Have tried multiple pressures, AHI wont go down, so weird

[wants2sleep]

Hi All,

New member of the board, have read through many of these posts. 

I have kept increasing my pressure (up to 20 max last night) but cannot get my AHI to go lower than 6-5. I keep seeing all of these lower numbers on here. I am still having a lot of events per evening. Any suggestions from you Jedi Masters?

Thank you!

Please see attached OSCAR Data

[OpalRose]

Take a look at the "clumps" of apnea... Obstructives and Hypopnea.  The pressure is trying to clear them, but unfortunately no amount of pressure will help with " Positional Apnea."  

You are sleeping in a way that is cutting off your air, possibly on your back and then tucking your chin into your chest.  This can also occur if your pillow is too tall which causes your head to tilt forward.  

Look at your bed pillow first and go for a firm but not too tall pillow.  Some also use a soft cervical collar to help support their neck.  

http://www.apneaboard.com/wiki/index.php...cal_Collar

Also your Flow Limitation is way too high and goes hand in hand with positional apnea.
You are using EPR 3, and that will help once the positional apnea is solved.

What pressure settings were you using before? Raising the max to 20cm will not help.

[Gideon]

As Opal has said. You have positional apnea and until you clear that nothing will help.

Read on the soft cervical collar and positional apnea wiki articles.

Let us know

[wants2sleep]

Yeah I have always slept with a thin pillow, as I feel like I have some chin tucking going on when I sleep. Would you recommend that I keep my machine settings as is for now and try the collar as see if results improve.

Thank you

[Gideon]

Your pressures are too high but first try a collar and get the positional down. Then it will be no probl to dial you in.

[OpalRose]

Not knowing what pressures you were using prior to raising it, I suggest starting with
8cm and bring your max down to 15cm. If you leave it at 20cm, the algorithm will automatically raise it with the detection of flow limitations. This is futile as long as there is positional apnea. Keep EPR at 3 full time.

Yes, try a collar.

[wants2sleep]

Wow... tried a collar last night... and for the first time in years of using a cpap I am below 1 AHI. 

Pretty shocking, you guys were spot on regarding the positional apnea. Thank you so much for taking the time to review my data, I really appreciate it!

I have attached lasts night sleep with collar and full face mask, any further refinements you guys suggest?

Thank you!

[KeepSmiling]

I am happy that the collar works for you.


I saw a couple of leaks at higher pressure, not sure if this a direct cause.


Did you have a titration done, if yes what pressure was recommended.


I would not suggest a lower pressure without having more info.

I do not see run away Central Apnea that is increasing the pressure, so i am assuming the pressure is needed to keep airway open.

If it were me I would now work RERA if they are causing disturbing my sleep.

Depending on what is doable and manageable, (not set in stone):
Pressure 16-20, EPR as is, increase pressure if RERA still the same/feeling not rested
Pressure at 20 as a CPAP

Some people use bilevel machine not because of specific reasons, but because it goes to higher pressure.

Have you been checked for other medical conditions.

[clownbell]

Congrats on such improvement via the collar. Please turn off the calendar in the left sidebar. it is hiding some numbers the experts will want to see.