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Low AHI, still having several arousals and bad sleep. Please help - Printable Version

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Low AHI, still having several arousals and bad sleep. Please help - Quimey - 02-06-2023

Hi everyone!

Hope somebody could help me out and throw some insight on my CPAP reports. I have been a CPAP user for two years now, and since I started using it, my sleep improved drastically and was able to get a good quality sleep. Unfortunately, it's been a few months since my sleep has gone to "hell". I keep waking up several times throughout the night despite having a low AHI. I have a resmed air10(CPAP,no APAP).

Initially I was put a fixed pressure of 9, now that I went back to the doctors, they gave me the APAP for 2 days and came back with a pressure of 6 along with a humidifier. I feel this has helped a bit, nevertheless arousals are frequent and I feel exausted all the time. I've been playing around with different pressures and my AHI seems to get away even with low pressures. My Epap is on 3

I've added reports from different days on different pressures. Let me know if any zoom or other detais are needed.

Thank you so much in advance!


RE: Low AHI, still having several arousals and bad sleep. Please help - Sleeprider - 02-06-2023

Quimey, welcom to Apnea board. At first glance, your therapy looks very good at a pressure of 7.0 with EPR 3. Most of your residual events are obstructive and are related to the flow limitation that remains at your current pressure. With EPR at 3, your pressure is very low at 7.0/4.0 (inhale/exhale), so since you have already used all the EPR available, you need to start titrating your pressure higher to see if you can improve your sleep and lower the flow limits which are currently in the 95% range of 0.07 to 0.15. I recommend you try increasing pressure in 1-cm increments and use the new pressure for several nights. Track the results based on how you feel as well as looking for changes in event rates and 95% flow limitation. I think you will see improvement somewhere around 9.0 cm pressure which will be 9.0/6.0 with EPR.


RE: Low AHI, still having several arousals and bad sleep. Please help - Quimey - 02-06-2023

Thank you for the response and the advice, I will try tonight on 8 to see how it goes although I am a bit concerned as the night with pressure 7 felt worst than the night with 5.6. Any reasons that's the way to go?

Thank you for your time and I will post the reports tomorrow on pressure 8.


RE: Low AHI, still having several arousals and bad sleep. Please help - Sleeprider - 02-06-2023

Well, I had no history on past pressures and what has felt best/worst or your results at any pressure other than the current 7.0/4.0. At 8.0/4.0, I'm looking for flow limitations to be reduced. This may be sufficient to stop arousals or awakening. We all have different tolerance for pressure and I hope you will give me honest feedback after trying this.


RE: Low AHI, still having several arousals and bad sleep. Please help - Quimey - 02-07-2023

Good morning,  I have tried the pressure on 8 and had a pretty bad night, woke up more than usual to be honest . I'll attach the report 

Thank you


RE: Low AHI, still having several arousals and bad sleep. Please help - Sleeprider - 02-07-2023

This lowered the 95% flow limitation below all previous charts to 0.05. I consider that to be a success for the numbers, but not for your sleep quality. Was the pressure specifically disruptive or something else?


RE: Low AHI, still having several arousals and bad sleep. Please help - Quimey - 02-07-2023

the only thing that changed was the pressure and I just noticed that had more arousals than usual. I cant tell if it was the pressure the disrupting factor.


RE: Low AHI, still having several arousals and bad sleep. Please help - Sleeprider - 02-07-2023

I suggest giving it another night before reverting back. If any of your arousal issues are related the CPAP therapy, then this is the only logical path forward. It's certainly possible that it is at least no worse. A 1-cm pressure change is relatively minor, and it had no effect on your respiratory statistics. Since your therapy is just fine at a pressure of 7 or 8, it's completely up to you.