11-10-2024, 11:29 AM
How to reduce AHI further
Hello everyone,
I wanted to see if anyone could help me determine the best course of action going forward. I'm a young, athletic male. Via a home pulse-ox wristband recording 33 AHI, my doctor prescribed me a CPAP that I have been using for a litte over a week (AS11 with F&P solo nasal pillow mask). While waiting for my machine, I watched YouTube videos, read this forum, etc to educate myself on as much as I could with sleep apnea.
My 10 nights worth of charts are posted below but here's a quick overview:
As soon as I got my machine, I set it the first night to 5-10 with 3 EPR. I slowly increased the minimum and maximum pressure based on my charts (to reduce OA's) while concurrently reducing the EPR (as I had a good amount of CA's along with my OA's and I was under the impression that EPR makes CA's worse) and also working towards a single fixed pressure (as I was trying to reduce the variables as I continue tweaking settings further). I eventually got to CPAP mode with zero EPR and added a vcom (which would help with CA's from my understanding) and was still increasing pressure further to get rid of my OA's. I was on a pressure of 12 two nights ago and felt like I almost wasn't getting enough air on inhale (I guess because of the vcom), and it was tough to exhale against the pressure. I removed the vcom and increased the pressure to 13 last night. I am not sure where to go from here as my OA's have not gone away (from what I understand, it suggests that I need to increase pressure), and my CA's are still present if not worse (from what I understand, I need to decrease pressure). At a pressure of 13, I also had the highest leak rate I've ever had, as well as aerophagia (I had it the very first night but have not had it again after elevating my head, tucking my chin, and taping my mouth). Also, I've had to tighten my mask more and more, and it seems like the more I tighten it, the less flow there is through the nasal pillows. I tried it slightly looser and the flow does feel increased. I just worry that it will fall off through the night with increased pressure.
As far as what I can gather from my charts: I try to be asleep around 11-11:30. I do usually fall asleep on my back, and there seem to be flow limits/OA's/hypopneas/CA's all associated with this so I will try not to sleep on my back anymore starting tonight. It also seems like there are a lot of central apneas clustered around the time I am going to sleep, specifically. MY lowest AHI is around 4.5, I have not been able to get it any lower, despite various expiratory pressures from 4 to 13.4. I have a check-in appt with my sleep doctor in a few weeks, I was planning on seeing if he will order me a lab study/titration test. Any ideas on setting changes would be much appreciated. Thank you everyone!
Overview
https://sleephq.com/public/bacfa9bb-bcf1...1ba256a534
I wanted to see if anyone could help me determine the best course of action going forward. I'm a young, athletic male. Via a home pulse-ox wristband recording 33 AHI, my doctor prescribed me a CPAP that I have been using for a litte over a week (AS11 with F&P solo nasal pillow mask). While waiting for my machine, I watched YouTube videos, read this forum, etc to educate myself on as much as I could with sleep apnea.
My 10 nights worth of charts are posted below but here's a quick overview:
As soon as I got my machine, I set it the first night to 5-10 with 3 EPR. I slowly increased the minimum and maximum pressure based on my charts (to reduce OA's) while concurrently reducing the EPR (as I had a good amount of CA's along with my OA's and I was under the impression that EPR makes CA's worse) and also working towards a single fixed pressure (as I was trying to reduce the variables as I continue tweaking settings further). I eventually got to CPAP mode with zero EPR and added a vcom (which would help with CA's from my understanding) and was still increasing pressure further to get rid of my OA's. I was on a pressure of 12 two nights ago and felt like I almost wasn't getting enough air on inhale (I guess because of the vcom), and it was tough to exhale against the pressure. I removed the vcom and increased the pressure to 13 last night. I am not sure where to go from here as my OA's have not gone away (from what I understand, it suggests that I need to increase pressure), and my CA's are still present if not worse (from what I understand, I need to decrease pressure). At a pressure of 13, I also had the highest leak rate I've ever had, as well as aerophagia (I had it the very first night but have not had it again after elevating my head, tucking my chin, and taping my mouth). Also, I've had to tighten my mask more and more, and it seems like the more I tighten it, the less flow there is through the nasal pillows. I tried it slightly looser and the flow does feel increased. I just worry that it will fall off through the night with increased pressure.
As far as what I can gather from my charts: I try to be asleep around 11-11:30. I do usually fall asleep on my back, and there seem to be flow limits/OA's/hypopneas/CA's all associated with this so I will try not to sleep on my back anymore starting tonight. It also seems like there are a lot of central apneas clustered around the time I am going to sleep, specifically. MY lowest AHI is around 4.5, I have not been able to get it any lower, despite various expiratory pressures from 4 to 13.4. I have a check-in appt with my sleep doctor in a few weeks, I was planning on seeing if he will order me a lab study/titration test. Any ideas on setting changes would be much appreciated. Thank you everyone!
Overview
https://sleephq.com/public/bacfa9bb-bcf1...1ba256a534
Night 10 (No VCOM, turned EPR back on so I could further increase pressure)
https://sleephq.com/public/4b3c7769-9345...5865500b28
https://sleephq.com/public/4b3c7769-9345...5865500b28
