[CPAP] Advice on lowering AHI score.

[forester07]

Here is last night's data.  I made a few changes.  I dropped the max pressure to 13.5 which appears to be too low.  I also wore a cervical collar the first half of the night.  I took it off a little after 3am.  I'm not sure it helped any and maybe made the clusters worse.  Any advice?  Tonight I plan on turning on ERP to see what that does. 

https://imgur.com/a/TLsBw

Thanks

James

[Sleeprider]

James, the breathing is irregular here, and the apnea seem to arise without a complete exhale which is a bit curious. This looks more like an arousal than sleep pattern, and I see a lot of swallowing and starts and stops that may not be typical sleep apnea.

You might find a comfortable fitting soft cervical collar clears up a lot of problems. I don't have a strong opinion on what is causing the apnea events at this point, and as we see more results from you, the picture may become clearer.

Tom

[trish6hundred]

Hi forester07,
WELCOME! to the forum.!
Good luck with CPAP therapy and getting it fine-tuned to better meet your needs, you have come to the right place for guidance.
Hang in there for more responses to your post.

[forester07]

Here are my results from last night.  Slightly better.  8.5 AHI.  I used the EPR feature. 

https://imgur.com/a/2TNjQ

[Sleeprider]

Events are down and you do fine with the Flex setting on. I think it would be interesting to see if you respond positively to a higher minimum pressure of 10.0. Events are kind of mixed, and a little less clustered, leaks remain in good shape. It is interesting that with Flex, which lowers EPAP pressure, your results improved. There is no clear indication of what direction to take regarding CPAP pressure, but increasing the minimum may improve hypopnea and obstruction, or show us you do better with lower pressure.

[forester07]

Last Night's data.   My best score I've had in a while.  I'm going to leave the settings along for a few days and see how I adjust and where I average out. I'll post again in a few days. 

https://imgur.com/a/BCAiT

Thanks,

James

[Sleeprider]

Things look more like conventional obstructive apnea now, with occasional sleep transition centrals. OA events are clustered, and point to the positional apnea or a cervical collar. No disagreement with using this pressure for several days and seeing how it settles out, but a higher minimum would likely help more than hurt. In fact, you seem to see events happen every time the machine returns to minimum pressure. I do think you're getting closer, but 11.0 is waiting when you're ready.

[forester07]

My latest results. This is my best AHI yet. 5.93. Let's see if it stay consistent. 

https://imgur.com/a/EWv62

[Walla Walla]

I agree with what Sleeprider said before. Bump your minimum pressure up to 11cm. Also the advise on using a soft cervical collar is good.

[forester07]

Bumped the pressure up to 11cm for the last three days.  Here is my latest data.  It has improved.  2.83 AHI.  I used a cervical collar for part of the night. 

https://imgur.com/a/5MGmD