Two plus months in and AHI varying widely

[3porpoise]

Hi wp6529,

In addition to what others have said.It may be that they recc a pressure of 13 as optimal and pressures above caused CA's .Do You have a copy of the full diagnostic sleep study results (5-6 pages)?
In the meantime while waiting to talk to your Dr or therapist,
I found it beneficial to side sleep only a few nights and back sleep a few nights even on apap to compare what was happening as side sleep generally had less apneas and lower pressures.Did end up with ASV. Just a thought.
Take care,
3

[Sleeprider]

I did the titration study (not split), and it recommended CPAP at 13. I specified the APAP since I figure one night of titration is not a real world simulation, not the variable position and adaptation once you've used a PAP for a week or two so I wanted the auto to be able to adapt and settle in at the most appropriate point. I started at 6-16 and tightened to 9-16 after I had some data showing the average and 90% pressures. This big question is what factors are affecting the good vs. bad nights, which hopefully I might get a handle on if I start a diary.

The reason I asked about the titration study is that if you had CPAP induced complex apnea, it might have showed up there. Similarly if you titrated on APAP at home, then no one would be aware of this issue. If your titration study was like the good night you posted, then no flags would have appeared to try an ASV type machine; however if you had events like the bad night, then I'm almost certain the technician would have tried some alternatives to deal with the centrals.

With your current pressure at 9-16 with EPR at 2.0 your effective minimum EPAP pressure is 7.0. I tend to see the H and OA events at the lower end of your pressure range, and I think I'd raise minimum pressure by 1.0 until OA+H is consistently less than 5.0. Pressure does not address CA events, and if you routinely have CA index over 15, it is a sufficient concern to involve your doctor as treating it would require an evaluation of why it is occurring and potentially a different type of machine. For now, your machine only treats OA+H and that is where you focus your efforts to minimize those events. It may or may not improve CA, however if those events get worse, then you're back to the doctor.

[quiescence at last]

wp, I sent you a private message.

[wp6529]

The last few nights have been ~10 AHI, not terrible, but not great either. Last night I adjusted min from 9 to 10 and EPR from 2 to 1 and this morning I had an AHI of 5.x (not near machine currently). We'll see if this continues...

[wp6529]

4.1 this morning, hopefully a trend...

[wp6529]

13.3 the next day then 7.7 last night. Only correlation so far seems to be stress, the 13.3 was the night after a particularly stressful day while yesterday wasn't too bad. I'll keep tracking and tweaking and see if I can at least keep it in the single digits consistently.

[Cygnus]

Let me know what you find.

I've been in the same boat but with bipap.

Been as low as .7 and as high as 11. Only trend that seems to show is mask...when using nasal, my Ahi plummets, but my leak rate soars...and I don't feel near as good.

With ffm I've been as low as 1 and as high as 10.

Figure I might need to go into auto mode to further identify, waiting to meet the dr before I do that.

Also, might switch over to cpap with epr of 3 for a try....

[GWild]

I'd be a bit curious regarding the pegged flow rate in that bad day chart. It is awfully coincidental to when the apneas are being logged, almost one for one.

Any chance there is hose or mask leakage ??

[wp6529]

I don't think there is really much for pegged flow rates, just a few spikes that likely coincide with me scratching a nose itch or wiping out some drool.

[GWild]

re The flow rate -- looking more closely at one of my charts, the marks I was referring to are an artifact of Sleepyhead, and not a real flow limit event. So ignore my earlier comment.