So, I have OSA with an AHI of something like 17 on my side and 55 on my back. Never adjusted to CPAP well though started trying to use it again recently because I want to sleep better. When I would begin falling asleep it would feel like the pressure was too much or I would stop breathing, so I would talk it off. Pressure was 10.
Went to see the sleep doctor, am now on an APAP trial with pressure setting of 6-16. They originally had me 4-14 but after a week of that I told them 4 was too weak. The one I am on is a Philips Respironics System One with Aflex.
So after the first night, I managed to keep it on for 6 hours and had an AHI of roughly 11, periodic breathing of 4%, and 90% pressure of 10.5. Last night I managed to keep it on for over 8 hours (a personal best! go me) and had an AHI of 9.5, periodic breathing of 2% and 90% pressure of 9.5. Still waking up a bit but obviously I don't expect that to resolve immediately. I was awake for a bit around 4 or 430am this morning (for maybe 30 or 45 minutes... which I never stay awake that long but attribute it to adjusting to the machine) and I am wondering if that explains the improvements in my numbers.
I guess my questions are:
- does it take a while for AHI to come down to <5? i.e. is it related to a period of comfort and adjustment to the machine?
- periodic breathing... is it also something that adjusts/resolves over time? Is 2-4% a concern this early into a trial with such a wide range of pressures? I did find this earlier today: In the case of inadequate or excessive titration, the breathing pattern can be stabilized by simply retitrating the patient using careful attention to detail. In the case of treatment-emergent central apneas, data suggest these events generally resolve spontaneously over time.
- they have me on the aflex but I have read here there are therapeutic trade offs in exchange for comfort. Could I expect improvement in my AHI/PB if on cflex? At this point while I still try to get used to the machine I like the exhalation relief but I don't really get the point of inhalation relief and I am not sure I need it. If there is relief on both I don't understand when/how the machine will actually get up to pressure.
I go back to the APAP provider Monday and they reset the machine to whatever my 90% pressure is and put it in CPAP mode and then I see the doc again on March 24.
Anyways, a lot there. I'm sorry. A lot on my mind and no one to talk to who "gets it". Thanks everyone.