[CPAP] Looking to further improve my CPAP data

[gadgetmaniah]

Hello,

I've been on CPAP for about 1.5 months now. I have seen a lot of improvement but not to the extent that I am satisfied. I still feel like I haven't had a full night's sleep after waking up and I feel drowsy during the day too. 

I've attached three screenshots of my data. I am using the Dreamstation (yes, I am aware of the recall and plan to buy a new machine soon). My AHI usually hovers around 2 and I notice that I always experience 10-13 hypopneas. I know that this isn't a significant number but could minimizing these help improve my sleep further? I have tried increasing my minimum pressure to 7, 8, and 9 but haven't felt much of a difference. I only tried a minimum pressure of 9 for one or two days so I could try that for a week or so and see if that helps I guess. I have read that Philips' algorithm is slow which is why you might need a higher minimum pressure than you would on a Resmed.

Appreciate any help. Thanks!

[SarcasticDave94]

Hypopnea are roughly a half Apnea event and require higher pressure. That is unless your Hypopnea events are Central Apnea based. I would consider trying Min pressure of 7 for a few days. Note the event trend to see if it diminishes. The pressure increase may need to be done again, continuing to increase enough to lower the event count. There is a number that likely lowers the Hypopnea, and hopefully that is met before it becomes uncomfortable. From there, you need to balance low event results and decent comfort.

[gadgetmaniah]

Thanks for the reply! Really appreciate it.

Also, I was just looking at my data and was wondering the hypopneas that I experience are even real hypopneas or just sleep/wake/junk breathing. I've attached a few zoomed in screenshots of the flow rate graph when the hypopnea occurs. It seems to be that it is S/W/J breathing since there usually seems to be a spike in my breath before a hypopnea occurs.

[staceyburke]

These charts are not looking positional apnea but some of your H events are grouped that MIGHT show some positional apnea. It may be you rolled to your back for a short time or some how cut off your own air way. 

Again these are just a few and not a problem that you have to solve but rather to watch out for.

[gadgetmaniah]

Thanks for the advice.

So I tried setting the minimum pressure at 10 last night and I had a much better sleep today. I usually experience around 10-13 hypoponeas during my sleep but today I experienced only 1, and my AHI was a lower too at 1.48. So I think I'll continue with these settings for about a week or so to see how if the improvement stays.

Also, does this mean that even if your hypopnea/obstructions aren't causing the AHI to rise above 5 (or even 3 or 4) they could still cause poor sleep?

[koala1]

You should get rid of the calendar view on the left to show more detailed data.
It seems min pressure was too low.
I have the same problem with hypopnea and DS1. It really seems slow to react.
After setting minimal pressure to my average pressure it is way better now. Try this or setting it to 1 below your 95% pressure

[gadgetmaniah]

I see, thanks. My average pressure is usually around 6 or 7, but as you say the Dreamstation is slow in increasing pressure to combat events. I've tried a pressure of 7 several times but I still experience hypopnea. I think a pressure of 9 and 10 would be better, which would be around where my 95% pressure falls.

[SarcasticDave94]

Yes for best results, medical will say you're treated well at AHI 5, but most here require and achieve lower. I feel best myself with AHI between 2-3. Zero across the board isn't necessary, just low enough your most comfortable and well rested. And to add one more bit of info, this isn't a sometimes goal, but one we strive and get on a frequent basis, building a consistent result that doctors do not gain for us. We get there by ourselves.

[Ratchick]

Absolutely, yes. While many people may feel fully rested at an AHI of 5 or 4, there are some people that will feel the effects much lower. If the pressure increase has helped, then stick with it, definitely.

[gadgetmaniah]

Thanks for the replies. I am getting a better AHI now with a minimum pressure of 10 and feeling better too.

Also, I wanted to ask, I've had enlarged adenoids since birth due to which I breathe from my mouth a lot of the times. I wonder if I should consider having the adenoids removed after discussion with an ENT. Would it be worth exploring this possibility or should I not bother about it? I was thinking that perhaps if I'm able better able to breathe with my nose when sleeping it would help me sleep better.