AHI very high after switching from Dreamstation to Aircurve 10

[Sleeprider]

mu502256, your settings include a pressure support of 8-cm. I'd like to suggest you change your settings as follows:

Mode: Vauto
EPAP min: 11.0
IPAP max: 19.0
PS: 4.0
Trigger sensitivity: Very High.

Your machine is simply setup wrong in S mode rather than Vauto, and the result is a PS that over-ventilates you. Give these settings a try, and call me in the morning.


Your machine is simply setup wrong in S mode rather

[PeaceLoveAndPizza]

(Note: I see I cross-posted with SleepRider. We ended up at about the same place so use what you prefer.)

I suggest going back to Stacey’s recommendation of using VPAPauto to find settings that may be more effective. 

It may be I am completely bonkers, but I think starting with something radically different may be worth a go. From there many here can help tweak things further. 

Mode VPAPauto
EPAPmin 8
IPAPmax 20
PS 4
No ramp
Trigger Very high

If you are willing to give it a try, give it a night or two. If it is completely wrong, no harm done. But if it is more comfortable with better sleep, it is a good starting point.

And listen to Dave and SleepRider regarding things ASV. They have years of experience with it and are a great resource.

[mu50256]

I really appreciate all of your responses. I am desperate right now as my exhaustion is physically affecting me. I will give these settings a try tonight and see how it goes.

Thank you!
Melanie

[mu50256]

I have an interesting update. I changed by settings to VAuto with Ipap Max at 18 and Epap at 10, trigger at very high. I tried sleeping laying flatter with a flatter pillow. My AHI was still very high and my 02 drops were really low and more frequent. Down to 74 still. I finally got the cervical collar and found it to be very difficult to wear as it felt like it was digging into the back of my head so I took it off after a short time.

Last night I decided to sit in a more upright position to sleep. My AHI today was 1.64 and my 02 didn't drop lower than 94. So for me, it seems sleeping more upright is actually going to work better. I still feel absolutely exhausted, but I haven't slept well for over a week since getting this new machine. I have some catching up to do.

The one bad thing is I had some severe large leaks and I need to figure out what is going on. My leak rate was over 20%, but I can't figure out where my mask is leaking. I can hear it is louder than normal and I can feel something is off with the pressure, but I didn't have any actual leaks around my mask on my face. I am wondering if I have a small hole in my hose possibly. I did catch my cat playing with it. I also wonder if it is possible that the leak issue is what contributed to a better outcome so this may not be an accurate positive outcome for me.

I may need to get a new hose and/or mask if there is an issue there and we'll have to see if I have the same outcome once I fix that issue.

[Jay51]

Here are some tips.  I hope they help:

Mask Primer

Mask leaks

[mawaw1992]

As far as the cervical collar, it takes time to get use to wearing it. It is stiff when it is brand new but will soften up and be more comfortable after usage. I had the same problem when I started using mine but got use to it and it did fix my positional obstructive apneas for a long time. Then last year my AHI started going up for no apparent reason except that apparently something changed in my airway. I saw different sleep doctors that told me to increase pressure and I let them know that higher pressure wasn't going to fix my problem because it was positional. Finally, I went to a regular nurse practitioner who suggested raising the head of my bed around 6 inches to see if that help and it did. It was just enough elevation to help my airway problem. My AHI average went from 0.9 last year to over 5.0 in just a few months and now in the last couple of months since raising my bed it is now below 2. Not only am I having fewer apneas but the length of the apneas have been reduced as well. I was sometimes having some that would last close to 2 minutes which is not good on the body. Now they rarely go over 35 seconds. 

As far as your leaks, it may be the mask leaking or something going on with your hose, but in my case since my Ipap was at 18 and Epap at 15, it was causing mouth leaks which higher pressures will cause. I finally started taping my mouth with the Cover Roll stretch tape which basically eliminated my leaks. Hope that might help.

[mu50256]

I was able to get my sleep study moved up and had it on Friday! I am waiting for the results, but the technician did state that she had to add on some respiratory relief to my therapy. I am not 100% sure what she meant by that.