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[Pressure] Higher Pressure = Higher AHI?
#1
Hi,

I'm new so please be patient with me. I use a Respironics CPAP with nasal pillows.

I have recently had my pressure increased from 12 to 13 because the lowest AHI was 5.9 and the doctor thought a higher pressure would reduce it.

After one night of the increased pressure, my AHI went up to 9 and I woke up with a white substance around my mouth. I don't know if the higher pressure is causing me to breathe through my mouth or if I need a chinstrap and maybe can go back to the lower pressure.

Can anyone help me solve this problem?

Thanks!
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#2
It is not unusual for changes in pressure to initially cause an increase in AHI. It takes several nights to adapt and determine if the new therapy pressure is going to work. One way you tell what happened is to download and extract the Sleepyhead software program http://www.sleepfiles.com/SH2/

By loading your data into Sleepyhead you can tell what kind of events occurred. It is important to know what kind of events are causing our elevated AHI. If you are experiencing CA (clear airway) events as opposed to OA (obstructive apnea) or H Hypopnea, then pressure is not the answer to the problem. Your PRS1 CPAP Pro 460P will provide this kind of data. Please download the software, and post the breakdown of the AHI events before and after the pressure change.
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#3
(04-01-2015, 10:40 AM)achoden Wrote: Hi,

I'm new so please be patient with me. I use a Respironics CPAP with nasal pillows.

I have recently had my pressure increased from 12 to 13 because the lowest AHI was 5.9 and the doctor thought a higher pressure would reduce it.

After one night of the increased pressure, my AHI went up to 9 and I woke up with a white substance around my mouth. I don't know if the higher pressure is causing me to breathe through my mouth or if I need a chinstrap and maybe can go back to the lower pressure.

Can anyone help me solve this problem?


Thanks!
Welcome to the forum.

Not knowing your actual data it is almost impossible to determine what pressure is needed just based on the AHI. The AHI is a combination of CA's (Central Apnea or Clear Airway), OA's (Obstructed Airways) and Hypopnea. Each responds differently to pressure changes. An increase in pressure can lead to an increase in CA's (Central Apnea or Clear Airway) which is the brain not telling the body to breathe. An increase in pressure can cause you to breathe through your mouth, as well as, cause chest discomfort. . . Not saying this is your problem; I'm just informing you as to things that can happen. Get Sleepyhead and post your sleep data so we can better see what is occurring.

Take Care!


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#4
(04-01-2015, 11:18 AM)sgearhart Wrote:
(04-01-2015, 10:40 AM)achoden Wrote: Hi,

I'm new so please be patient with me. I use a Respironics CPAP with nasal pillows.

I have recently had my pressure increased from 12 to 13 because the lowest AHI was 5.9 and the doctor thought a higher pressure would reduce it.

After one night of the increased pressure, my AHI went up to 9 and I woke up with a white substance around my mouth. I don't know if the higher pressure is causing me to breathe through my mouth or if I need a chinstrap and maybe can go back to the lower pressure.

Can anyone help me solve this problem?


Thanks!
Welcome to the forum.

Not knowing your actual data it is almost impossible to determine what pressure is needed just based on the AHI. The AHI is a combination of CA's (Central Apnea or Clear Airway), OA's (Obstructed Airways) and Hypopnea. Each responds differently to pressure changes. An increase in pressure can lead to an increase in CA's (Central Apnea or Clear Airway) which is the brain not telling the body to breathe. An increase in pressure can cause you to breathe through your mouth, as well as, cause chest discomfort. . . Not saying this is your problem; I'm just informing you as to things that can happen. Get Sleepyhead and post your sleep data so we can better see what is occurring.

Take Care!

To clarify: I was diagnosed with mild Obstructive Sleep Apnea and hypersomnia in 2014. The titrated sleep study showed an AHI of 11.9.

I will get Sleepyhead and post my sleep data.

Thanks.
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#5
Hi achoden,
WELCOME! to the forum.!
Much success to you with your CPAP therapy.
trish6hundred
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#6
I agree with we need more info. I look forward to seeing the sleepyhead data. Best of luck with adjusting to cpap, just don't give up!
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#7
Achoden, I saw from another post that you have Sleepyhead, and it confirms you have significant AHI and major leaks. To help you interpret that data, it would be best if you could post a detailed graph. Here is a tutorial that describes how to do that on the forum: https://sleep.tnet.com/reference/tips/imgur

As an example, here is a graph of my data from last night. Note this chart has detailed waveforms for Events, Flow Rate, Pressure, and Leaks. Those will be the most relevant for us to see for you as well. On the left the summary has the calendar minimized so the machine settings show as well as the therapy results. Once you have the data arranged the way you want, just press F12 and the screenshot will be saved in My Documents/Sleepyhead/Screenshots.

[Image: mib4FJXl.png]

My AHI appears to be kinda high for this night, but looking more closely, all of the events are clusters of CA in the morning when I was awake. Without those, AHI is about 0.3. You can see leaks are low. The summary says:

The last time you used your Philips Respironics RemStar BiPAP Auto with Bi-Flex...
was last night (on Tuesday, March 31, 2015)
You had an AHI of 1.54, which is considered reasonably good
You machine was on for 9 hours, 5 minutes and 2 seconds.
You had no major mask leaks (maximum was 2.00 L/min).
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