[Treatment] AHI at 24 while using APAP 8-12mbar

[Exodus]

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AHI from Clinic: 55
AHI form Clinic while on APAP 8-12mbar: 24

I Cranked the APAP up to 12-18 mbar

I Am 1 Year in and still feel really tired all the time. I Never feel well rested and need 10-14h Sleep a day. Can't work because of that and gained lots of weight.

Have Morbus Scheuermann, Insuline Resistance, Acne Inversa and OSAS

Please help me Guys

[Dormeo]

Welcome! Your AHI is excellent, if this chart is typical. You are having some large leaks, that is, leaks that are large enough potentially to make it impossible for your machine to compensate. Do you think the leaks are coming from your mouth? Or are they coming from your mask? Or maybe some of each?

What is striking in your chart is the flow limitations. Could you zoom in on about 1.5 minutes where we're seeing a lot of those FL markers? I'd like to see what your flow rate looks like. No need to provide all three charts -- just the left-most one (labeled 3.png).

I also wonder whether your doctor has evaluated you for other conditions that might be interfering with your ability to feel adequately rested. Possible areas for testing: testosterone, thyroid, vitamin D, B vitamins, autoimmune disease, especially in the connective-tissue-disease family, iron. Any chance you have long covid or Lyme disease?

[staceyburke]

I have not seen flow limits that large... I think you need to rule out positional apnea.  Positional Apnea is when you sleep in a position where you cut off your own airway.  It is also known as chin tucking where your chin is dropping down to your sternum cutting off your own airway.  There is NO adjustments you can make on a pap machine to help this type of apnea.  The only way is not to sleep in that position.  

Sleeping on your back or using to high of pillows can be the cause and just changing that can help control it.  BUT if it does not you will need a collar.  I have a link for collars in my signature (at the bottom of this post).  Please take a look at it.

[Deborah K.]

Yes, your flow limits are extremely high.  Do you have Prisma's version of EPR in use?  If not, set it to its highest setting.  Even then I doubt that yours can be lowered enough to help much.  

You may need to obtain a bilevel machine.  The bilevel most of us think is the best is the ResMed AirCurve 10 Vauto.  Even if your machine is not old, if your doctor (any kind of doctor, even NPs, LPNs, dentists, etc.) prescribes a bilevel, your insurance should still cover it because it is a different type of machine.  If you want the specific machine I mentioned, ask your Dr. to prescribe it by name, with a note that nothing is to be substituted.

[Jay51]

Here are some tips from our Wiki on how to optimize your Lowenstein:    Lowenstein PrismaLine optimization