My original prescription in 2010 was for 20 cmH2O and I was provided with a ResMed VPAP Auto 25 set up in Spontaneous mode at 20cm/16cm. I have been using this set up until yesterday. Now that I have learned from this website what most of the data means, I am questioning what I am doing. For one thing my leakage rate with my P&K nasal mask at the original set up is running between 1.4 and 1.7 L/s, which is not good, although my AHI was 1.7-2.7 with an AI of 0.1. I am waiting for a card reader so that I may look at the data in more detail.
The crux of my question is that yesterday I converted my machines operation to auto mode with a min. EPAP of 10cm and a max. IPAP of 20cm. I looked at my daily data this morning and I had reduced the leakage rate to 0.44 L/s. The reported pressure was 16.6cm but my AHI was 10.8 with an AI of 0.7.
My question is, are these event scores something that may get better as I get used to this mode of operation? One other question, I am used to starting up with a long ramp in the S mode so it starts very gently. When I started the settle period in the auto mode, I thought it was going to blow me away but I decided to go with it for a little while and it seemed to settle down and it did. Is this normal?
If the overall leak rate is high the entire night, or for long periods of the night, then the AHI is going to be skewed. Any events reported during a leak is invalid and during a leak, there could be events and it not know. Now that you have fixed the leaks, it can now give you the true AHI.
I *think* the AI of 0.7 includes both obstructive and central so the bulk of your 10.8 AHI is hypopneas.
It probably didn't settle down, rather you got used to it. I no longer use the ramp feature as I found it was more of a hindrance than a help.
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One way or another, it really sounds like you are being under-treated with a residual AHI of 10. Perhaps you need BiPap or something else.