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[CPAP] Looking for suggestions, AHI of 10 for the last 3 months
#1
Looking for suggestions, AHI of 10 for the last 3 months
Hi all,

I started using my CPAP after being diagnosed with sleep apnea while treating Hodgkin's Lymphoma. I've done a autologous transplant on March 2020 and stopped chemo around December/20. Since then, my wife started to notice than I was snoring way more than normal. I did a sleep study and my AHI was around 45~50.
I'm 32M, 209lbs, 1,75cm (5'8). After I bought a CPAP, I've been struggling to get my AHI below 10. My doctor tried several configurations, but my communication with him is very async and sometimes it takes 5 days for him to answer. Also, I've never felt reaaally tired, and even with an AHI of 10, I've been feeling pretty well, but I worry this might be bad in the long term

I have a Resmed Airsense 10 with a nasal mask N30i.

Unfortunately I don't have my sleep study, my doctor never gave it to me. If I forgot any information, please ask that I'll put it here!

   
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#2
RE: Looking for suggestions, AHI of 10 for the last 3 months
haruspex,

I hope you are doing better.

Did you do a titration? I am wondering where the doctor got settings from.

Do you sleep on your side or back. Where the are groupings of blue lines, it could be:
- on your back, --try on sleeping on your side
-deeper sleep, or maybe need higher pressure.
- tucking your neck in. try cervical collar.

If the the night was back and side, even though changes are done 1 cm at a time I would suggest you set minimum pressure to 11 cm. You spent most of the night above that so it will not be much different. If the high pressure was due to back and on your side is lower can be lowered.

For ramp set pressure to 7 cm to get full effect of expire pressure relief (EPR).
For ramp time reduce the time to 5-10 minutes. While in ramp it will not react to events.

Without knowing if you had centrals in sleep lab I would be hesitant to increase max pressure.

Can you post a couple of scans with 3 min of flow rate where there are no flag events.
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#3
RE: Looking for suggestions, AHI of 10 for the last 3 months
Thank you for your response!!

I sleep on my side 100% of the time, I can't sleep on my back. 
About my sleep test: as far as my doctor told me months ago, I don't suffer from central apnea, she only mentioned to me severe obstructive apnea.

Here are the prints:


Attached Files Thumbnail(s)
       
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#4
RE: Looking for suggestions, AHI of 10 for the last 3 months
From your graph, once RAMP is over, your pressure jumps way above 8 and never drops back to that. As such, I would recommend you a minimum of 8 instead of 6.

As for the maximum, you still have some events once you are maxed. With a nasal mask, it may be uncomfortable to go too high on the pressure but if you need it... Also, it may create mouth leak. In your case, you may have some but not too much. I would try a smaller increase, something like 16.2.

Good luck and keep working on it, you will make it.
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#5
RE: Looking for suggestions, AHI of 10 for the last 3 months
Thank you!

I also use an app to track my snoring and sometimes I get some "open mouth" events. So far, I don't have many of those, so I'll try increasing and keep checking if it gets worse. Also, if necessary, I'm willing to buy a new mask if the pressure needs to be higher!

Thanks again!
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#6
RE: Looking for suggestions, AHI of 10 for the last 3 months
See these directions for organizing your OSCAR charts:
http://www.apneaboard.com/wiki/index.php...ganization

It can help us advise you if you organize your charts that way and post them. For example, we can get a good look at your leak rate graph.

Also, most users turn the ramp feature off after a few nights or weeks. Kind of like training wheels.
Sleepster

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Looking for suggestions, AHI of 10 for the last 3 months
You are bumping up against your highest pressure an awful lot.  I think you should raise your highest to 20.  You will only go up that high if you need it.
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#8
RE: Looking for suggestions, AHI of 10 for the last 3 months
(11-09-2022, 01:19 AM)Deborah K. Wrote: You will only go up that high if you need it.

That is not entirely true... Resmed has a tendency to increase pressure more than required (as opposed to Phillips which does not increase as much as needed). An algorithm will never be perfect.

Because ResMed often increases too much, to let the pressure goes up unrestricted may create other problems like aerophagia. As such, unless the maxed pressure is associated with apnea events, to see it maxed on a Resmed device is not a sufficient criteria to increase it in my opinion. If you do, be careful of other problems (leaks, aerophagia and more).
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#9
RE: Looking for suggestions, AHI of 10 for the last 3 months
Ok,

See the clusters of OA events. This is most likely you tucking your chin, it could be your side sleeping and tilting your neck to the side. This CANNOT be fixed with increased pressure, your windpipe is "kinked" and unless you straighten your neck your numbers will not significantly improve. For you I'll suggest a soft cervical collar. Read the wiki linked in my signature on soft cervical collars.

Once that is mostly concerned we will be able to tackle what is left.
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#10
RE: Looking for suggestions, AHI of 10 for the last 3 months
(11-09-2022, 11:36 AM)Gideon Wrote: Ok,

See the clusters of OA events.  This is most likely you tucking your chin, it could be your side sleeping and tilting your neck to the side.  This CANNOT be fixed with increased pressure, your windpipe is "kinked" and unless you straighten your neck your numbers will not significantly improve.  For you I'll suggest a soft cervical collar.  Read the wiki linked in my signature on soft cervical collars.

Once that is mostly concerned we will be able to tackle what is left.

Thank you! Just bought the soft cervical collar and will test this next week!
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