Help Getting AHI Lower

[olywa]

Hi All:

I have been using my machine for about a month now.  After reading a lot of the great posts/replies and making adjustments to my settings, my events per hour have gradually decreased.  I am now at a point where some advice on lowering my AHI or any other suggestions would very helpful. 

Thank you,  Peggy

https://i.imgur.com/0kiuRm1.png

[Walla Walla]

I would set the minimum pressure to 11cm and leave the maximum pressure where it is.

[Gideon]

How well are you sleeping thru the night?

[olywa]

I toss and turn quite a bit.  Last night was better than some.  I feel more refreshed today than most, but that could be because I am not at work.  

[olywa]

Thanks Walla Walla.  They started me out at 4 and I have been creeping up ever since.  I was a little leary of going higher without some feedback.  So, thanks.

[OpalRose]

Hi olywa,
Yes, I agree with Walla Walla on a minimum setting of 11cm.  You are mostly experiencing Hypopneas, and your 90% pressure is over 14cm.

This simply means that for 95% of the time, you were at a pressure of 14.82 and lower.  Note the "and lower" which means you were not at 14.82 all of that time.

You may also want to try an EPR setting if you find it hard to exhale against pressure.  Try a setting of 1 or 2.

[olywa]

Thanks OpalRose.  I have been able to tolerate exhaling, but am only at 8.4.  When I go up to 11 I probably will need EPR on.

[OpalRose]

Thanks OpalRose.  I have been able to tolerate exhaling, but am only at 8.4.  When I go up to 11 I probably will need EPR on.

You can take it slow. Move it to 9cm and move up .5cm until you reach 11. This way you can see what effect it has.

[olywa]

I will take it slow.  I am at 8.4 because I was creeping it up.  I was just sitting here wondering if I should jump to 11, but slower does sound better.

[Sleeprider]

Olywa, I have a little different take on this. I agree a minimum pressure of 11.0 is a good start, but your events are nearly all hypopnea. I think you'd benefit from using EPR (exhale pressure relief). While on the Autoset this is regarded as a comfort setting, it is actually a bilevel setting that can give 1-3 cm pressure difference between inhale and exhale pressures. So with a minimum pressure of 11.0 and EPR at 3, your starting pressure becomes 11/8 (IPAP/EPAP). I suspect this will work great for you, although sometimes it can increase central events in a few people.

The EPR settings are in the clinical settings under comfort. You will need to turn EPR on Full-Time at your choice of 1, 2 or 3. I have see very good results from people with hypopnea using EPR.