New to Treatment- Looking for Guidance to Improve AHI

[bokonon]

Success!  Lowest AHI yet.  Clusters are gone, so the collar seems to have worked.  I'll have to give others a try in terms of comfort, but now I know it will be worth the effort.  Here are my charts from last night.
   

I'm open to any other suggestions for adjustments I could make.  Also, I'm not sure what the story with the large leaks is.  Much higher than previous nights, but I don't recall any of them waking me up.  Thanks again.

[staceyburke]

Good job, it sure looks better.  Now it is getting use to the therapy and hopefully the centrals will lessen.  AFTER that we will need to work on the flow limits.  A flow limit is just a small apena.  You can look at the bottom of the post and I have the different types of apnea listed.  We try to limit the number of flow limit events by using EPR but as you know that is what usually brings on some centrals.  So it will take a while for your body to adjust to the use of the machine and as the centrals go away you can add EPR to lessen the flow limits.

[SarcasticDave94]

I'd say if you're comfortable and you can repeat this chart, more or less, and if leaks do not get worse or didn't disturb sleep, let it ride. If there's lack in rest, in disturbance, in comfort, we need to find things to change. The numbers are great, so no indications for change there. Yes the only areas to monitor I see are leaks and CA which means to the machine clear apnea, but are really Central Apnea.

So stick with it and if something begins feeling off or CA or leaks go up, then we look again. A possible collar named Corflex may be a wish list item in future if your current collar ends up failing your expectations.

[bokonon]

So, it's been a few weeks and I thought I would follow-up.  I've made a couple of changes to my therapy after some experimentation:  I'm using a resmed p30i mask and velpeau collar.  I attach charts from my two most recent nights.  One with min pressure 10 and one with min pressure 11.  These are pretty representative of a typical night.  I'd love to bring the non-central events down more if possible without aggravating the centrals.  I know I may need to wait another month or two to see if the centrals come down more as my body further adjusts to treatment.  Also would like to try to address the flow limits, but again need to balance out the impact on centrals.

Would love to hear any suggestions.  Thanks!

   
   

[Sleeprider]

I like your pressure at 11.0 better, however pressure is moving around a lot in response to flow limitations. I know you are concerned about CA events, but they are really concentrated to the end of the night. It would be worthwhile to introduce EPR gradually and watch the response. The more you can tolerate without a significant increase in CA, the more comfortable your therapy will become, and fewer flow limits, hypopnea and arousals. Just take the leap and give it a try. You can add in gradually starting at 1, or get in at a setting of 2 and see where it takes you.

[bokonon]

Thanks. I'll give EPR 2 a shot tonight and report back.

Would it make sense trying to go higher than 11 for the minimum pressure?

[Sleeprider]

One thing at at time. If a pressure increase is needed after EPR is in, we can discuss it tomorrow. Using EPR 2 is likely going to reduce your maximum pressure and pressure variation.

[Skipness]

Hello all and Happy Holidays.  I started my PAP journey this week with a ResMed 10 AirSense AutoSet.  I am excited to start treating my OSA and happy to have discovered such a wealth of information in these message boards.  I was diagnosed with moderate OSA using an at-home sleep study.  Night 1 had an AHI of 14.7.  Night 2 had an AHI of 21.4.

I attach my Oscar screenshots (hopefully formatted correctly) for each of the past four nights (the 4th night will be attached to my second post).  The first night I was using a ResMed N20 nasal mask.  The other nights I was using a ResMed N30i nasal cushion.  The first three nights the machine was set to 5-15.  The fourth night I tried raising the minimum pressure to 8 and turning off ramp.

I am off to a good start with the treatment in the sense that I have no trouble wearing the mask all night and falling and staying asleep.  The first few nights I had a couple of episodes of rainout, but I now have that sorted.  My concern, however, is that my best AHI has been 4.8 and all others have been above 5.  Last night was 15, but I suspect something odd was going on in the last hour or so of sleep.

I am hoping the collective wisdom of the board may have suggestions for calibrating my settings so that I can bring my AHI consistently below 5, and hopefully much lower than that.  Thank you in advance.

---

Here is Oscar for night 4.

[Skipness]

My machine is set at 2-12 and has been for years. My AHI is rarely above 0.1.
Regarding Central Apnea, this is what Mayo Clinic says:
Central sleep apnea is a disorder in which your breathing repeatedly stops and starts during sleep.

Central sleep apnea occurs because your brain doesn't send proper signals to the muscles that control your breathing. This condition is different from obstructive sleep apnea, in which you can't breathe normally because of upper airway obstruction. Central sleep apnea is less common than obstructive sleep apnea.

[staceyburke]

I'm sorry but noting came across.  To take a screen shot of your OSCAR charts just push F12 and make sure you know where they are storied.  After writing what you want go to browse at the bottom of the page then after that you must push "add attachment".