New DreamWear FFM - conclusions and a question how to proceed with treatment

[Arik]

Hi Guys,
 
After 2 weeks with the DraemWear FFM, that replaced my Nasal mask , I can conclude the following:
 
1.      Quality of sleep is much better.
2.      Significant leak that I have with the nasal mask reduced to normal (2.5L/min).
3.      AHI decreased from about 10 to 5 or less as follows:
      a.      Obstructive Apneas – 0.
      b.     Central Apneas – 0.
      c.      Obstructive Hypopneas – about 3/hour.
      d.     Central Hypopneas – about 3/hour.  (it looks like having more of these with the FFM..).
4.      Current settings:
      a.      Pressure – 4-12 (Median reduced from about 9 to 5 cmH2O, P90 is 6.5). 
      b.     softPAP=2 (meaning reducing 2 cmH2O on exhale).
 
Please advise how I can further improve the treatment. See attached file for more details.
 
Note 1: Does it make sense to have more central events with the FFM?
Note 2: Not absolutely sure that the PRISMA 20A knows to distinguish between Obstructive and Central Hypopneas but consider it as true for the sake of the discussion,
 
Thanks,
Arik.

[jaswilliams]

If that was my graph I would look at increasing the minimum pressure to a much higher value say 8 and see if your events drop further as more minimum pressure is needed to treat the Obstructive apnoea, we may need to go even higher but lest try there first