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Suggestion to improve AHI, especially CA - caffee666 - 01-27-2023
Hi, my wife have been diagnosed with severe sleep apnea with AHI 30.5 (with zero CA) in a sleep study three months ago and was prescribed a CPAP. She has been using the Resmed Airsense 10 since then. We have been trying out different minimum pressure and maximum pressure but the AHI is always 2 - 3.5 for most of the nights and we can't get AHI to be below 2.0. Currently the setting is min 8cmH20 and the max 13.2H20, EPR 3 full-time. Any suggestions on how to improve the AHI, particularly CA is greatly appreciated. Thank you in advance!
RE: Suggestion to improve AHI, especially CA - Melman - 01-27-2023
Given that pressure increases to around 10 at the end of ramp and stays there or higher I suggest an increase in lower pressure to 9 or 10. The CA are minimal and will probably decrease in time. It is not unusual for new users to have treatment emergent ca which decrease as they adjust to the therapy. How is she feeling. An AHI of 2-3 is a big improvement over 30.5 and is in the range where how she is feeling is more important than chasing numbers.
RE: Suggestion to improve AHI, especially CA - caffee666 - 01-28-2023
She has not been resting well. Will change min pressure to 9 and post results next. Will reducing EPR to 2 helps in CA ?
RE: Suggestion to improve AHI, especially CA - caffee666 - 01-31-2023
Have increased min pressure from 8 to 9. However, my wife still feel not rested. Chart for last night attached. Any suggestions on how to improve her therapy? Thank you!
RE: Suggestion to improve AHI, especially CA - Gideon - 01-31-2023
Your flow limits just went crazy. The increase of 1 cmw should not have for that. My suggestion after the first post would have been to not chase numbers.
Can you be more specific to the my wife did not feel rested.
My first thought on the flow limits is that they might be positional, only might be. What does your wife use for a pillow? Any changes? When?
I'd like to see a few 4-minute views of her charts as I'd like to see what is going on down at the breath by breath level.
RE: Suggestion to improve AHI, especially CA - Sleeprider - 01-31-2023
I'm seeing some strong indicators of a positional issue here. OA events are unrelated to pressure and sometimes occur in clusters. If you look at examples in the positional apnea wiki article, you will see some of the same patterns http://www.apneaboard.com/wiki/index.php/Optimizing_therapy#Positional_Apnea
RE: Suggestion to improve AHI, especially CA - caffee666 - 01-31-2023
Thanks for your replies Gideon and Sleeprider.
Despite sleeping for more than 8 hours, she has been yawning whole day and she looks very tired, with panda eyes.
She has not changed pillow since the first posting. She has been using the normal type of pillow.
Attached are some 4min charts. Thank you for your time!
RE: Suggestion to improve AHI, especially CA - Gideon - 01-31-2023
The events you have chosen to highlight in the 4-monute views are all arousals.
What I cannot tell is what is causing those arousals.
Does this occur also when events are not present?