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AHI/RDI on CPAP therapy
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kdmorris410 Offline

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Post: #1
AHI/RDI on CPAP therapy
So in my sleep studies, my AHI was only 5, but my RDI was 15 on one, 36 on the other. My doctor was able to get me cpap therapy due to symptoms and generally it's been working well, but my AHI, while good, is still a little higher than I thought it would be. I've only been on cpap for 12 nights, but my AHI has only been below 2 twice. In another thread, someone mentioned that I might need to increase my lower pressure from the native 4. I thought my doctor would go over the info with me, but I basically saw the nurse who said everything looks great and sent me on my way. I'm pretty sure all they cared about is that I'm compliant.

My AHI has in order from first night to last night has been: 1.76, 2.75, 2.99, 2.60, 1.65, 2.3, 2.15, 2.61, 3.01, 2.66, 2.03, 2.59. The good news is that the RDI has been just a little bit higher than each of these... always under 5 though. I have had to add a chin strap to my Wisp mask due to very high mouth leakage, but I had to do this on my own. I don't want to move to a full face mask yet if I can avoid it.

So, I was thinking about following the advice to raise my lower pressure from 4 to 5 or 6. But I was wondering if I will "get in trouble" for this? Will someone notice and freak out that I'm outside of the "prescription range"? I've gotten the best sleep of years over the last couple of weeks and I don't want to do anything to jeopardize that. I'm renting the machine, if it makes a difference.

If you were me, would you increase the lower pressure to 5 or 6?
03-05-2015 07:03 AM
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DeepBreathing Offline
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Post: #2
RE: AHI/RDI on CPAP therapy
From what others have written on this forum,most of the DMEs and docs are interested in your compliance hours, possibly your AHI, and not much else. If I were you I wouldn't worry about their reaction.

On the other hand, you've got excellent results for only a couple of weeks in. It took me months to get below two! Remember, under five is classed as no apnea, so you're doing well.

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03-05-2015 09:06 AM
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OpalRose Offline

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Post: #3
RE: AHI/RDI on CPAP therapy
kdmorris410,
You are off to a really good start.
Alot of Doctors leave that setting at 4-20, but you can get even better results if your bottom number is moved up to maby one or two numbers below where you are spending 90% of the time at.
And no, you won't get in trouble. My machine is rented too, and the Doc and DME only cared about my AHI number and if I am compliant, not settings.
Good Luck!
OpalRose
Sleep-well

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(This post was last modified: 03-05-2015 09:34 AM by OpalRose.)
03-05-2015 09:32 AM
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kdmorris410 Offline

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Post: #4
RE: AHI/RDI on CPAP therapy
(03-05-2015 09:32 AM)OpalRose Wrote:  kdmorris410,
You are off to a really good start.
Alot of Doctors leave that setting at 4-20, but you can get even better results if your bottom number is moved up to maby one or two numbers below where you are spending 90% of the time at.
And no, you won't get in trouble. My machine is rented too, and the Doc and DME only cared about my AHI number and if I am compliant, not settings.
Good Luck!
OpalRose
Sleep-well

So, per Sleepyhead, my 90% number is 10.84. So that leave me some room to play with, I guess.

I might set it to 6-20 for pressure and leave it like that for a couple of weeks to see if I can get my AHI to below 1. That would be nice, considering that my AHI was fairly mild anyway.
03-05-2015 01:29 PM
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Sleeprider Online
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Post: #5
RE: AHI/RDI on CPAP therapy
(03-05-2015 01:29 PM)kdmorris410 Wrote:  
(03-05-2015 09:32 AM)OpalRose Wrote:  kdmorris410,
You are off to a really good start.
Alot of Doctors leave that setting at 4-20, but you can get even better results if your bottom number is moved up to maby one or two numbers below where you are spending 90% of the time at.
And no, you won't get in trouble. My machine is rented too, and the Doc and DME only cared about my AHI number and if I am compliant, not settings.
Good Luck!
OpalRose
Sleep-well

So, per Sleepyhead, my 90% number is 10.84. So that leave me some room to play with, I guess.

I might set it to 6-20 for pressure and leave it like that for a couple of weeks to see if I can get my AHI to below 1. That would be nice, considering that my AHI was fairly mild anyway.

If you were using a fixed CPAP, the correct titration would be approximately at your 90% pressure. What is your median or mean pressure? That is usually a good minimum APAP pressure. It will prevent most events including snores and flow limitation. I would bet that if you set your minimum pressure at approximately your mean nightly pressure, you would cut the current AHI in half.

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03-05-2015 02:33 PM
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kdmorris410 Offline

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Machine: Resmed Airsense 10 AutoSet for Her
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Post: #6
RE: AHI/RDI on CPAP therapy
(03-05-2015 02:33 PM)Sleeprider Wrote:  
(03-05-2015 01:29 PM)kdmorris410 Wrote:  
(03-05-2015 09:32 AM)OpalRose Wrote:  kdmorris410,
You are off to a really good start.
Alot of Doctors leave that setting at 4-20, but you can get even better results if your bottom number is moved up to maby one or two numbers below where you are spending 90% of the time at.
And no, you won't get in trouble. My machine is rented too, and the Doc and DME only cared about my AHI number and if I am compliant, not settings.
Good Luck!
OpalRose
Sleep-well

So, per Sleepyhead, my 90% number is 10.84. So that leave me some room to play with, I guess.

I might set it to 6-20 for pressure and leave it like that for a couple of weeks to see if I can get my AHI to below 1. That would be nice, considering that my AHI was fairly mild anyway.

If you were using a fixed CPAP, the correct titration would be approximately at your 90% pressure. What is your median or mean pressure? That is usually a good minimum APAP pressure. It will prevent most events including snores and flow limitation. I would bet that if you set your minimum pressure at approximately your mean nightly pressure, you would cut the current AHI in half.

My median is 8.7 or so
03-05-2015 07:20 PM
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Sleeprider Online
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Post: #7
RE: AHI/RDI on CPAP therapy
Like I said, a minimum pressure of 8.5 would work great.

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03-05-2015 09:52 PM
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ClarkK Offline

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Post: #8
RE: AHI/RDI on CPAP therapy
My initial settings were 5-20. I told them I was uncomfortable at the 5, and asked for a settings change which got my bottom number raised. A helpful respiratory therapist at the DME suggested my range be raised to 8-20 to get that bottom number closer to my 90% number which was between 9-10. That both made me far more comfortable at start up and lowered my AHI.

I'm only 45 days into this -- but loving my CPAP (and the forums I lurk in) :grin:

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03-07-2015 04:24 AM
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on the virge Offline

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Post: #9
RE: AHI/RDI on CPAP therapy
I am using Sleepyhead data and so are you. Here is what I did. I have been keeping track of how much time I "spend" in each of the "pressure cells" from the "By Pressure wave form" on the details page. I am using a spreadsheet but pencil and paper works. For each day since I began in January, I record the minutes at pressure. In my spreadsheet, I keep a running calculation of the average time in each "pressure cell". Last week I decided to change my lower pressure from 8 to 7 because I was spending about 78% of the night in the 8-cell with average pressures around 8.5 and my AHIs were good. I am now keeping the pressure data matrix since I changed and observing the differences in my apnea events. Next week I will meet the doctor for the first time and together we will decide the best pressure range based on the data.
My wife recently began using APAP and we are analyzing her data similarly. She had not been titrated and initial pressure range was 4-9. The data show she is not spending very much time in the 4-cell and a number of her events occur while she is there. So this morning we decided to increase her lower pressure to 5 and again analyze the result. Once we have the data, we will present the analysis to her sleep doctor for consultation based on data.
By the way, her sleep doctor recommends patients use Sleepyhead.

Something to consider.
03-07-2015 03:09 PM
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OpalRose Offline

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Post: #10
RE: AHI/RDI on CPAP therapy
(03-07-2015 04:24 AM)ClarkK Wrote:  My initial settings were 5-20. I told them I was uncomfortable at the 5, and asked for a settings change which got my bottom number raised. A helpful respiratory therapist at the DME suggested my range be raised to 8-20 to get that bottom number closer to my 90% number which was between 9-10. That both made me far more comfortable at start up and lowered my AHI.

I'm only 45 days into this -- but loving my CPAP (and the forums I lurk in) :grin:

Hi ClarkK,
Glad your "lurking", there is alot to learn here! Your settings sound like their right on track. Good Luck!
Sleep-well
OpalRose

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03-07-2015 04:47 PM
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