Sudden jump in AHI

[redslug]

Hi,

I'm new to CPAP and would like some help in understanding what is causing the sudden jump in AHI I've observed last night.

I've started therapy a few weeks ago and while I'm struggling a bit in finding the best tradeoff between mask comfort, leak level, and AHI, I've been generally successful in keeping the AHI under 2-3 and the leak rate under the large leak level.  However, my AHI spiked last night (especially CA) and not really sure why. The main change on my end last night is that I tried to wear the mask a little higher to give some relief to my nose bridge.

I attached my Oscar screenshots for a couple of previous nights and for last night.

Thanks!

[Gideon]

Welcome to the forum.
The reason your AHI went up is you had a group of central apneas, why I don't know.

You do have excessive flow limits which I believe are the cause of your higher pressures. The higher pressures could cause the central apneas.

On future charts please include the flow limit chart and remove the respiration rate chart.

To better manage your flow limitations
Set your min pressure to 7 which will allow full utilization of EPR
Set EPR=2, Fulltime. EPR is your best treatment for hypopneas, RERAS, UARS, and Flow Limitations.
ResMed uses flow limitations as one of its reasons to increase pressure so by minimizing them we reduce pressure.

[redslug]

Thanks for your response.  I will try these settings.

For reference, I have attached here the same screenshots with flow limit.

[clownbell]

@ Gideon - curious why you have recommended EPR of 2 rather than 3.

[redslug]

Last night was a bit better (AHI ~5. see pic attached), but still quite a high AHI compared to what I have been able to achieve in the prior weeks.  I'm also puzzled by the number of OA events as I thought I had been able to nearly get rid of them.