Great AHI readings but wrong pressures

[Davidacarrick]

So...firstly I’m using a Resmed Airsense 10 Auto with humidifcation, resmed F20 full face and climate line hose. Happy with my set up.

Was initially at min pressure of 4 and max 20. Standard setup but found the minimum pressure too low so changed things up to

Min pressure 8
Max pressure 20 
Starting pressure 8

I would never get a AHI reading above 1! Usually like 0.0 to 0.3 so I thought great my apnea cured and everything is fine and dandy but I still felt like sh*t the next day!

So I came across some dude on YouTube, can’t remember his name but great advice, who talked about the Resmed airsense 10 auto and setting it up etc in line with the recorded pressure readings. So my data was showing average pressure readings of 12.6 so I changed my maximum pressure setting to this and have since dropped it by 0.2 pressure every second night whilst keeping an eye on my AHI overnight. I’m down to pressure of 12 maximum now and still readings of around 1! 

I’m wondering whether my maximum pressure was set too high so during the night my pressures were going too high for what I needed, waking me up and making me feel rubbish the next day.

Someone also said to keep playing with maximum pressure until you can get to the lowest comfortable pressure but keeping AHI below 5.0 but preferably around 3.0! What’s your thoughts? Would mean my APAP would only vary pressure over night between about 8 and 11.5, doesn’t seem very significant However I might be thinking about this wrong

[jaswilliams]

How about posting your current daily graph so we can see what I get looks like but it could be something else causing your tiredness if the Sleep Apnoea is treated.

[Sleeprider]

A driver of pressure increases in the Resmed Autoset is flow limitation. As long as the machine detects that your airflow is restricted (looks like a flat inspiratory peak), it will increase pressure, even if there are no events. We frequently recommend to people with flow limiation and few apnea or hypopnea events to limit the maximum pressure so therapy stays comfortable. Another setting on your machine is EPR (exhale pressure relief) in the comfort settings. EPR reduces pressure during exhale, and can help to reduce flow limitations. If these are a feature of your sleep disordered breathing, and I bet it is, a higher EPR setting can help.