[CPAP] AHI Creeping Up

[eseedhouse]

I have no idea ...r why you alternately stuff up your nose on one side or the other. 

This is actually normal and it's known as the "Nasal cycle".  Wikipedia article at https://en.wikipedia.org/wiki/Nasal_cycle

[Sleeprider]

I have no idea ...r why you alternately stuff up your nose on one side or the other. 

This is actually normal and it's known as the "Nasal cycle".  Wikipedia article at https://en.wikipedia.org/wiki/Nasal_cycle

Quit making it easy for the lil' white dog.  

[cadogan]

ok..here is the latest from the little white dog...lol

I used the nasal pillows last night.  As I mentioned, I have trouble with the nasal pillows.  They airflow into my nose can be irritating, and the pillows don't align well into my nostrils.

I tried to adjust the temperature, thinking the humidity might help.  I raised it to 81 degrees.

I used the pillows for four hours or so.  This morning, the results showed I had a large leak all night.  Here are the results.  Any thoughts or suggestions?  The good news is that AHI is 3.6 which for me is good.

Thanks!

http://imgur.com/a/5s5gC

[Sleeprider]

Your ability to tolerate a leak is pretty amazing. Which nasal pillows mask is this, and what size?

Thanks for playing...fetch.

[cadogan]

ResMed AirFit ™ P10 Nasal Pillow CPAP Mask with Headgear

Is there a better one do you think?  I think with my deviated septum, one nostril is bigger than the other.  Is there a really great pillow that fits easily and tightly into the nostril?  If so, I'm all ears...or nose...

[Sleeprider]

With the P10 the larger pillow is usually better. If you're using the medium, try the large.  Otherwise, I agree it's an awesome mask for most of us.  Your chart does look like the leak source is through the mouth.  It's a high leak rate, but just over the large leak threshold.  Have you ever considered starting ramp at 6?

[cadogan]

When you say try ramping it at 6, what does that mean. And why might that make a difference. Thanks...!!!

[Sleeprider]

Currently your ramp settings use a starting pressure of 4.0. You can change the starting pressure, and ramp time in settings. My suggestion is a starting pressure of 6 may be more comfortable, and help you establish a better mask fit. Eventually you will probably not use ramp at all, but a very low starting pressure is not something most of us enjoy, and you will often see some large volume breaths taken during ramp (see your graph flow rate) until pressure reaches a comfortable rate that supports our needs.

[Marillion]

I agree with Sleeprider.  Based on my own experiences with the P10.  I was fitted with a medium but switched myself to a Large size nose piece with much better comfort and results all around.

I also learned after a few weeks to change my start pressure to a higher number so that I didn't feel starved for air at all.  After a couple weeks I turned off the ramp setting as well.  Still experimenting with that.

I do have a question though.  Not meaning to hijack the thread but this may be of some use to Cadogan also.  Should we set our start pressure to a number very close to what our average pressure was during the night on our auto cpap machine?

[OpalRose]

I do have a question though.  Not meaning to hijack the thread but this may be of some use to Cadogan also.  Should we set our start pressure to a number very close to what our average pressure was during the night on our auto cpap machine?

In your case, because you use an auto machine (this won't help Cadogan because he uses a straight pressure cpap)....I usually recommend setting the minimum pressure 2cm below the 90% pressure reading and 2cm above.

Often times, if you look #SleepyHead stats., the med. will be fairly close to the 90% number.  
What you don't want is your minimum pressure to be so far from your 90% pressure as to make the machine work harder to reach the pressure needed.

FYI....the 90% pressure does not mean you were at that pressure for 90% of the night.  It means that you were at and "below" that pressure for 90% of the time.  Note the "and below".