[CPAP] AHI > 10 with mask on

[Tactful3149]

Please take a look at the attached OSCAR report for last night.  Why was my AHI so high between 1045pm and 1230am despite having the mask on the whole time?  Any suggestions?  Thanks in advance!
   

[Old Steve]

That appears to be Positional Apnea (cluster of apneas). PA is caused by your neck/throat being out of alignment.  Similar to bending over a garden hose to stop the water, but in this case you are stopping the air. Your CPAP pressure will not fix Positional Apnea.  The answer could be as simple as reducing the height of your pillow, sleeping on your side or purchasing and using a soft cervical collar.  Looking at your OSCAR chart and your flow limits I would also suggest raising your minimum pressure to 7cm and your EPR at 3, you may also want to change the soft start to the normal setting. See how it goes for two or three days and post some more OSCAR charts.

[Deborah K.]

I think you should also turn off ramp altogether.

[Tactful3149]

   
I think I have made the setting changes on my Air sense 11 as Steve suggested.  My AHI's are generally 5-8 now, which is better than 10, but not low enough.  I have pasted the graphs from last night.  Any ideas?  Interestingly, last week I was travelling, and used my AirMini, and my AHI's were consistently below 1.0!  There are no "settings" on the Airmini, so now I am wondering how I can make my Air sense 11 behave like the AirMini!

[SarcasticDave94]

You're still sleeping in positions that choke off your airway. Looking at the 2 big clusters of events, if those were removed your therapy would be much better.

So you need to examine how you're sleeping. Propped up on a thick pillow would do it. Sleeping with your chin tucking into your chest will do it. For you, likely your best answer is not settings but getting a soft cervical collar to physically restrict to chin tucking.

Read the wiki on Positional Apnea


As for settings, you need a minimum of 7 to get the benefit of EPR 3. Your setting still indicates Min 4. Ramp is at 4 also. You need more starting pressure to help.

[Tactful3149]

Thank you for the fast reply.  Your pillow assertion would also explain why I got such good results with travelling with the AirMini - it was different pillows.  I've tried sleeping with a cervical collar, and found it very hot.  I'm going to try a smaller/softer pillow tonight.  will be interesting to see how much of my apnea is positional vs obstructive.