Are "events per hour" on the MyAir App the same as AHI ?

[theMezz]

Had an appointment with ENT today.
First time I've met him. 
He was pretty into sleep apnea and CPAPs

I told him my story

[to recap anyone reading:]

1) Diagnosed with AHI 21 in-home test
2) Got APAP that only created higher AHI's 20-40
3) Had in-clinic overnight titration that showed CPAP 9 would work (wrong!)
4) Exchanged CPAP for another (same model - different firmware)
5) AHI's in low teens
6) Added c-collar, now AHI 8-9
7) After a couple few more weeks AHI median is 6.8

ENT examined me and said all looked good and that I 6.8 is just fine as long as I feel better. "Don't get too hung up on the numbers, if you feel better" 

I DO feel *MUCH* better, but I told him I wanted below 5 and that I have lowered the max pressure form 20 to 15 which he totally agreed with.

I also told him I was slowly increasing the min of 4 by .4 every couple of weeks, he also thought THAT was a good idea.

Bottom line is to keep doing what I am doing and that my airways look ok. 

He stressed that the numbers are important but that I should consider how I actually feel more than the numbers. 

So a few days ago I went from 4 min to 4.4 and I am going to creep that up every few days towards 8 and see what happens.

Thanks .. 

[Sleeprider]

Given that your median pressure has always been in excess of 10.0, and that our advise has always been to raise your minimum pressure to match your median, I think you are perhaps finally on your way. There is no mystery that your minimum pressure has been too low.

[1holegrouper]

Thank you all for this fascinating thread. I'm glad to hear that you are doing better. Hope that things continue to improve for you.

[theMezz]

I have two suggestions: First, I would raise the minimum pressure up to 8 or thereabouts, but only by .4 or .6 cmH2O every three or four days, so that your body can adapt to the increases. This is based on your Median Pressure being 9.7 or higher.
Second, You have what I call a 'grassy' flow limitations graph, as I did. I found the cure for that was to use the Exhalation Pressure Relief at the maximum level of 3. This may require a further increase in your minimum pressure, but we would watch your charts to see how they go.
These changes are made in the Clinical Menu, which is accessed from the regular menus by pressing both the Home button and the Round knob for 3 to 5 seconds. The Clinician's Manual is useful here, and can be obtained by following the directions you'll find after clicking on the CPAP Setup Manuals in the menu bar at the top of the page here. Pardon me if you already know this - I tend not to re-read an entire thread before commenting.

THANKS,!

Min pressure now at 4.4 for day #4 and AHI dropped below 4
Nice!

[attachment=8141]

[Sleeprider]

Your median pressure still moves quickly to over 9-cm. I think you'd do better if you would just short-cut the minimum pressure to 7.0.

[theMezz]

Your median pressure still moves quickly to over 9-cm. I think you'd do better if you would just short-cut the minimum pressure to 7.0.

Do you mean just move from 4.4 to 7 in one jump or keep using .4 increments ?

[pholynyk]

I think SleepRider wants you to go directly to 7, and I see from reviewing my own early changes that I bumped my pressure by 1 cmH2O each time I moved up. I guess I tend to be more cautious in my advice than in my practice. A lot of people start out at 6 with no problems; I found That I was sucking air - working hard to pull enough air - until I got up to 8 cmH2O. At these low pressures I found that the ramp was irrelevant, and I turned it off.
There's no reason why you shouldn't try 7 cmH2O, as it will short circuit the time it takes to get to effective pressures for you. If you find the new pressure uncomfortable, you can always back off a bit. I think you will end up somewhere around 8 eventually. The object is to have both low AHI and good comfortable sleep.

[Sleeprider]

I mean just do it. I can assure you this is a thoughtfully considered recommendation, based on looking at many charts you have posted. Your median pressure will still be a bit higher than 7, but this puts you in the right therapy neighborhood.

[theMezz]

I mean just do it. I can assure you this is a thoughtfully considered recommendation, based on looking at many charts you have posted.  Your median pressure will still be a bit higher than 7, but this puts you in the right therapy neighborhood.

When I told Doc I was moving min it up, he said up it a little, wait a few days and up it a little again until I was higher 

But I like the idea of just going to 7

[Sleeprider]

I rarely see anyone treated for obstructive apnea at pressures less than 6.0. The Resmed Autoset is a great machine, and it thinks you need between 9 and 11 cm of pressure, but it doesn't hurt to give it a head start. It is this minimum pressure which will support a significant reduction in events and help the way you feel. It will not only provide better therapy, but the more stable pressure will make you more rested.