[Pressure] Lowering AHI

[oliviaissleepy]

I've been using CPAP for three months now. My first two months were great, with my AHI consistently under 1. I felt amazing. But while traveling the first week of June, my machine started having problems with airflow after a power outage and surge. I got my machine replaced and have struggled to get consistent results ever since. I find that I feel the difference in energy and brain fog between, for example, an AHI of 0.3 vs an AHI of 0.8. I've tried playing around with EPR and it initially lowered my AHI, but only for a couple nights. I have included screenshots from the last three nights. I would love any and all suggestions.

[Phaleronic]

Welcome to the forum oliviaissleepy

You're on fixed pressure at 8cm with EPR on 3, you please need to raise the pressure to 9.4cm for now or turn EPR down to 1, EPR at 3 really needs higher pressure to support apnea control, and you are having quite a few CA events as well.

You are also having some serious leaks, what is your sleeping position?

[oliviaissleepy]

Thank you for the welcome and advice! Would lowering the EPR help with CA events? 
I typically fall asleep on my side, but sometimes wake up having moved onto my stomach.

[Phaleronic]

You're welcome, and stomach sleeping is problematic as the best when on SA therapy, that may be where the leaks are coming from. Yes, lowering the EPR will help with the CA events.

[HalfAsleep]

Be careful about falling asleep on your belly. Masks have exhaust valves for CO2. You don’t want to run the risk of blocking them. You don’t want to get it buried in bed coverings or a pillow.

I’m not skilled with settings advice, but I wouldn’t be able to exhale with an epap of 5. I need higher. In this regard, I am pretty typical for adults.

For your next batch of charts, de-select the calendar, so folks can see the bottom of the left column.

[oliviaissleepy]

Hi! A few days ago I asked on here about managing my CA and was advised to lower my EPR from 3 to 1. I did so, and at first it worked really well for me-- I actually had a night with an AHI of 0! But after a few nights, my AHI has risen again. What can I do to get it back down? Thanks in advance!

[Narcil]

your AHI is very good, you had a bit of positional apnea on the 31st but nothing to worry about unless it happens repeatedly. You cannot expect to be at 0 every night.

Did your sleep study note CAs? How long have you been on CPAP?

i wouldn't touch settings and i wouldn't turn EPR off cuz you have some flow limits remaining. seems to be a good balance for now.

[OpalRose]

olivaissleepy,
I'm combined your two threads.

This will be easier for those that wish to advise, to see your history in one place.

[oliviaissleepy]

Thank you for your reply! I don’t have the data from my initial sleep study so I’m not sure if there were CA there, but I do know that there were CA recorded during my CPAP titration. I have been on CPAP for just three months now.

[SarcasticDave94]

The prescribing physician would have that sleep study report on file. Call the office, request the full diagnostic report. Post it in a new post as attachments from your computer, redacted of your personal info.

You'll really want it in your own personal health file anyway, so it's worth getting. This may prevent you from being forced to take a test again if the need crops up.

Oh, bonus info. The doctor must give you a copy once requested. No is not acceptable on this request, just ask HIPAA law.