Is AHI the thing I need to improve?

[Wulfman...]

Some people use things like Neti-Pot irrigation systems.
Whatever it takes to clear out the nasal passages.
Most any other nasal spray besides Afrin should be OK to use. Some claim that Afrin can be used more often, but I wouldn't chance it. Too many horror stories in these archives.

If you're going to use a range, I think I would limit the top pressure to 15 and maybe the bottom to 10 to start with. You're going above that now, so it shouldn't be a problem. If you want to try a fixed pressure, you could try setting the minimum and maximum to about 12 and see how that goes.
Until you get the snores fixed, the pressure is probably going to go to the maximum pressure regardless (if using a range).
This is another reason I started and pretty much stayed with a fixed pressure. I have very few apneas or hypopneas and my snores were horrendous, so I didn't want to have the pressure changes disturbing my sleep.


Den

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[Wulfman...]

One thing about using fixed pressure is that you can adjust your mask for that pressure. With ranges, you need to adjust it for the highest pressure you may encounter. That may end up being a little tighter than is comfortable when the pressures are lower.


Den

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[KC1977]

Thanks Den, that’s really helpful.

I’ll raise the minimum as high as I can stand for now and tweak the other settings over the next week. I’ll look at he data daily because after the first 2 nights I had no clue what was happening until I downloaded Sleepyhead yesterday. I also feel better today than I normally do on a Saturday so hopefully I’m getting better sleep than normal.

I have my review appointment on 3rd January and I don’t know how they’ll react to me making tweaks. I’m accessing the hidden menu to do this and they probably presume I won’t do that etc. I don’t think there is any harm in methodically trying different strategies.

[palerider]

I have my review appointment on 3rd January and I don’t know how they’ll react to me making tweaks. I’m accessing the hidden menu to do this and they probably presume I won’t do that etc. I don’t think there is any harm in methodically trying different strategies.

It all depends, if you've got a good doctor, they'll be pleased that you're involved and improving.

if you've got a power tripping control freak... get another doctor.

[TedVPAP]

Hi Folks,

I've just been diagnosed and have had 3 nights with my DreamStationAutoCPAP. I was told by my Doctor my AHI was 43 during my test.

I'm looking at the results using SleepyHead and I can see the AHI was 13.21 on Wed, 7.32 on Thu and 5.78 last night (Fri). Friday was the best night sleep I've had so far.

Is this the key metric I'm trying to improve or is there something else I should be looking out for? I can see from the graphs when the pressure ramps up, I wake up and press the ramp button so I presume long periods of sleep are also a goal?

Here is the SleepyHead data from last night.


Any thoughts or comments very welcome - I know nothing about any of this.

Many Thanks!

Your data is a great example as to why it is so important to set the minimum pressure close to where your TRUE need will be. By setting the minimum pressure higher, the fire trucks will be close enough to extinguish the flame before it burns down the building.

[coconur]

Why do you think fixed would be better than a range?

Another potential reason for fixed pressure, or at least a tight range, (and don't worry about this until after you've got all of your breathing events well controlled) is if you have high blood pressure. For, me my breathing events were all well controlled at a pressure of 8, but my BP was still high. I started tweaking my pressure, seeking control of my BP, and it turned out I needed to run my CPAP at 12 to get the BP back to normal. Even good sleep doctors can be reluctant to go after blood pressure, and I wonder if that's not due, at least in part, to an NIH study from about 10 years ago that flat out stated that mild apnea should not be treated, and that BP didn't respond to CPAP therapy. (In some cases it may not if there's a different cause, or they simply may not have been curious enough to try a higher pressure than the AHI indicated was necessary.)

Anyway, welcome to the forum. It looks like you're on your way to better sleep and feeling better.

[coconur]

Here's a link to the NIH study. I'm the opposite of the conclusions in this study.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564770/

[Midnight Strangler]

Another potential reason for fixed pressure, or at least a tight range, (and don't worry about this until after you've got all of your breathing events well controlled) is if you have high blood pressure. For, me my breathing events were all well controlled at a pressure of 8, but my BP was still high. I started tweaking my pressure, seeking control of my BP, and it turned out I needed to run my CPAP at 12 to get the BP back to normal.

By what mechanism do you think a pressure that is higher than necessary to control breathing events is able to bring blood pressure down to normal? I suspect confounding variables are causing you to assume causation where there is no causation.

[coconur]

Another potential reason for fixed pressure, or at least a tight range, (and don't worry about this until after you've got all of your breathing events well controlled) is if you have high blood pressure. For, me my breathing events were all well controlled at a pressure of 8, but my BP was still high. I started tweaking my pressure, seeking control of my BP, and it turned out I needed to run my CPAP at 12 to get the BP back to normal.

By what mechanism do you think a pressure that is higher than necessary to control breathing events is able to bring blood pressure down to normal? I suspect confounding variables are causing you to assume causation where there is no causation.

Twice in my life I've had high BP, and both times I have been able to bring it back down to normal levels by treating my sleep disordered breathing, the first time with a mandibular advancement device, and the second time with the cpap -- but only at the higher pressure. My sleep doctor was dubious at first about whether my BP could be controlled by the cpap, but after several months of high BP at lower cpap pressures, then seeing my BP drop to normal at a cpap pressure of 12, he looked at me and said I had just proven to him that, in my case, my BP was related to my apnea. I don't pretend to be able to explain why I needed more pressure to bring my BP down, but it's been working for nearly 10 years. At my last checkup a few weeks ago, it was 110/60. I'd rather control it with cpap than with drugs.

Causality? Maybe this isn't proof, but what a coincidence that my BP dropped to normal twice with two different apnea treatments.

[Midnight Strangler]

Maybe this isn't proof

Maybe isn't proof? It certainly isn't proof.

[coconur]

Maybe this isn't proof

Maybe isn't proof? It certainly isn't proof.

Of course, it's equally true that there is no proof the cpap didn't bring my BP down...

[Midnight Strangler]

it's equally true that there is no proof the cpap didn't bring my BP down...

There is also no proof that CPAP didn't bring down the population of elephants in the wild.

[Goofproof]

it's equally true that there is no proof the cpap didn't bring my BP down...

There is also no proof that CPAP didn't bring down the population of elephants in the wild.

But it too is unlikely, as the extension cord was too short. Jim