Before: 16 AHI, After: 2-3 AHI. Please help analyze to see if I can improve at all

[kenmai9]

Hello,

I am new CPAP user, for about 1 week. 

I was diagnosed a month ago with 16 AHI. Had a sleep study with CPAP and 5 cmH2O during the study gave me 0 AHI, which is great!

Once I got my machine and tried it out, I had 8, 6, 2, 3, 2.5 AHI for the first few nights at 5 cmH2O.

I was happy to get the AHI to below 5, but I'm always looking to optimize if I can.

I changed to APAP at 5-20 cmH2O and tried it last night, and you can see the results below (2.58 AHI).

Can someone please help me analyze the data and see where I can improve?

Thank you.

[multicast]

Don't care about "improving data" as long as you feel alright. If so, don't change anything.

[eok361]

if i were you, i'd try to fix the leaks first. and i'd definitely drop that max down from 20 cmh20. going by that chart, if i were going to use APAP, i'd set the max at 10...maybe 8.

with those leaks, you might get runaway pressures at those settings.

[kenmai9]

I have changed to 6.5-10 last night and got 5.3 AHI. Gonna see if it improves for a few more nights and if it doesn't I'm gonna just switch back to 5

Also does anyone know why is there a gap in my osa vs ca vs hypopneas?

OSA: 1
CA: 10
Total hypopneas: 33

What are the remaining 22 hypopneas? The machine was unable to categorize as either?

[gainerfull]

I have changed to 6.5-10 last night and got 5.3 AHI. Gonna see if it improves for a few more nights and if it doesn't I'm gonna just switch back to 5

Also does anyone know why is there a gap in my osa vs ca vs hypopneas?

OSA: 1
CA: 10
Total hypopneas: 33

What are the remaining 22 hypopneas? The machine was unable to categorize as either?

Can we see the data for this night please?

[kenmai9]

Here you go

[gainerfull]

1. You would benefit SIGNIFICANTLY from fixing your leaks and keeping your mouth closed at night (mouth tape, chinstrap, etc.) I wouldn't recommend the next step until you get your leaks under control because it's only going to make leaks worse.

2. Increase your minimum pressure to 7.5 and your max to 12 as minimum is too low (as evidenced by all of the events) and maximum is too low as you can see the pressure wanting to go higher than 9.

Someone else may chime in with more experience on a-flex / c-flex etc.

[kenmai9]

https://www dot apneaboard.com/wiki/index.php/OSCAR_leaks#:~:text=If%20your%20pressure%20is%20set,is%20about%2040%20L%2Fmin.

Doesnt it say here that leak rate under 25 is acceptable? I went over 25 just once.

[Crimson Nape]

If you have a Resmed, any leak AT or above 24L/min is a large leak.  Resmed deducts the mask's intended leak from its reported leak rate.   Philips doesn't publish a maximum threshold.  They seem to flag around 50 to 60 L/min total leaks as a large leak, depending on your model.

- Red

[Sleeprider]

Leaks are not a problem here and you only had a few brief seconds of large leak. Events are primarily hypopnea, and with a Resmed machine we might clean this up with exhale pressure relief, but with Philips we have to increase minimum pressure to stent the airway. Let's take minimum pressure to 7.0 and see if that improves things.