CPAP Pressure & High AHI following turbinate reduction

[christay]

Hi - I would appreciate your advice & comments on my experience following my recent turbinate reduction surgery. I have over the past 10 years suffered from a chronic nasal congestion. I have been using a nasal steroid spray Budesonide which of late was losing its effectiveness. I have seen a couple of ENTs who all unanimously suggested surgery. I just underwent the surgery 4 days ago. 

I have been using a CPAP for a good 9-10 years. Prior to the surgery, my average AHI is 0.9 & I have a Dreamstation Auto CPAP with a AirFit N20 nasal mask. Min Pressure 10, Max Pressure 14, Average 90% Pressure 11.4

My ENT suggested I get a full face mask to use the second night after the surgery & I opted for the AirFit F20. 
I noted the normal pressure of 10 now seemed to be very strong when breathing through my nose.
Prior to the surgery, I am told the surgery will likely help my sleep apnea in that it will enable me to breathe better & easier & it may also lower the CPAP pressure required.
I also observed my AHI for the past 2 nights were 6.6 (Thurs) & 4.8 (Fri).

Given some of you having undergone similar surgery in the past. I welcome your advice on the following:-

1. Could I revise the CPAP pressure from 10 to say 8 or 9 to try out?

2. What is the likely reason for the high AHI? I am just guessing the turbinates are still swollen from the surgery hence causing the AHI to rise.
    Note- the mask fit for the F20 is not as good as the N20 for my case.

3. How best to determine the right CPAP Pressure once the wounds have healed & settled? 
    Do I have to have a sleep test done & who would be the right person to do this - sleep technician or doctor?

Thank you.

[ardenum]

your turbinates werent the only swollen thing in your airway, im pretty sure the exit of the nasal to mouth passage was also swollen and now when you can finally breathe better its what making the ahi worse, you might need a minimal palatoplasty i believe, that is if the trend continues on, after all youre only 4 days after surgery.

[Walla Walla]

There are a couple of reasons that could be a factor. Swelling has already been mentioned. Moving from a Nasal mask to a full face mask usually requires an increase of around 1 cm in pressure to maintain the same AHI. Once your healed up finding the settings will be easy. Just a matter of tracking your results over a few days and adjusting the minimum pressure as needed.

[OpalRose]

Given some of you having undergone similar surgery in the past. I welcome your advice on the following:-

1. Could I revise the CPAP pressure from 10 to say 8 or 9 to try out?

2. What is the likely reason for the high AHI? I am just guessing the turbinates are still swollen from the surgery hence causing the AHI to rise.
    Note- the mask fit for the F20 is not as good as the N20 for my case.

3. How best to determine the right CPAP Pressure once the wounds have healed & settled? 
    Do I have to have a sleep test done & who would be the right person to do this - sleep technician or doctor?
Thank you.

Hi christay,
I wouldn’t have a problem with lowering the pressure a bit to give yourself time to heal.  But remember, a full face mask usually requires a little higher pressure to achieve the same results as using a nasal mask, so you may experience higher AHI numbers for a little while.

Your numbers could also be higher simply due to the surgery, healing process, and any possible pain pills you may be taking.  Give yourself the time needed to heal.  Eventually, you will be able to go back to using your nasal mask if you wish.  

I don’t see a reason for a sleep study after healing.  You have a data capable auto machine.  It will be easy enough to determine your own pressure needs by using #SleepyHead software and all the help and advice you can receive here.

Remember, we are not doctors... but give pretty accurate advice based on our experiences.

[Sleeprider]

Using #Sleepyhead would allow close examination of the flow rate and enable you to determine if the increased OA relates to flow limitation. Dreammapper is not going to help you or us make anything but best guesses. I think this problem will pass soon, and your therapy will return to normal...that is my best guess.

[christay]

Many thanks to you all who provided your advice & comments to my questions. Much appreciated.

I will also try out the SleepyHead as per your suggestion.

Wishing you folks a great day - it's a beautiful sunny morning in Vancouver!