Pressure lowered from 10 to 8 need advise

[gilbert123]

Hi,
I have been on CPAP for 6 months on a pressure of 10 with AHI below 3 every night.
I just did a second sleep test because I could not sleep on my back as my cheeks swelled up with air causing major leaks on my mask.
My pressure was lowered to 8 from 10 by the lab doctor in the morning right after my test and since then, my AHI has been over 5
the last 2 nights hittng 6.06 tonight.

I have attached here a capture of the night previous to the test and one after the test.

h ttp://imgur.com/a/TnDF7

My question is, do I need time to adjust to the new pressure of 8

Thanks,
Gilbert

[Crimson Nape]

I don't believe that it is a "getting use to" moment.  Sleeping on one's back is the least optimal position when dealing with sleep apnea.  Is there a reason that you have or want to use that position?  Sleeping on your side may provide a better result.  Changing sleeping position and keeping your chin from tucking into your chest may allow you to return back to a pressure that will better address your apneas by reducing the airway resistance.

[gilbert123]

I agree with you regarding sleeping on your back but I would like to be able to sleep in any position.
Having said that is there anything that my data shows that indicates the reason that my AHI shot up with the lower pressure.

The sleep lab doctor said that 8 was ideal for sleeping in all positions

Thanks again Gilbert

[ajack]

If it was my chart, I would turn off the flex/pressure releif to try and stop the clear airways.
I would raise the pressure to 9 and try this setting without flex for a couple of weeks and then review, hopefully the CA have settled and the pressure can be raised for the H, if needed

[Sleepster]

I just did a second sleep test because I could not sleep on my back as my cheeks swelled up with air causing major leaks on my mask.

I'm a bit puzzled. That doesn't seem like a reason to have a second sleep test. Also, if you have a full face mask the pressure inside your cheeks equals the pressure outside your cheeks, so I don't understand why they would swell. On the other hand, if had a nasal mask the pressure inside the cheeks could be higher than the pressure outside the cheeks, and that would cause them to swell.

It seems you need the pressure of 10 to treat your sleep apnea. I recommend you call whoever lowered your pressure and explain that your AHI has risen because of it. Perhaps a different mask would fix the leak problems you've been having.

[justMongo]

With pressure of 8, too many hypopneas are permitted to occur.
At 10, they were reduced.

IMHO: You would have been served better by an Auto PAP.

[quiescence at last]

I think there is a good reason your AHI bumped up besides not being used to it.

You are having more obstructive events.

I assume the chubby cheeks Are eliminated? That may have been the trade off.

I use a full face mask as well, and chubby cheeks occur at higher pressures. The cheek has a pressure difference because the cheeks are not held in by the mask. Just the front of the mouth is covered.

You would have to try a total face mask that covers your eyes and cheeks to get relief, or get used to a full mouth of air, the feeling of discomfort does wear off for me. 

Good luck. 

QAL

[gilbert123]

Thanks everyone for the input

I will visit the hospital tomorrow to meet up with the technician and to let him know that my AHI went up
due to the pressure drop.
 I will also look into buying a dreamstation auto CPAP machine.

[Sleeprider]

I like your results at 10 better than 8.  If this is typical, I sure would not trade 2-cm for double the events.  I agree, you would be better off with auto, but that is true about 90% of the time.

[trish6hundred]

Hi gilbert123,
WELCOME! to the forum.!
Good luck to you with CPAP therapy and straightening out your pressure settings.