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Further reduce AHI and OA events?
#1
Further reduce AHI and OA events?
Hello, I've been on CPAP for about a week now. I was diagnosed with moderate obstructive sleep apnea with an AHI of 28 during the sleep study. So far I continue to sleep for 10-11 hours per night, still feel tired when waking, and often take a short nap midday. I have noticed, however, that I seem to have more energy when my AHI numbers are around 2.50. However, my numbers tend to hover around 3.50 or higher, with OA events typically being the highest. What are some ways I can get my numbers lower, particularly the OA events?

Some additional info:
  • I'm a mouth breather, so I use a full face mask. I had to switch from a Medium to Large, but otherwise find it comfortable.
  • My machine came set at 5-20. I haven't changed this yet. (The lower minimum doesn't bother me as I see it can with some people.) 
  • EPR was originally off, but I've experienced aerophagia so I've been tweaking that setting, first at 1 and last night at 2. This has improved but not eliminated those symptoms.
  • I'm a side sleeper.
Thanks for any advice!

               
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#2
RE: Further reduce AHI and OA events?
You have 2 different nights. Let’s take the 2 nd one first. You have zoomed in to the repeated obstructions. Those were caused by sleep position. Most likely you were tucking your chin again likely while sleeping on your back. These can NOT be helped with pressure. You have to find a way not to get in that sleeping position. If they continue you need to look at a collar (link about collars at the bottom of the post).

Now the other stuff you need to address. 1st you low number is way to low. To get rid of obstructions your machine has to rev up from 5 to a pressure high enough to treat the apnea. I would suggest setting it at 9 and it may need to go up from there. 2nd you have a ramp of 45 minutes. If possible turn it off if not cut it back as far as possible. You are getting NO therapy while it is on ramp. 4td flow limits (they are just smaller apnea) are high and to help with that raise the epr to 2.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Further reduce AHI and OA events?
Welcome to Apnea board and it looks like your Airsense 10 machine has improved your AHI a lot. When it comes to pressures there are folks here that have a lot more experience than myself. Looks like your ramp time is to long and should be only 5 minutes or don't use it at all. Also looks like your bottom pressure is low and 7 CMH2O would be better. From your charts you are chin tucking and can get clusters of OH & H apneas from this sleep position that can be remedied with a soft Cervical collar. I will leave a link on the collar.
A few changes should get you closer to 2.5 AHI or your comfort area.
http://www.apneaboard.com/wiki/index.php...cal_Collar
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