Up starting Pressure?

[Weird Tolkienish Figure]

I feel great! BUt AHI is still too high and I am getting post lunch crashes. I have attached my sleepyhead data, is it time to up starting pressure? I have kept it at 5.

[Sleepster]

I suggest a minimum pressure of 9. You are having lots of hypopneas when the pressure is low.

[Weird Tolkienish Figure]

I think I will try to incrementally up the starting pressure to 9 starting with 6, maybe by week. Thanks!!

[Sleeprider]

The problem is the too low minimum pressure of 5.0. Your average pressure is over 11.0 and your 95% pressure is 17.6. I think a minimum pressure of 9.0 is fairly conservative, and your proposal to use 6.0 will not have the desired effect. From this graph, I would have suggested a minimum pressure of 11.0 since you have many hypopnea and snores below that pressure.

Your initial round of hypopnea occurred at low pressure, and by the time your machine caught up you had already had many events. Later in the night you had a cluster of OA that arose out of a pressure of 15.0. This could be a matter of sleep position or REM. On the positive side, you had really good results between 0:00 and 01:00 where your pressure leveled out at 14-15 cm.

You are one of the minority of people with an inverse I:E ratio where inspiration is about half of your exhale time. We don't know if that is a problem, however, the stubborn high rate of hypopnea and clusters of OA seem to go hand in hand with that pattern.

[Sleepster]

I agree. As long as you are not experiencing any discomfort or other issues associated with the higher pressures, 9 is a conservative lower end. It would probably need to be higher than that, and anything lower won't help much.

[Weird Tolkienish Figure]

I will start with 9 and see how it goes. My average AHI isn't represented by this one night, and from looking at the data since Halloween, when I started, average AHI is way down. I didn't realize this but on my second night (back in November) my AHI was over 30!