My AHI is VERY high

[mattmceza]

Hi all,

I am a new CPAP user - started about 2 weeks ago.

I have the ResMed Airsense 10 auto machine with humidifier and the F20 full mask.

After 2 weeks of use my AHI was still ranges between 35-60.

After some tweaking and increasing the pressure I have managed to get the AHI down to 20.

My pressure is now min 10 and max 20 and I turned the EPR down to 1 from 3.

But it doesnt feel like its working for me.

Here is a screenshot from Oscar below. 

   

[jaswilliams]

Mattmceza


Your machine is blowing at max pressure and you are still showing snores and obstructive apnoea, These events are in clusters an it is likely that you would be helped by a soft cervical collar see our wiki for further information http://www.apneaboard.com/wiki/index.php...cal_Collar

[Gideon]

Welcome to the forum

Your chin is tucking. There is no way to correct this on any machine with settings.
Read the wiki article on the soft cervical collar in my signature and get a collar.

The clustered obstructive events are the indicator.

[mattmceza]

thanks for the advice. I just went to my pharmacy and bought a soft collar. Will report how it goes tonight.

[Dormeo]

It will also be important to keep working on mask fit -- or to try another mask that might work better for you. About 14% of the time your machine can't compensate for your leaks.

Any chance you could try a nasal pillow mask? The perimeter where the mask touches your face is a lot smaller, hence reducing mask leaks can be easier. The question would be whether you can keep your mouth closed during the night. The cervical collar will keep your jaw from dropping; that may be all you need to avoid mouth breathing.

I'll be quite interested to see whether the cervical collar does the trick for you. That might mean you could be successfully treated with lower pressures and/or more EPR.

[mesenteria]

I think we're all going to learn over the next few days that the way you sleep is the big problem here.  It might be head position, body position, the type of pillow(s) you're using...or not...the type of mask and its fit and suitability....the list goes on.  Please don't give in to frustration and impatience.  You're already feeling a bit behind the 8 ball due to the newness and urgency of your condition, and you'd like to be able to forget it at the same rate as you'd get used to a leg cast...a few days at most.  You might be in for a several week journey until you get yourself and your machine dialed-in. 

Keep an open mind, and be optimistic.  We'll have you a lot better before long.  Maybe not perfect, but a lot better. 

[mattmceza]

Here are my results last night with the soft collar. My AHI nearly doubled??

   

[Sleeprider]

Some collars are better than others. Is this one impinging on the soft tissue at the front of your throat behind the jaw? Is is possible you are tucking your chin behind the collar? You have positional obstructive apnea, and need the right tool to resolve it. Increasing events after using a collar is a pretty unusual outcome, but it probably indicates a fit issue. If the generic one from the pharmacy failed, maybe consider getting the Coreflex or Releaf collar from Amazon. http://www.apneaboard.com/forums/Thread-...#pid355222

[mattmceza]

I bought nasal only mask yesterday ( Resmed Mirage FX)

The results are very different. My AHI came right down but I still felt tired when I woke up.

   

[Dormeo]

I'm not surprised you felt tired when you woke up. Although your AHI is much improved, you are still experiencing obstructive events at a rate qualifying as mild apnea in need of treatment.

Were you wearing the collar last night? If yes, is there any possibility it's loose enough that your chin is sneaking down behind the front of it? Or that it's tight enough that it constricts the tissues in your neck and hence airway?

If you were wearing the collar, and you think the fit is optimal, then I suspect Bonjour and Sleeprider will recommend that you increase your minimum pressure, but I will defer to them, of course.

Good job on the mask and leaks. It looks like you're on a better path there. Did any of the leakage wake you up?