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+--- Thread: Not able to achieve AHI below 1 consistently (/Thread-Not-able-to-achieve-AHI-below-1-consistently)
RE: Not able to achieve AHI below 1 consistently - UnicornRider - 11-24-2023
I am glad to find you are going with PL&P's recommendation of pressure Min 10.0, Max 15.0, EPR 2 cmH2O.
When you mention "Ergonomic Pillow" are you referring to an incline or ramp shaped pillow? Do you have heart burn or Gastroesophageal reflux disease (GERD)?
I really think you would benefit from PL&P's suggestion "Read the “optimising therapy” link in my sig. It has very good information."
I have use their printable version to make a three ring binder of the printed Guide to Optimizing Therapy. That enables me to refer to the guide, while on line with the Apnea Board forum. I also share the printed version with other elderly people I am helping with therapy off line.
https://www.apneaboard.com/wiki/index.php?title=Optimizing_therapy&printable=yes
It has screenshots, graphs, drawings as well as printed descriptions of answers, to all of your questions. It is easier to guide you after you have that information to refer to.
I think you are getting close to finding that "sweet spot"
RE: Not able to achieve AHI below 1 consistently - PeaceLoveAndPizza - 11-24-2023
First thing, you don’t need to quote replies. Simply responding will be enough as those following the thread will be able to figure out to whom you are responding. No big deal that you have quoted, it is just easier to follow without quoting. If you do feel you need to quote something, you can edit it in the window to remove the extraneous information.
The pillow I personally use is a Contour CPAPmax pillow at home and when travelling. There are plenty to choose from on the market.
Onto flow limits. The best explanation I have seen is that it is comparable to kinking a garden hose. When you have it in a straight line you have full flow, but when you start bending it at a point you impede the water flow which slows the amount that comes out at the end (flow limitations). If you continue kinking it you will dramatically impact flow (hypopnoea). If you bend it all the way to a 180, you completely stop the flow (obstructive).
The more things get “kinked”, the more pressure is needed to open the airway.
Central apnoea/clear airways are different beasties as they are related to when the need to breathe is slowed or stopped for a period of time.
There is a lot of great information in the wiki on all these topics. Highly recommended reading with a nice glass of Chianti….
RE: Not able to achieve AHI below 1 consistently - aslotaru - 11-28-2023
changed to 10-15 EPR 2, AHI still higher than previous setting 8-10.2 EPR off
Any comment?
RE: Not able to achieve AHI below 1 consistently - SarcasticDave94 - 11-28-2023
It doesn't look bad here on the data. However here's the all important test for effectiveness.
How did you feel after sleeping session that created the chart? We're digging for some details, so not one word OK, FINE, BAD, etc. Just trying to highlight it's about how you're feeling with therapy as a result. Numbers are great to help guide, but low numbers aren't the whole picture.
I myself felt better with about 3 AHI than zero, and I did get both with the same settings. My theory was my ASV had to add extra that made sleep worse despite AHI zero score.
RE: Not able to achieve AHI below 1 consistently - aslotaru - 11-28-2023
Honestly I still feel sleepy in the middle of the day
I remembered when I'm using it the first time, it's very impressive, but after several months, I lost that significant improvement feeling
Talking about my current setting, I'll wake up in the middle of the night, not able to sleep through
RE: Not able to achieve AHI below 1 consistently - aslotaru - 11-30-2023
Should I change the pressure range? Also epap?
RE: Not able to achieve AHI below 1 consistently - PeaceLoveAndPizza - 11-30-2023
Your flow limits are a bit high and likely impacting sleep quality. As a suggestion to try, consider setting your pressure range of 11-14 with EPR 3. Depending on how the flow limits look, we may ask you to decrease EPR back to 2.
A bit more pressure should help with the OA’s and the extra EPR should help with flow limits. Let’s see how it goes.
RE: Not able to achieve AHI below 1 consistently - aslotaru - 11-30-2023
I tried epap 3 before, not comfortable, feels like braking, it worsen my AHI
RE: Not able to achieve AHI below 1 consistently - PeaceLoveAndPizza - 11-30-2023
Back to my original proposal.
You need more EPR to handle the flow limits and stop the wild pressure swings. If you have problems with EPR 3 you likely need to increase pressure to offset the extra pressure relief. Something like 11-14 EPR 3.
Your events still look positional to me. You need to find a way to stop kinking your neck and a soft cervical collar is the easiest way to do so.
RE: Not able to achieve AHI below 1 consistently - aslotaru - 11-30-2023
Where can I get a cervical collar?