Daytime sleepiness despite low AHI, low leak, 7+ hours of daily use

[vas2000]

An update after 3 days of the fixed bilevel: I started with 12/9 and it was pretty uncomfortable (I remember awakening a lot). Here's the chart for one of those nights:



I then dropped it to 11/8 for last night - my comfort level was higher (don't remember awakening too much) and very interestingly, the AHI was actually lower. Here's the chart:



Any explanation for why the AHI would drop with a drop in pressure? It seems that most of the reduction was in the number of CA's. Of course, it was just one night so it may be transient.

I'm thinking that I will drop it to 10/7 (perhaps after a couple of nights) and then raise it to 10.5/7.5 if needed. My theory is that I want the lowest pressures that result in a reasonable AHI - is that an appropriate way of looking at it? I am thinking that an AHI of less than 2 is a good target.

Thanks.

[Sleeprider]

There is not suggestion of flow limitation or snores in either chart, so I suspect a lower pressure will not result in more events. As much as anything else, I think you're adapting to the therapy, and doing a good job of making it comfortable and your own. At this point you don't need any of our permission to try anything you think might advance that progress. As you note, it's not about the numbers, but good rest.

tom

[Marillion]