[CPAP] New user, OSCAR interpretation for high AHI

[Dormeo]

Apt65, it's very good to hear you're sleeping more deeply and feeling more comfortable. The advice to raise your pressure again and reduce flex comes from two forum members with deep knowledge and experience -- you're in the best of hands!

Next step, I would say: minimum pressure up to 7 and flex down to 1. Then let's take a look at a daily chart and see whether the experts advise raising the minimum to 8 and lowering the flex to off.

[apt65]

Apt65, it's very good to hear you're sleeping more deeply and feeling more comfortable.  The advice to raise your pressure again and reduce flex comes from two forum members with deep knowledge and experience -- you're in the best of hands!

Next step, I would say: minimum pressure up to 7 and flex down to 1.  Then let's take a look at a daily chart and see whether the experts advise raising the minimum to 8 and lowering the flex to off.

I appreciate the help. I'll do this and report back tomorrow with results.

[SarcasticDave94]

Glad to see the improvements and that it's feeling like your treatment is more effective. Basically, this is the process called titration, albeit without a lab setting. However, this is real life and these setting adjustments will mean more and will be of more value to you because unlike the lab titration, your input counts a lot. Imagine that, better titration for free. Congrats and keep at it.

[apt65]

Another night in the bag. Last night started off well, but I awoke in the middle of the night completely congested, and had to use nasal spray to get back to sleep. I still had some congestion, and I think it caused some issues for me. I wokeup a few more times mouth breathing. 

 Anyway, AHI went up a little, but I FEEL as though I slept much better than any night to this point. I was actually surprised to see my AHI increase based on how I feel.

   

[Dormeo]

Very good to hear it felt like a restful night. You might consider using some over-the-counter Flonase before bedtime to see whether that helps your nose to stay clear. Also, as time goes by, you can play around with the humidity level. For some people, low humidity or none is what helps them stay clear; for others, higher humidity is the key.

I'm going to try to channel Bonjour and Sleeprider and suggest that you turn off flex and see how that goes. You will be looking to see whether that reduces the centrals. You will probably also want to be raising your minimum before long, but it can be useful to make one change at a time. I also wouldn't want you to feel uncomfortable exhaling against greater pressure right now.

You're doing very well. Keep us posted!

[apt65]

Dormeo, thanks for the help. I did turn off flex as suggested and I'll post the results. I found it easier to fall asleep with flex off, but once again I was battling congestion issues last night, so my score likely suffered a bit there, as I was mouth breathing from the nasal restriction. So far so good, I'll get there. I'll get some flonase today.

   

[Dormeo]

Well done. Turning the flex off really knocked down the CAs. I'm glad you were comfortable with no flex. To address the remaining events -- mostly hypopneas and obstructive apneas -- you will want to raise your minimum pressure.

The only question is how quickly to do that. I'm inclined to suggest that you go slowly, partly because you want to stay comfortable and partly because you don't want to invite an uptick in centrals. So to my mind, a reasonable plan would be to stick with these settings for another night or two, then raise the minimum pressure by .5. If that doesn't trigger more centrals, then after 2 or 3 days, try another .5. If it does trigger centrals, back off for a few more days, then go up by .5 again. Proceed in this way until you get to 9, unless you see an AHI under 2 before then.

Does that sound feasible? We'll see if others have different advice. Please keep us posted; I'm really curious to see how this goes.

[apt65]

That's sounds reasonable to me. I'll do just that and report back. It's really encouraging to see those events decrease in frequency. Thanks again.

[SarcasticDave94]

IMO don't worry too much about the numbers you see. Now if you see big changes for the worse, especially if you feel worse, make a note of it and tell us. Concentrate on using the machine and try to monitor how you feel, better or worse, after using the CPAP. The fractional settings are there for a reason, so turn it up a little at a time if necessary.