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Next step(s) after getting AHI <5
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Roy289 Online

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Posts: 77
Joined: Apr 2016

Machine: ResMed AirSense™ 10 AutoSet™ for Her CPAP w/ HumidAir™ Humidifier
Mask Type: Nasal mask
Mask Make & Model: P&S 405
Humidifier: Climateline
CPAP Pressure: 7-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Canada

Post: #1
Next step(s) after getting AHI <5
New APAP user (in third week)

History:
PSG gave AHI of 57
started with 7-14

Noticed that many CA'S clustered when transitioning out of and into sleep. My habit was to stay in bed snoozing after waking but now get out of bed when awake. This change alone seems to bring the AHI below 5.

While on APAP only getting up once per night for bathroom which is big improvement as Type II Diabetic and though 2 or 3 times would be my norm.

Last night AHI was 1.99 with 1-OA /3-H/10-CA

Using Autostart and pressure at 5 until asleep. Typically within 5 - 10 min.

A10 ramps quickly (about 5 min) to mid 10 range and then cycles through pressure (up/down) in response to Flow Limitations.

Channel Min Med 95% Max
PressureTherapy Pressure (cmH2O)
W-Avg: 9.60 5.00 10.02 10.72 11.32
EPAPExpiratory Pressure (cmH2O)
W-Avg: 6.86 4.08 7.08 7.72 8.32

Next steps
1. Should the low range be increased to 9 from 7?
2. EPR is set to 3, should this be decreased to 1 or 2?

Still struggling with mask leakage and fitting (sore on bridge of nose) but think this is typical in adjusting to CPAP.
04-28-2016 12:50 PM
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Sleepster Offline
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Posts: 4,995
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #2
RE: Next step(s) after getting AHI <5
(04-28-2016 12:50 PM)Roy289 Wrote:  Still struggling with mask leakage and fitting (sore on bridge of nose) but think this is typical in adjusting to CPAP.

You'll need to get that under control before worrying about the AHI and the pressure range, although it appears that lowering the EPR or the pressure, or both, might lower the number of central apneas.

A sore on your nose indicates a poor mask fit, as does the leaks. Contact your equipment provider and get a different mask. This is normal. Putting up with a poor-fitting mask is not!

Sleepster
Apnea Board Moderator
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04-28-2016 12:56 PM
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PoolQ Offline

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Posts: 986
Joined: Jul 2015

Machine: AirCurve 10 VAUTO
Mask Type: Full face mask
Mask Make & Model: Amara View
Humidifier: Integrated
CPAP Pressure: 6.2, 15, PS4.0
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Sillicon Valley

Post: #3
RE: Next step(s) after getting AHI <5
You seem to be treated well where you are. Are you having problems sleeping? do you want to feel more rested the next day? From just what you have said I am not sure why you feel the need to change any settings, as far as treatment goes, your setting are fine.

Regardless of what the numbers say, if most of the apneas are happening when entering or exiting sleep, this is known as sleep/wake junk and are not really considered apneas by most.

You change the low range and/or EPR settings if you are having problems, on their own there is nothing wrong with the settings you have.

What is your goal?
04-28-2016 01:00 PM
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tmoody Offline

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Posts: 175
Joined: Mar 2016

Machine: PR System 1 BPAP AutoSV
Mask Type: Nasal pillows
Mask Make & Model: Swift FX nose pillows
Humidifier: PR System 1 attached
CPAP Pressure: 8-25
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Philadelphia

Post: #4
RE: Next step(s) after getting AHI <5
Looks like you've done well. I don't know that you need to tweak the pressure settings anymore, if your AHI stays that low. You might experiment with the EPR. I don't know much about that, but from what I've read here, some people see a change in AHI, for better or worse, when they change the EPR setting. EPR is a "comfort" setting that provides a short "ramp" to full EPAP pressure when you exhale, as I understand it (Expiratory Pressure Relief, no?). At 3, you're at the highest comfort setting. You might see if reducing it does anything to the centrals. And see if there's any noticeable difference in comfort.
04-28-2016 01:08 PM
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Roy289 Online

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Posts: 77
Joined: Apr 2016

Machine: ResMed AirSense™ 10 AutoSet™ for Her CPAP w/ HumidAir™ Humidifier
Mask Type: Nasal mask
Mask Make & Model: P&S 405
Humidifier: Climateline
CPAP Pressure: 7-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Canada

Post: #5
RE: Next step(s) after getting AHI <5
My goal is to feel more rested in the morning and less tired during the day. Since using APAP haven't had urge to nap so that's progress.

Three masks have been tried,
F&P Flexifit 405 (came with A10)
Resmed N10 (not able to lie on my side due to stiff mask frame shifting mask )
Amara View ffm - many issues with leaking and returned after 2 days

went back to the 405 and trying different pillow insert from Med to Large to reduce pressure on nose.
04-28-2016 01:13 PM
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BadGoodDeb Offline

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Posts: 210
Joined: Apr 2015

Machine: ResMed Airsense 10 autoset
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 for Her
Humidifier: no
CPAP Pressure: 8 (testing 7.8-10)
CPAP Software: SleepyHead

Other Comments: New to AirSense 10 and AirFit P10, but 4 years on prev unit

Sex: Female
Location: Chicago outskirts (Aurora, IL)

Post: #6
RE: Next step(s) after getting AHI <5
Have you tried a nasal PILLOWS mask, at all? It's much smaller than a full face mask or a nasal mask. It just sits under your nose (and blocks some of your mouth). The only pressure points on mine are the nostrils and some days, the top lip (the philtrum, is that?) But you have to be able to keep your mouth closed -- you probably are doing that already, since you say you have a nasal mask. The AirSense P10 nasal pillows (google it for a picture) has soft straps going around your head, but no real frame beyond an inch from the nasal pillows.
04-28-2016 04:21 PM
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OpalRose Offline

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Posts: 3,181
Joined: Nov 2014

Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #7
RE: Next step(s) after getting AHI <5
I wouldn't change actual pressure settings right now, but lowering EPR from 3 to 2 may help with the centrals.

OpalRose
04-28-2016 04:29 PM
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PaytonA Offline
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Posts: 3,015
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #8
RE: Next step(s) after getting AHI <5
If you are struggling with leakage your AHI and pressure settings may not be very relevant. I agree with Sleepster. You need to get the leaks under control first. Depending on the size and type of leaks, the rest of your data *may* be suspect.

Best Regards,

PaytonA
04-28-2016 04:39 PM
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Roy289 Online

Preferred Members

Posts: 77
Joined: Apr 2016

Machine: ResMed AirSense™ 10 AutoSet™ for Her CPAP w/ HumidAir™ Humidifier
Mask Type: Nasal mask
Mask Make & Model: P&S 405
Humidifier: Climateline
CPAP Pressure: 7-14
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Canada

Post: #9
RE: Next step(s) after getting AHI <5
BadGoodDeb,
Not sure if I would tolerate pillow style of mask like Resmed P10. Certainly will try them if no success reducing leakage.

PaytonA,
Examining the leakage areas there doesn't appear to be apnea events nearby. Perhaps there is an impact on apneas but not sure. My goal is to reduce leakage to a minimum.

OpalRose,
May try reducing EPR to 2 as suggested

Thanks everyone for the comments
04-28-2016 07:12 PM
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trish6hundred Offline

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Posts: 6,450
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #10
RE: Next step(s) after getting AHI <5
Hi Roy289,
Sounds like you are doing well.
Keep up the good work.

trish6hundred
04-28-2016 07:25 PM
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