[CPAP] AHI hovering around 10, how to lower?

[Vultures]

Hi,

First Post Here. I have been on CPAP therapy since last November. It seems to be working well and I am feeling rested, however my AHI seems high. often I'm getting readings above 10 or so for the night. I'm wondering if some of you experienced folks can help me as I'm unimpressed with my sleep Doc, and have crappy insurance so each visit is expensive, and plagued with billing issues.

Hopefully I've attached the data that is necessary. Please let me know what else I would need to provide.

Thanks

Nik


   

   
   

[staceyburke]

To begin with I assume you know that you machine is been “recalled” and told you should not use. There is a huge thread on the board about it you can read. 

The main problem is positional apnea. That is when you sleep in a position where you cut off your own airway. Nothing the machine can do can help, you have to find a way not to sleep in that position. It could be as easy as sleeping on your side and not your back or sleeping on one pillow that is thinner. If you can’t stop with easy solutions a collar WILL help. Please read about a collar in my signature.

[Vultures]

Thanks. I'm aware it was recalled. I don't have another and I just bought this one out of pocket. earlier this year. I'm hoping it is ok to use for a little while as it is brand new and hopefully not deteriorating yet. Not using any oxy cleaners, and I need to use something as having a machine is better than no machine. The whole situation is very frustrating.

Thanks for the note on positional apnea. I'm already using a very thin pillow but I think i move around a lot at night. I will check the link.

Edit to add I am currently sleeping on my side (to my knowledge)

[notam2]

You might benefit from an increase in CPAP pressure. How did you arrive at 10.5 cmw? Did you have an in-lab titration done at any point?

[Vultures]

Yes I had a titration study done. The initial setting was given by my sleep doc was 12. I lowered it to 11.5 to see if that helped at all. Haven’t noticed a change, maybe I will revert back.

[multicast]

Your unintentional leakage is too high.  Try to fix that first. Which mask do you use exactly?

[WookieeInLaw]

A few observations. 

Firstly, it appears that a lot of your events are during your ramp time. Turn your starting ramp pressure up as high as you can comfortably tolerate. The entire time you’re in ramp mode, you’re not getting the pressure you need for your therapy. 

Secondly, you might be better off in APAP mode. That way your machine could respond to position changes. Just spitballing here, I would try a min pressure 0.5cmH20 below your prescribed pressure, and a max pressure 3cmH20 above that.  

Then bring some new OSCAR data to the hive mind for suggested tweaks.

[staceyburke]

Again, your main problem is positional apnea and no change of setting will help!!  The first thing you have to do is to stop getting in that position -  a collar is what helps most people.  A link to a collar is in my signature.  You can play with all of the settings you want to but nothing is going to change until you take care of the positional apnea.

[notam2]

My initial thoughts are to turn off flex, turn off ramp, set the pressure up to 12.0 cmw, and see what those results are. Flex isn't doing anything to help you now anyways.

Have you received copies of your diagnostic study and titration study? Posting redacted copies of those might be useful for getting help on here. Do you recall what your untreated AHI was, and what your AHI was reduced to in the titration study?

[WookieeInLaw]

Your unintentional leakage is too high.  Try to fix that first.  Which mask do you use exactly?

D'oh! Yep, I missed that. That's the number one thing to focus on for now!