AHI higher on cpap than before therapy.

[ajack]

If it were me, I'd get to a sleep doctor for an overnight titration on an ASV type machine. this isn't working for you.

[Sleeprider]

I think reset Flex back to 1. You did not display this level of CA prior to changing the Flex. Your reaction is not uncommon. I really think you need to set your minimum to 7.0 and maximum to 9.0. Your events in the past have been overwhelmingly obstructive. I'm not believing the most recent results change that.

[Sweetpea]

I think reset Flex back to 1.  You did not display this level of CA prior to changing the Flex.  Your reaction is not uncommon.  I really think you need to set your minimum to 7.0 and maximum to 9.0.  Your events in the past have been overwhelmingly obstructive.  I'm not believing the most recent results change that.

Sleeprider, the reason for changing the flex to 3 was to see if it would make exhaling any more comfortable 
and it did. I can change it back to 1 and set minimum pressure to 7 but then I need a trick so it does not feel like I am exhaling forcefully, which wakes me up. Any ideas, oh wise one?
Also, I only used the cpap for 15 minutes last night because I am experiencing bronchial irritation. I obviously did not fall asleep in those few minutes. I checked the AHI which showed 67.5 which is, of course, absurd. But it makes a point about all the other nights. It takes me two hours to fall asleep and in that time, the machine is recording these high numbers, which are not indicative of sleep time at all! Now it has me wondering if when I did the at home sleep study, and also spent considerable time waiting to fall asleep, those numbers may also be skewed. And that was my best AHI by far. Only 11. I feel like a puzzle taken apart. Any ideas how to put myself back together? Thanks!
Sweetpea

[quiescence at last]

yep. my settings would be raised to minimum of 6, and maximum of 9.

I would also do both the following at the same time:
1) place the machine on Auto CPAP mode, instead of APAP.
2) place the Cflex setting to highest = 3.

What this does is gives a similar setting to Sleeprider suggestion of 7-9 APAP with Aflex of 1, but a slightly different feeling. - it gives the maximum relief at the moment exhale starts.

also, at some point you have to be willing to trust that just breathing how you breathe will be fine. no need to force exhale. during sleep the brain give no signal for exhale, but lets the diaphragm just recover.

good luck.

QAL

[ajack]

I didn't realise you still aren't using your CPAP all night. for me when I started, the rule was to keep the cpap on, no excuses. I made myself sit up to adjust or take off the mask for a minute, so I couldn't fall back to sleep without it.

until you can keep your mask on, adjusting pressure seems a bit futile to me. I would be tempted to set whatever you are comfortable with for a month. Then work on the AHI after you can keep it on all night. They say an ASV is harder to get use to than CPAP, so it would be worthwhile getting this right.

[Sweetpea]

Ajack, I usually do sleep with it 'all night' but for me, that means only 4 hours. I could not sleep with it on last night because of the bronchial, and now throat, irritation.  I do use the humidifier with it. The same symptoms occurred in March, a couple weeks after I got the machine, but I just kept on with it in spite of the irritation and the fact that it interrupted what little sleep I was getting. That ended in a sinus infection that kept me off the machine for 2 weeks. I dont want to miss that much time again, so thought I would head it off early, if that is where it was headed.
I hate having it seem like I keep throwing a wrench in suggestions. I heed all suggestions, take them seriously, and really appreciate all the help!
Thanks, Sweetpea

[Sweetpea]

Qal, yet another surprise. I am not aware of an adjustment that allows me to change from Apap to Auto cpap. I will check it out. Thanks for thus information.
Sweetpea

[Sweetpea]

Thank you, Sleeprider!