[Treatment] Should I change machine

[jm54]

146 days afteer using CPAP. AHI still between 4~6. Mostly Hypopnea and OSA. Spo2 is around 94.5. I have been gradully rasing pressure to 9. It has been stable for 2 months now. Should I consider changing to another type of machine to lower AHI?[attachment=3098]

http://imgur.com/a/h6KTp

[Sleeprider]

Your average pressure is less than 10 cm, and it seems you do not produce the cues that would normally raise pressure in advance of OA and H events. You do not seem to have CA problems. For the period of record you have posted, there has been no change in your average or 90% pressures, and I would not conclude your AHI is intractable until your minimum pressure is around 11.5. My suggestion would be to slowly increase your minimum to that level (not coincidentally your consistent 90% pressure), and see where AHI is best treated.

I would not expect bilevel to be therapeutically better than CPAP, and tolerance should not be a problem at these pressures.

[jm54]

Thanks Sleeprider. I shall try raising my pressure. However I feel my mouth dry in the morning though humilifier was on. My place is rather humid.

Do you think Resmed Sense 10 worth a try since some commented it more responsive to events?

BTW, does flex matter? I tried 0~3, seems no difference. Also periodic breathings were recorded regularly most of the nights from 1~3%

[Sleeprider]

Well, I think the Resmed Autoset is significantly superior to the Philips Auto for both of the reasons you cited. In fact you may have been thinking of posts I have made on the subject. With Resmed you get a 3-cm bilevel. With Philips you get up to 2 cm of flow-based pressure relief at the beginning of exhale. Technically, you will have a very very difficult time pursuading insurance to pay for a bilevel, but the method of EPR in the Resmed can be beneficial to hypopnea and low tidal volume, and it is definitely faster to attack obstructive events from a lower pressure.

[kwhenrykerr]

Raise your low pressure setting is a good idea. It may allow your machine to respond better to events. It worked for me and hope it will for you too.