AHI below 5, do I still need a CPAP?

[crazycoconut]

Kind of a dumb question, but I did a 10-day trial and according to OSCAR, my AHI is below 5, on average 1.7. My mean pressure is 5.638 on a prescribed 4-14 cm H2O. I only sleep about 6 hours a day at most, sometimes less. I use a Phillips Dreamwear Full Face Mask on a Resmed 11. Age 30.

Questions:

Can I forego the CPAP? I am not really that comfortable with it, I get aerophagia sometimes so I am gassy when I wake up. I notice it does help (I wake up with my heart beating like normal rather than before, I would wake up with my heart racing but the refreshed feeling is not there). I have tried mouth device to no avail (unfortunately, I have TMJ and it was just too painful), so I was thinking about going the Inspire route and foregoing the CPAP altogether. 

One thing OSCAR picked up was hypopnea during sleep. <1 but it's present. Is this a case of concern?

Can I tighten my pressures to 5-7? Or should I leave my prescription alone?

Thanks in advance!

Edit: Forgot to mention but I have a Ramp time of 5 and an EPR of 2. I'm not sure what this EPR number should really be.

[mecutl3r]

Obvious question - what is your AHI without a mask? 

My original sleep study showed an AHI around 8. I was told that was not considered bad and would normally not require a mask, but since I also had Atrial Fibrillation, there was enough concern so that I should wear a mask. With the mask, my AHI is usually below 0.5.

[staceyburke]

The only way is with a sleep study in a sleep lab to say if you need cpap.  The numbers you are getting is WITH therapy so no one can say what your number would be without using cpap.  

You asked about the settings you are on. The min of 4 is to low for most people.  If your mask is sealed correctly you are only getting 4 cm of air and that is not enough for an adult.  I would suggest a couple of changes.

Min 7
EPR full time
EPR 3

It really does not matter the max UNLESS it is going to high and causing problems with leakage or you swallowing air into your stomach.  If you had those we would lower the max pressure to help.

[Rickyricardo]

And turn off ramp even if it is 5 minutes. It's 5 wasted minutes.

[crazycoconut]

Obvious question - what is your AHI without a mask? 

My original sleep study showed an AHI around 8. I was told that was not considered bad and would normally not require a mask, but since I also had Atrial Fibrillation, there was enough concern so that I should wear a mask. With the mask, my AHI is usually below 0.5.

Honestly, you got me there. I was around that same number on the original sleep study but a decade later, I came out to around AHI 34. It's my peabrain telling me I don't need it when I obviously do. I'm gonna have to embrace the machine, so it's back to reality for me. I needed that. Thanks.

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The only way is with a sleep study in a sleep lab to say if you need cpap.  The numbers you are getting is WITH therapy so no one can say what your number would be without using cpap.  

You asked about the settings you are on. The min of 4 is to low for most people.  If your mask is sealed correctly you are only getting 4 cm of air and that is not enough for an adult.  I would suggest a couple of changes.

Min 7
EPR full time
EPR 3

It really does not matter the max UNLESS it is going to high and causing problems with leakage or you swallowing air into your stomach.  If you had those we would lower the max pressure to help.

Interesting. Thanks, I'll try those numbers. I do tend to swallow air via my mouth.

---

And turn off ramp even if it is 5 minutes. It's 5 wasted minutes.

Noted! 

[Hmm888]

[quote pid='539694' dateline='1733966377']

You asked about the settings you are on. The min of 4 is to low for most people.  If your mask is sealed correctly you are only getting 4 cm of air and that is not enough for an adult.  I would suggest a couple of changes.

Min 7
EPR full time
EPR 3

It really does not matter the max UNLESS it is going to high and causing problems with leakage or you swallowing air into your stomach.  If you had those we would lower the max pressure to help.
[/quote]

I suppose I'm not most people. 4 as the minium is a Godsend for me. For whatever reason my events only start well after 60 minutes of crashing. I loved the 2 to 4 hour ramp on the legacy Respironics Remstar models.

[gnowjneb]

I consistently get under 5 AHI but there's no possible way I could sleep without my BiPap machine. I would say if your doctor recommends you use it, then stick with it.