of impact on 'how' you sleep, or how well anyway...).

It's an interesting situation because better than 95% of us will find things unraveling pretty quickly if we tinker with our settings substantially.  It would at the least be instructive (for me, anyway) how you can...ummmm........get away with it. 

[Deweym]

I started to questioning it because I lost about 20 pounds and noticed that my AHI was consistently below 1.00 at the 12-16 pressure.

[Sleeprider]

I think the pressure support effect of the Resmed Airsense 10 is clearly helping to manage hypopnea and RERA, evan as the minmum pressure drops in response to your need to control OA. This is not unusual, and I would offer my own settings as proof. If I was using a CPAP, I would need much higher pressure, but with a minimum pressure of 9.0 on bilevel (13/9) I get excellent results. At 12-16 with EPR 3, your starting pressure is also 12/9 to 16/13. As you lose weight, your pressure requirement may drop, and you are using a very good machine to give optimal treatment as that happens.

[Deweym]

If a 12-16 pressure results in an AHI of .67, and pressure of 8-12 results in an AHI of .87, what would be wrong with using the 8-12 pressure?

[Sleeprider]

If a 12-16 pressure results in an AHI of .67, and pressure of 8-12 results in an AHI of .87, what would be wrong with using the 8-12 pressure?

Nothing at all assuming you feel the same or better. The event rate difference is not significant. I have had nights I thought were great, but had a higher AHI. Go figure.

[Gideon]

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