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Does AHI contunue to improve?
#1
I am a new APAP user. The machine is pretty much set full 'auto' at 5-20.
My 90% number is ~13.

During my sleep study my AHI was in the 30's. Most of my apneas were obstructive and occurring during REM stages. Very few central apnea events.

Since I have been on APAP my AHI is stuck around 7-9 with only 2-3 OSA event/night. The rest are now showing up as clear apneas or hypoapneas.

Should I continue to see improvements or is this the best I will see?

I am using the system all-night (>7 hours) and have no indicated mask leaking.

Does the Flex setting have any effect on these other apnea events?
Should I try a higher or lower 'Flex' number?
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#2
Hi NorthernGuy,
Your minimum pressure of 5 is too low. Ideally, the minimum pressure should be set at 2 to 3cm below the 90% number. If you 90% is at 13, then set the minimum pressure to 10 or 11.

You may want to raise pressure 1cm at a time, and watch your stats on SleepyHead for a few days.
I would also bring the max pressure down to 16. In other words, your range should be set around the 90% number.

You don't say what your flex setting is, but if it helps you, set it to 2 and adjust if needed.
OpalRose
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How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
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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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#3
The AHI does tend to drop as we adapt to the therapy.

In general, higher pressures and higher flex settings can induce central apneas. But lower pressure can result in more hypopneas.

If you post some of the details you see in SleepyHead we can better help you. Here is a guide:

http://sleep.tnet.com/resources/sleepyhead/shorganize.

More info on attaching screenshots here:

http://www.apneaboard.com/forums/Thread-...08#pid3908
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#4
Thanks for the replies. I will look through the data posting instructions and find some data to post. It may take a few days with the holiday (US) weekend.
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#5
Hi NorthernGuy,
WELCOME! to the forum.!
Much success to you with your CPAP therapy.
trish6hundred
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#6
Compliance, consistency (keeping to a routine), the right mask (to avoid excessive leaks), and finding appropriate settings that end the constant temptation to want to tinker with machine settings every night were the things that finally got my AHI to a tolerable range.

For myself, my first 6-12 months saw a struggle to get significantly below an AHI of 10. I was guilty of messing with my machine settings too frequently and mask leaking was a challenge. After almost a year, I seemed to settle on some settings that produced the best results. I then focused on consistent usage and stopped messing with the settings every few days. Suddenly, my AHI after that seemed to drop to below 5 consistently and I'm very happy with that. It's a surviving range not necessarily a blissful living range.

In summary, it was not a "continuous daily improvement" for me, but improvement in stages after a period of time.

Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
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#7
Once you get a min pressure dialed in to get you in the 1.5 to 2 range,,, flex where you want it, then leave it alone for a couple weeks.
May find ypur ahi going under 1 often.
If not touch up the min a notch and use that for a while.

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#8
Not everybody can continue to improve. This week my AHI was between 0.4 and 0.9. I don't expect much improvement in my numbers from there. However I am always looking for ways to improve my sleep and the way I feel during the day.
It took me 65 years to discover that I have sleep apnea. I know I have suffered some damage to my body in that time. I am going to allow the next 65 years to correct that damage. If I still haven't achieved perfection maybe I will have to extend the time, until I am satisfied with the results.
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#9
My numbers have settled over the last few months because I have not played with the settings for a while. While I'm still not regularly under 1, I am nearly always under 3 and am starting to get regular figures between 1 and 2.

I feel much better but not what I'd like to feel. However, I fell asleep before putting the mask on the other night and found out what you feel like when you don't use APAP - like absolute crap!

I read about the 'sweet spot' and wonder how close I am to that. That's my next goal

Bottom line is that you do improve if you are prepared to be patient.
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#10
(05-26-2016, 08:12 PM)NorthernGuy Wrote: I am a new APAP user....... During my sleep study my AHI was in the 30's. Most of my apneas were obstructive and occurring during REM stages. Very few central apnea events......Since I have been on APAP my AHI is stuck around 7-9 with only 2-3 OSA event/night. The rest are now showing up as clear apneas or hypoapneas.

Should I continue to see improvements or is this the best I will see?

Hello Northern Guy - when you say 'new user' how long have you actually been using xPAP? My advice would echo other Members' replies but for me it would also depend on how long you have been on treatment.

Based on my experience - it took at least a month for the AHI to settle down, it was very rarely below 5. My test AHI was 60, no centrals.

But then, for the next year, I could have some good results - AHI 2-3 and decent nights' sleep - sometimes, but also very poor results (AHI to 15) and poor quality sleep, for maybe 15-20% of nights. Over this time the central apnoeas started to appear and increased, to 3-5/hour.

Your centrals may well be temporary - caused by xPAP pressures - but if you have already been on treatment for months then they may be 'real' and permanent.

To cut a long story short, I asked to change to BiPAP (as I was not tolerating expiration against the very high pressures I sometimes needed). By mistake, my technician actually arrived with an Aircurve ASV for me, not BiPAP, but we decided between us that, why not, I should try it.

I would fight to the death now! not to hand back my ASV machine - the quality of sleep, the disappearance of almost all sleep apnoea related symptoms, and an average AHI of less than 1.

So, in summary, yes it can take time (weeks, months) to settle to xPAP. The advice above re tinkering with settings, finding the right mask etc, is crucial. But if you are 'doing all the right things' and consistently, for months, more than 50% of your events are central, and you still have poor sleep or SA symptoms, than I would suggest documenting all this with Sleepyhead graphs and discussing it with your doctor. Many, many posts on this Board unfortunately confirm the tedious and stressful journey many SA patients have to undertake to eventually be given the ASV machine that was indicated from early on.
..................................................................................................
All my opinions are only as an xPAP user trying to help another xPAP user.
No suggestions I may make should be taken as professional advice.
If you have medical concerns please consult a doctor


My current pressures: Auto-ASV. EPAP 10-13. PS 3-10


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