New member looking for advice on how to improve AHI

[ExhaustedAl]

Hi Everyone,

I'm new here so please go easy on me ;-) My name's Al and I'm from the UK. I've had sleep apnea and been using an auto CPAP machine for a number of years now but never really tried to fine tune my therapy, I just accepted that I'd always be a bit tired. I stumbled on this board and was hoping maybe one of you guys could help me get better results?

After a while of using my CPAP machine (Philips dreamstation) I played with the machine settings a bit and changed the pressure from 5(min)-20(max) to 10(min)-13.5(max) based on the fact that a pressure much more than 13.5 tends to wake me up as the mask pops off my face and since i've been using CPAP for a number of years I can tolerate a starting level of 10 ok.

I have dabbled with the software to look at the data on the SD card but I don't fully understand it, or at least how to interpret the data. I have a question I'm hoping someone can help me with. I've attached the data from my machine as I notice my AHI is a bit higher than I'd like and it seems that the issue tends to be with the first hour or so of sleep.

Can anyone offer an explanation of what might be happening? Is it something to do with the stage of sleep or could it be a setting on my CPAP machine (a ramp or something)?

Thanks in advance

Al

[staceyburke]

Welcome to the board...  What happened at the beginning of the night was positional apnea.  Meaning that the position you were sleeping in - your chin dropped down to your sternum and cut off your own airway.  Think of it as a garden hose, if there is a kink in it nothing gets through no matter what the pressure is.  Same way with positional apnea.  You have to find out the position you were in and stop from getting in that position.

Many times it is from sleeping on your back but you can "chin tuck" in any position.  It could be to high of pillows.  What ever it was, you did not get back in that position again during the night.  IF it continues to happen then a collar may be needed to keep the kink from happening.   I have a link to collars in my signature if you would like to take a look at the subject.

Other than that you are topping out most of the night (13.5), so I would suggest your raise the max to 16.

[ExhaustedAl]

Thank you StaceyBurke

Now you say it, I guess it seems obvious. When I read your initial response I though, no that's not it but... I think you're right.

Since starting CPAP I changed the way I sleep. I now go to sleep on my back and then end up on my side (used to be a stomach sleeper before cpap). So although I have a very thin pillow I guess it's causing my chin to tuck in as I relax (as you suggest) I later end up on my side and that solves the issue. Last night, before i saw your response, I had some congestion so went to sleep on my side as I couldn't beathe properly on my back. Today my numbers for last night are improved! (attached).

Tonight I will try to creep up the max value, maybe to 14. The reason i'm hesitant is because I suffer from air in my stomach / bloating in the morning and at a high pressure the mask comes off my face and wakes me up but i'll see how high I can stand it and monitor the situation.

I guess for conclusive proof I could set up a webcam and video myself sleep but maybe that's overkill 


 

Alec

[staceyburke]

It does look as you need a higher max BUT yourAHI is low - so move the max up and see - any problems bring it back down. It is about comfort and how you FEEL.

[Dog Slobber]

Your device is basically parked at your maximum pressure (13.5) all night. A couple times it drops down, but then almost immediately comes back up to 13.5.

Your machine wants to go higher but can't.

This suggests the minimum is too low and the maximum is too low.

Increase you minimum by 0.5, and maximum by 0.5, wait a few days. You know you're at a good place with the maximum when it stops flat-lining at your maximum pressure.

By staying at the same pressure statistics for a while you can take advantage of of OSCAR to optimise AHI