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Help adjusting pressure to lower AHI :)
#1
Help adjusting pressure to lower AHI :)
I was diagnosed a year ish ago with sleep apnea and have been consistent with using the air sense 10.  I was averaging 5.25 AHI's the first 9 ish months, but started to see higher AHI's so began research and started changing the pressure on the machine and with trial and error the adjustment did not get me to my goal so recently downloaded Oscar so I would have clear data to go by.

I came across this wonderful community site and hope that the experts can provide insight on how to adjust the pressure to the ideal settings for my condition (and any other advice) so I can consistently stay below 5. 

Thank you so much in advance <3
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#2
RE: Help adjusting pressure to lower AHI :)
Included Oscar results from last night Smile


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#3
RE: Help adjusting pressure to lower AHI :)
Welcome! It's great you've started using Oscar.

Almost all of your events are central apneas. A CA means there was a pause in your breathing of 10 seconds or more without any restriction in your airway. When you had your sleep test, did you have mostly obstructive apnea events, mostly CAs, or some of each?

Do you commonly see clusters of CAs toward the beginning of the night when you are falling asleep? If yes, this may be a sleep transition issue, where the handoff from your waking neurochemical breathing controls to your sleeping controls doesn't work as smoothly as it might.

For now, a good experiment to try is to turn off the EPR. EPR can sometimes lead to CAs.
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#4
RE: Help adjusting pressure to lower AHI :)
Thank you for taking the time to look over my Oscar results and offer advice.  I will turn off my EPR for now.

I am unsure of a pattern yet as I am new to Oscar, but will watch going forward around the clusters of CAs toward the beginning of the night and post images for further advice Wink

Additionally, Will ask for a copy of my sleep report so I can answer your query around type of apneas during my sleep study. 

Smile 
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#5
RE: Help adjusting pressure to lower AHI :)
Welcome to the forum. Your stats imply that you were very likely awake during the i.itial period of your sleep. Your breathing often appears to be very irregular when you are awake and as a general rule we will ignore values in that window.
If you post some 5-minute views of that portion we should be able to verify that. When we toss we normally hold our breath, no obstruction, so our paps call it central apnea or clear airway.
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#6
RE: Help adjusting pressure to lower AHI :)
Thank you both, I appreciate the help immensely Smile

I turned off EPR and my AHI's went down a bit, also I did get air in my tummy.

I do take a bit of time to fall asleep and attached a 5 minute view for verification.
Also, I wake up and do not immediately take the mask off.


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#7
RE: Help adjusting pressure to lower AHI :)
Gideon is vastly more experienced than I am, so I hope he will comment. To my eye, the zoomed-in view doesn't really show awake breathing or breath-holding. Awake breathing generally looks deeper and more irregular, and you're pausing after exhaling rather than after inhaling.

This most recent chart also shows a cluster of CAs toward the end of the night. This, too, could be a sleep-transition CA phenomenon, or maybe it's when you were awake with your mask on. You might try removing your mask when you know you're at the end of your night's sleep, just to clarify that a little.

Because CAs are so variable from one night to the next, I'm inclined to suggest you stick with your current settings for a few more nights and see how it goes.
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#8
RE: Help adjusting pressure to lower AHI :)
I will stay the course for a few days and see what the data renders.
Also will take off the mask as soon as I was up and see if that makes a difference Smile

Thank you!
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#9
RE: Help adjusting pressure to lower AHI :)
That zoom is showing normal sleep breathing as in not awake. The Centrals are not showing the typical waxing waning pattern we often see that results from our CO2 going below the apneic threshold. A bit of this appears at 222640. You have some hypopnea at 222820 and few indications of flow limited breathing.

Did you have any Central Apnea indicated on your diagnostic test?
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#10
RE: Help adjusting pressure to lower AHI :)
My numbers went up last night to 7.8 Sad, however I did not get as much air in my tummy as the previous night. 

I did take my mask off as soon as I woke, per suggestion.

My nurse practitioner replied back to me saying in my original sleep study the data shows predominant obstructive sleep apnea and she would get a copy of the study sent to me so I could look at the data myself. 

I googled flow limited breathing and CA's, so much information :/  
Almost wonder if I am getting CPAP induced centrals?  Totally swag on my part as I am not savvy in this area (yet).


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