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Good AHI reduction, but what waking up a lot and snore?
#1
Hi
I am new here and sorry if this question was posted elsewhere.
Just completed my fifth night with my resmed auto set 10 for her, and my AHI is consistently down to 0-0.5. Big Grin it was 26-92.

A few things though - I keep waking up. Generally seems as if I wake up as the pressure rises. Should I consider reducing the max pressure and see if that helps?
Machine is set 4-14. My prescription was for 8. It's getting up to 12 max most nights, and what I see in sleepyhead is the pressure ramps up over a couple of hours then I wake up. Do I try a lower max for a night, or just wait to adjust?
I'm delighted my ahi is down, but waking up 3-4 times a night is meaning I'm not feelin any less tired.

Also Sleepyhead software seems to indicate I am still snoring frequently. Should I do anything about this? Would a different mask help? I was prescribed nasal, but am having to adjust to not breath through my mouth at all.

By the way - love this forum! So happy to find it and all the usefull help.
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#2
Welcome Jaquini,
First of all, do you have the ramp feature on, and if so, what is it set at? A lot of people don't like to use the ramp feature. It just depends if the ramping up of pressure bothers you and wakes you up.
You state that your prescription pressure is for 8. What is your 90% pressure number?
Your setting of 4 to start is fairly low. You could turn ramp off, and start moving pressure to 5 or 6, and leave the upper number alone for now. If you AHI is only 0.5, check sleepyhead results to see at what pressure the apnea events occured at.
Overall your AHI number is good, but need to zero in on what is waking you up.
Don't make a lot of changes at one time...it is best to start looking at sleepyhead graphs to determine what is going on. And remember, not everyone sleeps through the night.
Bed
OpalRose
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#3
Hi
Thanks for the quick answer, my 95 percent is between 9.7-10.5 so far. And median is 7.3-9.
Events are happening at pressures under 8.
Ramp is indeed set on, at the auto setting.
I'm going to try adjusting start to 6 and am wondering if turning ramp of as well is to much change? I may just do pressure and see.
Thanks!
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#4
Yes. And, please look at how your RERA score is as well. Your machine reacts to flow limitations and RERAs, so it will build pressure seemingly for no reason (ie. before an event even happens). The Overview charts in Sleepyhead can be changed to show the RERAs in addition to the apneas, but selecting File Preferences then in Tab CPAP, picking display of RDI instead of AHI.

Another great thing about your machine is that it adjusts the pressure more gradually than the Autoset, given the same conditions.

Welcome to the forum. It looks like you are off to a great start.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#5
Hi Jaquinl,
WELCOME! to the forum.!
It sounds like you are off to a pretty good start.
Hang in there for more suggestions and much success to you as you continue and fine tune your CPAP therapy.
trish6hundred
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#6
It usually takes time for the machine to react. If your on Auto and you start snoring or having events, it takes time for the machine to react. So if you start having snores--RERAS... You might have a few which will cause you to wake up. Im an RPSGT and prefer the set pressure because of this. If you are at a pressure that eliminates everything, you don't need adjusting. My opinion.
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#7
Thanks for all the replies. I'm gradually starting to feel more alert and am now at 4-13, ramp on setting. I find the events tend to happen in the middle of the night, and I still wake up twice on average. I bought a hose management clip system which has definitely helped.
Machine head- do you ramp to your fixed pressure, or just go straight to that? I'm wondering if to try a night on fixed?
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#8
(03-18-2015, 08:33 PM)Jaquinl Wrote: Machine head- do you ramp to your fixed pressure, or just go straight to that? I'm wondering if to try a night on fixed?

Some do away with ramp feature, find they don't need time to adjust. Preference only.

If it were me experimenting, I would do as you mention, straight 8 or 9. There are some that have problems with pressure changes of any kind. My reading tells me you can easily find people that have experienced better results with straight CPAP.

.. g'luck and let us know either way it goes if you elect to experiment.
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#9
(02-22-2015, 09:59 AM)Jaquinl Wrote: A few things though - I keep waking up. Generally seems as if I wake up as the pressure rises. Should I consider reducing the max pressure and see if that helps?

No, you should consider raising the lower limit so it doesn't have so far to go.

Using using SleepyHead you can find the 95% pressure (or 90% pressure depending on your machine) and raise your lower limit so it's just a little less than that.

This means you won't have to start having events that can disturb your sleep before your machine reacts, and the machine won't have to jack up the pressure from 4 - 12 or wherever it needs to be, which can also wake you up.

Ideally, your machine's minimum pressure should be close to the pressure needed to keep you breathing, and the upper limit should be high enough to give it some space if it needs to raise it.

The less your machine has to play with the pressure, the better you'll sleep. also as someone else mentioned, switch Sleepyhead to RDI instead of AHI. This will make it include events that will disturb your sleep, but aren't severe enough to qualify as apneas or hyopneas.

Terry


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#10
Hello Jaquinl, Welcome to the board I'm glad to see your doing well with your therapy besides being awoken a few times a night over time as you pinpoint and adjust your machine you will get a full nights rest without being awoken. Good Luck in the future and keep us posted on how your therapy is going. I'm still waiting to start my therapy and hopefully the Doctor orders my Machine real soon
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