(05-21-2014, 01:13 PM)Ramen Bear Wrote: Hello guys! Sorry I came back just now.
Robysue was right. I had to increase the pressure to 20 and my AHI went below 5.0.
My only problem is that my lungs feels like it's been stretched or something.
It's worth reporting your discomfort to the sleep doc. Be specific in how you are describing it---tell him that at 20cm your lungs feel like they're being stretched and that it's hard to inhale.
Your current machine is only capable of going up to 20cm of pressure. So right now there's no room at the top if things take a turn for the worse.
Your high pressure needs combined with your on-going discomfort indicate that you might be
more comfortable and get better therapy from a bilevel device rather than Resmed S9 AutoSet that you are currently using. The Resmed bilevels that would be compatible with your humidifier are the Resmed S9 VPAP S and the S9 VPAP Auto. The VPAP S is a fixed bilevel machine: There's one pressure for IPAP and one for EPAP and they can differ by (much) more than the 3cm that the AutoSet's EPR allows. The VPAP Auto allows you to set up a range of pressures for both EPAP and IPAP; in other words, you start off with a minimum EPAP/IPAP, and as events, snoring, and flow limitations happen, the machine adjusts both the EPAP and IPAP (at the same time) as needed to take care of the events.
In the US one of the criteria for switching people from CPAP/APAP to bilevel is a required pressure of 15+cm with on-going difficulties/discomfort breathing with the machine at the required pressure. Many labs will switch from a CPAP titration to a bilevel titration once the patient hits 15 or 16 cm of pressure---particularly if there is any evidence that the patient is in discomfort.
Quote:I'm beginning to think that AHI number is okay even if it's high as long as my snoring is muffled.
How high is high? And what was your AHI on your diagnostic sleep study? If "high AHI" on your machine means an AHI between 4 and 6 and your diagnostic AHI > 30, then, yeah, it's probably ok. But if "high AHI" on your machine means that the AHI is often above 10, then it's not really "ok".
And the snoring really should be essentially gone rather than merely muffled. I don't mean "no snoring at all ever," but realistically you should not be snoring (even if it is muffled) for most of the night on most nights.
Quote:I'm probably just obsessing with these numbers I find in the machine.
I would just follow the prescription and visit the doctor with the SD card after 6 months.
Given the combination of:
- a pressure need of 20cm to get the AHI around or below 5
- a feeling of "my lungs feel stretched"
- a feeling that inhaling is uncomfortable
- continued evidence of muffled snoring
- a "high AHI" as reported by the machine
I personally think you should NOT wait for 6 months before seeing the doc. I think you need to call and see if you can get a follow-up much sooner than that. A switch to bilevel may very well be recommended and if you need the bilevel to increase your comfort and lower the AHI, it's silly to wait for six additional months before bringing that idea up with the sleep doc.