[Treatment] Husbands AHI numbers not dropping .

[FrustratedWife]

My husband has been trying to adapt to his CPAP for four months now and is still not getting the desired results. Can you give us some insight on what we might try. He is a very active 81 year old diagnosed through an overnight sleep study to need help. His AHI was in the 35 area and although he is using the machine nightly it is still in the 18 to 24 range. He had mask leakage problems to start but that improved when increased mask size to large. His mask was getting into his mouth and thus leaking. His pressure has been increased from the starting 8 to 14 to current 12-18. Problem now it blows out when it gets high.
BIG THANKS to my reading a post yesterday about skin oils and cleaning mask area with soap. Last night was MUCH better. 94% fit. and AHI at 18.1
Problem is HOW to lower his AHI as I have read it should be about 5 or less. He is using the mask four to six hours per night. When pressure gets high and starts leaking he get frustrated if unable to stop and he takes it off. Reading last night was : 3 clear/94Obstructed/8 Hyp.for AHI of 18.1.
Using Dream Mapper to follow. How long does it usually take to get the lower numbers???? Help -- I need to get more sleep myself so solving his problem will be so helpful.

[tmoody]

What kinds pig events does dream mapper report when you tap the "details" tab? How many centrals, obstructive, and hypo? That will give us an idea what's happening.

[Sleeprider]

Your husband's Dreamstation Auto produces data that we can use to see where and why the problems exist. The software to read that data is free, and is linked at the top of this forum page. Just download and install Sleepyhead. You can then use the SD card in the back of that machine to upload all of his results. This article describes some of what you can expect, and the instructions for posting data https://sleep.tnet.com/resources/sleepyhead

Without knowing some of the information being produced by his machine, it will be very difficult to guide you. Please take a look at the software and ask any questions about how to use it to let us help you.

[FrustratedWife]

The readings for the last few days: May 10 -- Clear 3/ Obst 94/ Hyp 8 =18.1 AHI in 5.48 hrs
May 9 -- 1/ 50/ 27 =17.9 AHI -- 4.20 hrs
May 8 -- 2/ 67/ 5 =18.4 AHI - 4.0 hrs
May 6 -- 4/ 99/ 2 = 18.7 AHI -- 5.36 hrs
The pressure was increased on May 4th from 8 - 18 to 12 - 18 thinking unit not responding fast enough.

Some Readings prior were 16/22/4 = 23.8 AHI for 5.58 hours
33/94/4 = 30.1 4.21
His AHI the first week starting was 35.4 = 13/149/19 so has improved some.

I have read how to figure the AHI by adding and dividing but have never come out with right number .

This site has been so much help as I have been so encouraged that we will find a solution to help him. I feel we did not get enough information when we started and now have a place to reach out for assistance. Thanks

[eseedhouse]

My take is that the most important thing is to get used to sleeping the whole night with the mask on the face. That may mean a lower pressure than is optimal and an AHI greater than 5. But don't panic about that - after all his apnea is already better on the machine than off it. I'd find a range he can sleep a full night with regularly, and once that is achieved then start upping the pressure slowly until the AHI is under control. A better fitting mask will likely be part of the successful formula. He may need a very high pressure to control his apnea and that would mean either a lot better fitting mask or another type of machine. As we get older it takes longer to adapt to things.

[FrustratedWife]

We were to test the new pressure for a week so I will call tomorrow and get an evaluation through the doctors office and Phillips. Will continue to encourage him to use it ALL night.

I use an Apple MacBook Pro and when I tried to download SleepyHead by using the name at the top of these pages, Safari could not open. I am not a computer whiz and need some guidance. I did just a search and came up with some options, but still unable to figure out how to download Sleepy Head. I saw a chart someone else showed in their request area - WOW lots of info so would like to be able to use.

[trish6hundred]

Hi FrustratedWife,
WELCOME! to the forum.!
Hang in there for more answers to your questions and much success to your husband with his CPAP therapy.

[Sleeprider]

The readings for the last few days: May 10 -- Clear 3/ Obst 94/ Hyp 8 =18.1 AHI in 5.48 hrs
May 9 -- 1/ 50/ 27 =17.9 AHI -- 4.20 hrs
May 8 -- 2/ 67/ 5 =18.4 AHI - 4.0 hrs
May 6 -- 4/ 99/ 2 = 18.7 AHI -- 5.36 hrs
The pressure was increased on May 4th from 8 - 18 to 12 - 18 thinking unit not responding fast enough.

Some Readings prior were 16/22/4 = 23.8 AHI for 5.58 hours
33/94/4 = 30.1 4.21
His AHI the first week starting was 35.4 = 13/149/19 so has improved some.

I have read how to figure the AHI by adding and dividing but have never come out with right number .

This site has been so much help as I have been so encouraged that we will find a solution to help him. I feel we did not get enough information when we started and now have a place to reach out for assistance. Thanks

Obstructive apnea is still very high for your husband. The pressures he is using should be more effective, and I think he has a particularly stubborn case that may be related to his sleep position. If he is predominately a back-sleeper, the airway can be more difficult to splint open with positive pressure. There are a couple things you can try. You might try to encourage side-sleeping, but most people are pretty resistant to that change. Another solution some members have found that works, is the use of a soft cervical collar. These are available very inexpensively at your drug store, and it works to prevent the chin from dropping into the chest. It is soft like a foam pillow, not the kind they strap on for a neck injury. The idea is to fit him with this to prevent his airway from closing due to head/neck position.

I know it sounds a bit odd, but it may be worth a try. Won't cost much.

[FrustratedWife]

The readings for the last few days: May 10 -- Clear 3/ Obst 94/ Hyp 8 =18.1 AHI in 5.48 hrs
May 9 -- 1/ 50/ 27 =17.9 AHI -- 4.20 hrs
May 8 -- 2/ 67/ 5 =18.4 AHI - 4.0 hrs
May 6 -- 4/ 99/ 2 = 18.7 AHI -- 5.36 hrs
The pressure was increased on May 4th from 8 - 18 to 12 - 18 thinking unit not responding fast enough.

Some Readings prior were 16/22/4 = 23.8 AHI for 5.58 hours
33/94/4 = 30.1 4.21
His AHI the first week starting was 35.4 = 13/149/19 so has improved some.

I have read how to figure the AHI by adding and dividing but have never come out with right number .

This site has been so much help as I have been so encouraged that we will find a solution to help him. I feel we did not get enough information when we started and now have a place to reach out for assistance. Thanks

Obstructive apnea is still very high for your husband. The pressures he is using should be more effective, and I think he has a particularly stubborn case that may be related to his sleep position. If he is predominately a back-sleeper, the airway can be more difficult to splint open with positive pressure. There are a couple things you can try. You might try to encourage side-sleeping, but most people are pretty resistant to that change. Another solution some members have found that works, is the use of a soft cervical collar. These are available very inexpensively at your drug store, and it works to prevent the chin from dropping into the chest. It is soft like a foam pillow, not the kind they strap on for a neck injury. The idea is to fit him with this to prevent his airway from closing due to head/neck position.

I know it sounds a bit odd, but it may be worth a try. Won't cost much.

THANKS for the tips. We have a collar here so will give that a go tonight.

[PoolQ]

Meanwhile, not using the mask could be caused by several different things and it looks like you are already going after treatment pressure. Also look into humidity/temperature settings if you machine is fitted with one and the flex settings. Try to get him to focus why he is removing the mask, what is it feeling like? Not enough air? hard to exhale? Fighting the machine to breath? congested?