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Does AHI contunue to improve?
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NorthernGuy Offline

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Machine: Philips Dreamstation Auto CPAP
Mask Type: Full face mask
Mask Make & Model: F&S Full face
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CPAP Pressure: 8-14
CPAP Software: SleepyHead

Other Comments: New (couple months) APAP user.

Sex: Male
Location: New York State, USA

Post: #1
Does AHI contunue to improve?
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?
05-26-2016 08:12 PM
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OpalRose Offline

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Posts: 3,166
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #2
RE: Does AHI contunue to improve?
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
05-26-2016 08:23 PM
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Sleepster Offline
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Posts: 4,989
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #3
RE: Does AHI contunue to improve?
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.
05-26-2016 08:26 PM
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NorthernGuy Offline

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Posts: 49
Joined: May 2016

Machine: Philips Dreamstation Auto CPAP
Mask Type: Full face mask
Mask Make & Model: F&S Full face
Humidifier: Dreamstation integrated
CPAP Pressure: 8-14
CPAP Software: SleepyHead

Other Comments: New (couple months) APAP user.

Sex: Male
Location: New York State, USA

Post: #4
RE: Does AHI contunue to improve?
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.
05-27-2016 05:41 AM
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trish6hundred Offline

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Posts: 6,430
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #5
RE: Does AHI contunue to improve?
Hi NorthernGuy,
WELCOME! to the forum.!
Much success to you with your CPAP therapy.

trish6hundred
05-27-2016 08:33 PM
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WakeUpTime Offline

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Machine: PR System One BiPAP S60 Auto 760
Mask Type: Nasal pillows
Mask Make & Model: P10 pillows
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CPAP Pressure: Auto / Inhale 11-12.5 / Exh 9
CPAP Software: SleepyHead EncoreBasic

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Sex: Male
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Post: #6
RE: Does AHI contunue to improve?
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.
05-29-2016 07:22 PM
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Ghost1958 Offline

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CPAP Software: SleepyHead EncoreBasic

Other Comments: Moderate to Severe SA Obstructive. Rapid O2 desat off the machine.

Sex: Male
Location: KY

Post: #7
RE: Does AHI contunue to improve?
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.
05-29-2016 09:35 PM
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bwexler Offline

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Machine: PRS 1 BiPAP autoSV Advanced, with Heated Tube humidifier
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Other Comments: CMS 50i with Software for SpO2

Sex: Male
Location: San Marcos, CA, USA

Post: #8
RE: Does AHI contunue to improve?
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.
05-29-2016 10:43 PM
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holden4th Offline

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Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
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CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #9
RE: Does AHI contunue to improve?
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.
05-30-2016 03:51 AM
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Asjb Offline

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CPAP Software: ResScan SleepyHead

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Location: France

Post: #10
RE: Does AHI contunue to improve?
(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
05-30-2016 04:30 AM
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