How to reduce AHI index?

[Attanasio89]

Hi! I'm new to the world of OSA.
My AHI index without CPAP is 16-32 depending of sleep position (16 side position, 32 supine position).

I am 61 and I started using CPAP machine from 5 days; I'm using a Philips DreamStation Auto CPAP with Amara View Mask.
I tryed to sets the APAP machine in CPAP-Check mode with a fixed pressure of 9 cm H2O (pressure value identified during my in-lab sleep study), but I obtained a quite bad result with an AHI of 7.41.

Then, I switched the machine to Auto CPAP mode trying sevaral combination of pressure range but with no AHI index improvement. 
My currently AHI index (with APAP machine) is between 7.5 and 10.
The mask fit value I read on the display of DreamStation is always 100%.

I'm changing the therapy settings day by day in order to reach a good AHI index, but I had no success.
Surfing on internet I found this forum so I decided to ask for help to you.

The following are the data of the first 5 days of therapy:
17/08 - Auto CPAP, pressure 4-20 cm H2O, AHI 7.70

18/08 - CPAP-Check, fixed pressure 9 cm H2O, AHI 7.41

19/08 - Auto CPAP, pressure 6-14 cm H2O, AHI 10.44

20/08 - Auto CPAP, pressure 6-14 cm H2O, AHI 9.59

21/08 - Auto CPAP, pressure 8-12 cm H2O, AHI 7.92

Can I do something to reduce the AHI index? 
What about the Flex settings?
I used AFlex = 3 during the first 4 days; last night I changed to CFlex = 1.
Can the Flex impact on the AHI index?

Thanks in advance for your help!

[Sleeprider]

What is the breakdown of the AHI? List the OA, CA and H rates. It seems you are making some pretty large changes to the pressure and mode on the machine and not seeing much response. The type of apnea that occurs matters. It would be ideal if you could post a chart as shown in the first two links in my signature.

[Attanasio89]

I need to post 4 times in order to do the image upload.

[Attanasio89]

I need to post 4 times in order to do the image upload.

I see the followinx message:

Please correct the following errors before continuing:

• I'm sorry, brand new members are not allowed to post links in this forum until they have 4 posts.
  

[Attanasio89]

I'm installing SleepyHead in order to prepare the screenshots.
Sorry for the multiple posts.

[Attanasio89]

What is the breakdown of the AHI?  List the OA, CA and H rates.  It seems you are making some pretty large changes to the pressure and mode on the machine and not seeing much response. The type of apnea that occurs matters.  It would be ideal if you could post a chart as shown in the first two links in my signature.

Since I can't post any link, I attached the first screenshot 17/08 to this post.

[Attanasio89]

What is the breakdown of the AHI?  List the OA, CA and H rates.  It seems you are making some pretty large changes to the pressure and mode on the machine and not seeing much response. The type of apnea that occurs matters.  It would be ideal if you could post a chart as shown in the first two links in my signature.

17/08 - Auto CPAP, pressure 4-20 cm H2O, AHI 7.70
hxxp://i.imgur.com/FgwpAOE.png


18/08 - CPAP-Check, fixed pressure 9 cm H2O, AHI 7.41
hxxp://i.imgur.com/KdPQdjq.png


19/08 - Auto CPAP, pressure 6-14 cm H2O, AHI 10.44
hxxp://i.imgur.com/SG8ycD4.png


20/08 - Auto CPAP, pressure 6-14 cm H2O, AHI 9.59
hxxp://i.imgur.com/bYnhJa6.png


21/08 - Auto CPAP, pressure 8-12 cm H2O, AHI 7.92
hxxp://i.imgur.com/yOmHZJo.png

[Sleeprider]

Your membership has been upgraded and you can now post your own images.  Your events are all over the place with a wide mixture at many different pressures.

[Sleeprider]

Low pressure clearly result in obstructed breathing as we see from the use of ramp on 8/21 and the relatively low minimum pressure on 8/19. My impression is that you need a minimum pressure of 9 maximum pressure 14 with whatever flex level you find comfortable. I think there is a possibility that you experience some degree of positional obstruction, and either a pillow that supports your neck or a soft cervical collar could help with some of the events. The central or clear apenea don't appear to be a serious problem, and are likely a matter of sleep disturbance and you just need time to adapt to CPAP.

This is going to improve with time, but I think the higher minimum pressure on auto mode is going to help you get there faster.

[trish6hundred]

Hi Attanasio89,
WELCOME! to the forum.!
Good luck with CPAP therapy and hang in there for more anser to your question about your graphs.