help requested with ahi

[rogerncormier74]

I've only been on CPAP for about 6 months now.  Trying out the airfit f20 because I found I was opening my mouth.  Lately my ahi has been going up above 5. Last night was 5.4. When looking at what made up the number, I always notice the hypopnea number is usually much higher than obstructive or clear airway. My hypopnea was 38, clear airway 7 and obstructive 1.  I have a dreamstation auto machine with a pressure range of 7 to 11. My 90 percent pressure seems to go from 8 to 9.5 lately.  Any ideas on what I can try to bring the number down?  Tips to bring the hypopnea number down? Thanks.

[ajack]

I would move the min pressure to 8 for now. I would download sleepyhead from the top of the page, as well as get the clinical manual for your machine from the links too. When you get some charts up, a clearer picture can be seen.

[Melman]

Welcome to the forum. ajack is correct in recommending that you post data. We can't provide much help without it. See the links below for how to organize and post SleepyHead data.

[rogerncormier74]

Hi guys, here is my data from last night.
A little better last night, but not by much.  Only thing i did last night was raise my minimum range to 8.
Any ideas?

[Walla Walla]

Maybe bump it up .5 more but I wouldn't go further than that for now.

[rogerncormier74]

I think i read somewhere that lowering or removing Flex can help with hypopneas?  My Flex is currently at 2 A-Flex.  Is this something I should consider?  I just questioned since a lot of my ahi seem to come from hypopneas.

[Walla Walla]

Lowering the flex won't reduce the hypopneas. It may help reduce the clear airway events though.

[Gideon]

Based on this chart I would disable the flex, if that makes you uncomfortable set to a lower value.  You need to keep a close eye on the central apneas and make sure they either drop or do not significantly go up.   You are nearly at a single pressure of 8, with some excursions above 8.  Sometimes we recommend fixed CPAP when we see centrals.  Not yet, but i'd like to see how you do without flex.

Fred

[SideSleeper]

My original prescription was for A-Flex 3 and like most newbies I had a lot of CA's. I followed information from this group and went to A-Flex 1. Mine have been practically eliminated but it took awhile. I'm now going after the hypopneas--fairly successfully--by bumping my low number from 10 to 11.5 and the top from 11 to 13.5 over a period of a couple of months. Hypops way down--had four 0.0 AHI nights in the last 10. Have high RERA's and I'm going to bump up the top soon to see if I can do anything about them. I keep my high and low figures pretty close since the PR machines are slower to react--and my sleep doc said I'd b probably be best in the 10 to 14 range--which has proved to be true. I have used CPAP 11 for long periods at a time also, but I like the freedom of APAP--and the results! Good luck

[rogerncormier74]

I noticed there were a couple Flex settings.  One that said A-Flex, C-Flex and None and one where you could change the Flex value.
Do I change that one that says A-Flex to None?  Does the Flex number one get changed also?
As for central apneas, my therapist initially recommended I go to fixed pressure.  That is what she prescribed as she said she noticed my centrals went up if the pressure went too high.
She had recently changed me to auto though at my request as I wanted to see what changed.  I knew I needed more pressure as my AHI number was never low anymore.
I am currently sitting a a range of 8 - 11 pressure for now.  I will try to change that Flex tonight and see if that changes anything.
Thanks.