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AHI of 9.83 with cpap.
#1
I have been using cpap for 3 months. I am concerned about my results.

SleepHead message when I down load data:

The last time you used your ResMed AutoSet...
was last night (on Saturday, December 26, 2015)
You had an AHI of 9.83, which is considered not very good
You machine was on for 8 hours, 2 minutes and 1 seconds.
You had no major mask leaks (maximum was 24.00 L/min).
Your pressure was under 16.34cmH2O for 95% of the time.

Should I be concerned? What should I do?

Date Sleep Wake Hours
12/27/2015 02:24:55 10:32:40 08:02:01
Cheyne Stokes Respiration 0.00%
Large Leak 0.00%
Clear Airway 3.86
Obstructive 3.86
Unclassified Apnea 0.00
Hypopnea 2.12
RERA 0.62

Event Breakdown

Statistics
Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 9.52 4.00 9.00 16.34 18.00

Total time in apnea 00:20:03
Time over leak redline 0.000%
Machine Settings

ModeCPAP Mode APAP
Pressure MinMinimum Therapy Pressure 4 cmH2O
Pressure MaxMaximum Therapy Pressure 18 cmH2O
EPRResMed Exhale Pressure Relief Full Time
EPR LevelExhale Pressure Relief Level 2cmH2O
Typical results.


Total time in apnea 00:20:03


Attached Files Thumbnail(s)
   
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#2
I would double check these statistics with ResScan. If you are concerned you need to meet with a competent specialist. I can usually see something that I can at least make a guess at adjusting, but in this case everything except the AHI itself looks good.

The other thing you might do is get an oximeter so you can see if your oxygen level is dropping. Look and see if any of the events are lasting significantly longer than 10 seconds. What was your untreated AHI? Do you feel well rested on at least some mornings?

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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#3
ResMed's "myAir" shows the same number of "events" per hour - 9.8 on their report for from last night. I was at 18.3 AHI untreated. I feel better then before on most days. I am meeting with the sleep doc in about a month.

Thank you for the feedback.
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#4
Hi CPAPjim,

First of all, your Min Pressure is way too low. Unfortunately, all too often doctors do not pay attention to the titration results and prescribe pressure settings which are wide open.

The Start Pressure for the Ramp and even the Min Pressure which follows the end of the Ramp are mostly comfort parameters which should be adjusted according to patient preference, unless the doctor wants a higher Min Pressure. But the Min Pressure should never be set a great deal lower than the pressure you need a significant amount of the time.

I recommend having the Min Pressure set not lower than 6 (and preferably not lower than 3) cm H2O below the 95 percentile pressure. The 95% pressure is the pressure your mask was at or below, for at least 95% of the time; it is also the pressure your mask was at or above for at least 5 percent of the time.

Between obstructive events which cause the pressure to be raised, the Min Pressure is treated by ResMed machines as a target which it is always trying to get back to within 20 minutes. The lower the min pressure is, the faster the pressure decays between events, leading to more events occurring because the pressure becomes too low, too quickly.

However, the Min Pressure won't need to be raised to 10 or higher if you can lower how much pressure you need, meaning if you can get the 95% pressure to stay a lot lower than 16. And we can usually lower how much pressure we need (by a lot!) by avoiding sleeping in the supine position. I think most patients find they need to take precautions to make sure they are never rolling onto their back while asleep.

If you need to use the ramp, I suggest having it's Start Pressure raised to like 6 or 8, or whatever is comfortable. If you do use the Ramp and the Ramp is in AutoRamp mode, the machine will hold the pressure at the ramp Start Pressure until you fall asleep (or until it gives up waiting for you to fall asleep) and then will fairly quickly ramp the pressure up until it reaches the Min Pressure, after which it will respond to obstructions or stay steady. Or, you can use the Ramp in timed mode, in which it does not wait for you to fall asleep, it just starts gradually increasing the pressure to reach the Min Pressure within an adjustable time limit.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#5
Agree bring your min pressure up to 7 or 8.
Your max and 95% will come down.
The mn is way to low. Taking your machine to long to get up where it needs to be.
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#6
Hi CPAPjim,
WELCOME! to the forum.!
Much success to you with your CPAP therapy and getting it fine tuned to meet your needs.
Hang in there for more responses to your post.
trish6hundred
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#7
Yet another vote to set th minimum pressure to 7 or 8. Then after a week or so look at your max see if you can gradually lower that.
You don't want the machine to be so restricted that it can't reach the required pressure for proper treatment,but you do want keep the range as close as possible to your upper and lower requirements.
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#8
I tried minimum of 6 last night and had better results. 5.8 AHI. I will move it to 7 tonight and see if it gets even better.

Thank you for the responses.
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