New here. First month. OSCAR results. How can I optimize my AHI?

[fumugu1234]

Hi there. I started using an airsense 10 with p10 pillow mask on March 31. I haven't touched the settings except temperature at 27c which I have since yesterday switched to fully auto because my mask felt wet the last few days. I haven't noticed feeling any better. I would say I feel worse as I'm finding it harder to get out of bed in the mornings (the warmer weather isn't helping here in Canada). I'm trying to figure out what I can improve on, any ideas? Is it possible to bring my AHI down further? If anyone wants more information I'd be happy to share.

Thanks a lot!

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Attached some maybe helpful stats.

[ICEMAN]

Hi fum you look to be 123 and away, but I will I take stab in the dark, may be possibly some Positional Apnea, Supine sleeping on back, Chin trucked possible to high pillow ? untuck chin or try out those cervical collar's, but with 2.67 AHI already as below 5 AHI is considered as treated. So and before jump on to the collar get accustomed to Mask and machine, as with mask hanging off face, pumping air etc, that takes some time to adapt. But hang in to suggest wait on others in here with more detail, specify knowledge, will better determine, from pressure flow limits graphs etc to my more of guess, past treatment knowledge. Do see have very few CA doubt pressure related and as pressure doesn't go close to the 15Max setting. May be those CA at end of sleep time most likely relate to junk sleep ? waking's tossing, turning hold breathe , but as said on your score already a winner ? Make sure machine is placed lower than your sleeping head height? thinking that can contribute to humidifier raining hose to mask? Also if do any changes only 1 change at a time so can measure reaction to the change. If do couple changes at same time then no certainty of which change action is of benefit or negative from the change? Will also add do see most Apnea lining up with pressure stopping at 7 so may be worth consideration to increasing Min pressure to 7cmH20 may possible quicker react then to those obstructions, and see if need a further Min higher pressure?

[OpalRose]

Although I don't see positional apnea*, I do agree with raising your minimum pressure to 7cm.  You pressure should be set closer to where the Obstructives are happening to get ahead of that.  

*Positional apnea occurs when you are cutting of your air by allowing your chin to tuck into your chest.  This would show up on your graph as "clumps" of apnea.  
I don't see this on your chart.

Also, you may need to turn down the EPR to 2, but make one change at a time and observe.

You may be experiencing some rainout.  Try lowering the humidity setting.  
Do you use a heated hose?  This works wonders by keeping condensation out of your hose and eventually ending up in your mask.  In addition, try a soft fleece type hose cover.  Your hose should also be directed upward from your Cpap and then down towards you.

[fumugu1234]

Hi fum you look to be 123 and away, but I will I take stab in the dark, may be possibly some Positional Apnea, Supine sleeping on back, Chin trucked possible to high pillow ? untuck chin or try out those cervical collar's,  but with 2.67 AHI already as below 5 AHI is considered as treated. So and before jump on to the collar get accustomed to Mask and machine, as with mask hanging off face, pumping air etc, that takes some time to adapt. But hang in to suggest wait on others in here with more detail, specify knowledge, will better determine, from pressure flow limits graphs etc to my more of guess, past treatment knowledge.  Do see have very few CA doubt pressure related and as pressure doesn't go close to the 15Max setting. May be those CA at end of sleep time most likely relate to junk sleep ? waking's tossing, turning hold breathe , but as said on your score already a winner ?  Make sure machine is placed lower than your sleeping head height? thinking that can contribute to humidifier raining hose to mask? Also if do any changes only 1 change at a time so can measure reaction to the change. If do couple changes at same time then no certainty of which change action is of benefit or negative from the change?  Will also add do see most Apnea lining up with pressure stopping at 7 so may be worth consideration to increasing Min pressure to  7cmH20 may possible quicker react then to those obstructions, and see if need a further Min higher pressure?

Thank you for your response. Lots to keep in mind! My cpap is below head level and I use an underbed hose support system that works great.

Although I don't see positional apnea*, I do agree with raising your minimum pressure to 7cm.  You pressure should be set closer to where the Obstructives are happening to get ahead of that.  

*Positional apnea occurs when you are cutting of your air by allowing your chin to tuck into your chest.  This would show up on your graph as "clumps" of apnea.  
I don't see this on your chart.

Also, you may need to turn down the EPR to 2, but make one change at a time and observe.

You may be experiencing some rainout.  Try lowering the humidity setting.  
Do you use a heated hose?  This works wonders by keeping condensation out of your hose and eventually ending up in your mask.  In addition, try a soft fleece type hose cover.  Your hose should also be directed upward from your Cpap and then down towards you.

Thank you. I have a heated hose (climate line) so I cannot adjust humidity if it's on auto. I believe this is better at preventing rainout though (which is why I switched temp to auto as well). I will try the cover if I get another episode.

I'm not comfortable changing the prescribed pressure range without MD's consent so I will speak with him about it!

A similar pillow to what I use:

   

I am mostly a side sleeper and this pillow has been the most comfortable for me. But if this is contributing to events I may need to change it.

[Gideon]

Please let us know how well your conversation with your doc goes.

[ICEMAN]

hi 123, from look of Pillow picture, if side sleeping, my view would be good thing except may still need to watchout, side sleeping Fetal position, which may automatically still more tucking in chin. Not sure how compare to Supine positional difference ? The pillow may may assist in prevent neck/chin tucked but still obviously in supine the Gravity "tounge blocking's obstruction risk's"?

I use standard pillows, endeavor to side sleeping, for a while was using Soft Collar, combined consciously awareness placing head on pillow, Tilt head back, to aligned clear straight neck position, make every effort to again repositioning in position changes/tossing.  I found to certain degree the head/weight help assist maintain chin/airways once positioned, more so with practice till auto actively body positioning in maintaining the prevention of chin tuck.  For me it mostly worked, while not 100%, but to a situation I don't, now worry about wearing collar, and Yes still get some occasional supine positional apneas, but I thinking is mostly under control?   "If the Resmed Machine AHI recordings are Correct "  then is also the times I unable get to sleep, tossing turning, so theory goes out window, don't worry about the side sleep, just will consciously, change to Supine position or to what ever works, accept the known risk of Positional, just for that night, main focus to get back to sleep, later on may endeavor to revert to side sleep.   But then Horses for Courses! and AHI / Sleep may be contributing to action you take?