[CPAP] AHI still High

[knubob]

I wear a FFM and like it because I usually feel better the following morning. But the AHI is High (16 last night). My pressure range is set at 8.5-14.5.

-What can I do to that to decrease the apnea events and AHI ?

-Will increasing the lower number from 8.5 to 9.5 have any effect on AHI, and if not, what will ?

[attachment=2151]

[stevewerth]

I'm new here as well, but it looks like you have very high leakage, which I think could be the cause of the high AHI. I think if leaks are that high, the mask becomes less effective.

[Rob S]

i'm no expert and i'm sure some of the more knowledgeable members will respond but i'll take a few guesses.
your min pressure is to low, in the time it takes the machine to ramp up to a pressure that will prevent further events you've just had 5-7 obstructive events.
your max pressure seems too low to treat some of your obstructive events
as your pressure rises you seem to be getting clear airways events

could be you have pressure induced central sleep apnea and maybe need an ASV

again i'm no expert and just venturing a few guesses based on some stuff i learned here over the last 7 months.

quick edit: i think your machine records total leak rate, including intentional mask leak. sleepyhead doesn't seem to score it as excessive.

[PoolQ]

There are some things that catch my eye, but I don't know enough about the RP machines to feel comfortable talking about it.
There are others here that do know those machines and they will chime in in a while, hang in there

[Ghost1958]

I wear a FFM and like it because I usually feel better the following morning. But the AHI is High (16 last night). My pressure range is set at 8.5-14.5.

-What can I do to that to decrease the apnea events and AHI ?

-Will increasing the lower number from 8.5 to 9.5 have any effect on AHI, and if not, what will ?

Your leak rate is fine. Pr machines count total leak. Under about 70 your good. Machne will log any large leaks it cant handle.

Yes your min is too low. Youll probably wind up around 10 to 11 min pressure to pull the apneas down. But good news is your machine probably wont go as high on the max side.
Your running up around 14 half the time anyway so a raise to 10 on min side wouldnt be unreasonable unless you just want to go .5 cm at a time.

[knubob]

[/quote]

Your leak rate is fine. Pr machines count total leak. Under about 70 your good. Machne will log any large leaks it cant handle.

Yes your min is too low. Youll probably wind up around 10 to 11 min pressure to pull the apneas down. But good news is your machine probably wont go as high on the max side.
Your running up around 14 half the time anyway so a raise to 10 on min side wouldnt be unreasonable unless you just want to go .5 cm at a time.
[/quote]

Thank you Ghost1958, I appreciate your input.

Where did you get the above "Under 70" number? I have been looking for "normal" values for much of the data I see in Sleepyhead. Except the AHI at 5 or under, I can not find them in the Sleepyhead guide or in the PR manual or the Provider Manual Any input would be much appreciated.

[Winterfrost]

From the Sleepyhead manual (online):

Philips-Respironics System One: There is no official "line in the sand" for flagging a Large Leak.

(Source: Encore Report Guide) Lots of System One user data posted on the forum indicates the Large Leak line for Total Leak Rate depends on whether the machine is a Series 50 (older) System One or a Series 60 (newer) System One. Lots of user data posted on the forum also indicates that the Large Leak line depends on the pressure used: People using less than 10 cm of pressure see Large Leaks being flagged much earlier than people using pressures greater than 10 cm. Here are some general estimated guidelines for where the undefined Philips Respironics Large Leak line is located:

Series 60 System One users may start to see Large Leaks being flagged when the Total Leak Rate reaches 60-70 L/min; if the prescribed pressure setting is below about 8cm, then Large Leaks may be flagged when the Total Leak Rate reaches 50-60 L/min in some circumstances.

Series 50 System One users may start to see Large Leaks being flagged when the Total Leak Rate reaches 80-90 L/min; if the prescribed pressure setting is below about 8cm, then Large Leaks may be flagged when the Total Leak Rate reaches 60 L/min in some circumstances.

[DariaVader]

Agree min is too low. suggest that the CA is induced by pressure changes, and you might find that you get a better nights sleep on a very tight or constant range (11 - 14?), and turning off flex. Your CA does not seem high enough to warrant ASV judging by that one night, but if CA continues to be a large component of AHI at fixed pressure, then you might consider it. JMO.