[Kohkie]

I have been on CPAP since Nov 21, 2011, almost 3 months. And I was obsessing about the numbers. My weekly average AHI was in the 2.X - 3.X range. Some nights my AHI was as high as 8. So I searched though the posts here, and found out how to get the information to adjust my settings. I started out slowly raising the minimum pressure. My sleep doctor started me on Max/Min of 15/9. I changed it to Max/Min of 15/10 then 15/11. I was also on level 3 for the Auto C-Flex. After I adjusted to the pressure changes, I lowered my Auto C-Flex to 2, and currently have it down to 1. My AHI has gone down to 1.X, with the lowest last week at 1.3 for the week. Now I'm thinking of raising the minimum pressure one more time to 12 and see if I can get it down to 0.X. I have learned that it takes me about 2 weeks to adjust to any changes I make, so I make small changes then wait two weeks to see if they helped.

I could never have done this without all the info I have gathered from the posts here, and all the great people who share their experiences, so us newbies can learn to help ourselves. Thank you everyone! And if you post a reply, would everyone post what they think the perfect average AHI should be.

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Machine: PR System One REMstar Auto CPAP Machine with A-Flex

Mask: Swift™ FX For Her Nasal Pillow CPAP Mask with Headgear

Humidifier: PR System One Heated Humidifier

[kteague]

Congrats on the quick progress you are making. About a desirable AHI, I would say the lower the better, but I would caution against a relentless pursuit of the oft elusive 0.0 AHI.

In theory, it seems to me a person should be able to set their pressure at a point high enough to prevent any events, however, preventing an occasional worst case scenario may come with a high price in the discomfort of aerophagia, mask leaks, or even centrals. How aggressively to pursue ultra low event numbers probably has a lot to do with to how high of a pressure one would have to go. Some feel anything below 5 is an acceptable AHI. Maybe it is, but in 8 hours of sleep that would be 40 events. If even a few of those resulted in arousal and/or desats, to me that is not very therapeutic treatment. It's been a while since I've checked my numbers, but I was hitting 0.0 maybe a couple times a week, rest of the time was usually well under 2. I did bump up my prescribed pressure by 1, but I sure hope I don't have to go higher because that small increase opened the door to more leaks and belly air.

Again, congrats, and best wishes moving forward.

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Humidifier: Remstar Integrated Passover Humidifier

Software: Encore Pro Smart Card

Additional Comments: Deconstructed Twilight NP

[Pugsy]

Now I'm thinking of raising the minimum pressure one more time to 12 and see if I can get it down to 0.X.

Perhaps a 0.5 increase in the minimum would be enough to get you below that 1.xxx mark?
At this stage full 1 cm increments may not be needed. You will have some nightly variations anyway.
Respironics machines only let us do change is 0.5 increments.

Don't go chasing that 0.0 AHI though....it is very elusive and while some people do attain it and fairly often..most of us don't and it really is not a realistic goal.

I found that when I switched to BiPap my AHI dropped from 3.x to around 1.x (with a few nights below 1) without ever changing anything but it took about 2 months for the changes to happen on a consistent basis. So when at this stage of things give it lots of time for the results to be seen in the numbers.

There comes a time when pressure changes don't really seem to affect the AHI all that much no matter how much we increase the pressure. Unless someone wants to use 15cm or 18 cm all the time...which we sure don't want to do and that can open up a whole new can of worms to deal with.

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Machine: PR System One REMstar BiPAP Auto with Bi-Flex

Humidifier: PR System One Heated Humidifier

Additional Comments: Also have S9 VPAP Auto, PR S1 BiPap Pro 60 series, pressure EPAP 9 cm & IPAP max 20 cm, software-SleepyHead, ResScan EncoreBasic

[Mary Z]

Kohkie, I don't think there is an ideal AHI. If you have an AHI of 1.3 and your symptoms are resolving I think that's pretty much ideal. Good work.

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Mask: Wisp Nasal CPAP Mask with Headgear - Fit Pack

Humidifier: PR System One Heated Humidifier

Additional Comments: PR System One Remstar BiPap Auto AS Advanced.

[Kohkie]

Thanks for the replies and advice. I don't think I'd want to go for 0.0, as you said it is more than likely unreachable on a regular basis. I only raised the minimum to 11.5 last week. I am just hoping to find a level that will keep me at 1.x. I did hit a 0.1 once. Pretty exciting stuff! After raising it to 11.5 my nightly AHI went up to 2.3, 2.3, 2.1, 2.1, 0.9, and 1.0. I've noticed it usually takes me about a week to get the benefits of any pressure change. So this next week will tell the story. If I don't see any improvement I will put it back to 11 and be happy with that. Once again, thanks everyone for you response and advice.

_________________

Machine: PR System One REMstar Auto CPAP Machine with A-Flex

Mask: Swift™ FX For Her Nasal Pillow CPAP Mask with Headgear

Humidifier: PR System One Heated Humidifier

[hades161]

I try to keep my AHI under 2.0 any more and I start to feel crappy. I know people say 5.0 is cool and maybe it is for others but for me 2.0 is my ceiling. If I go higher I start looking at things more closely if lower it's gravy =).

Great work on getting things under control ! and Best wished for the future!

_________________

Machine: S9 AutoSet™ CPAP Machine

Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear

Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control

Additional Comments: I swap out the Swift FX as needed with the Mirage Quatro Full Face with Headgear.

[Kohkie]

Yeap, we think we're doing great, everything is under control, and then we hit a night like last night. I can't tell you how many times I woke up during the night. Pretty well knew the numbers were going to be bad when I finally got up. Last night was a 4.3. I too like to keep the AHI down around 2 and under. Amazing that I can recognize a 4.3 now that my body has adjusted to sleeping all night, when according to my sleep study I was living with a 63.6 AHI.

I've been reading some of the posts and some people seem to have a link between food and sleep. I did go to The Old Spaghetti Factory for dinner yesterday. Maybe I should take a look at my food diary and compare it to my AHI diary. Maybe I can spot a trend there. Something to think about...

_________________

Machine: PR System One REMstar Auto CPAP Machine with A-Flex

Mask: Swift™ FX For Her Nasal Pillow CPAP Mask with Headgear

Humidifier: PR System One Heated Humidifier

[hades161]

Oh indeed !

Food or Drink can effect your AHI for a night.

If you drink alcohol shortly before bed or say eat something that triggers heartburn. Or you eat something that seems to "stay with you" for a while. Good Idea to look over your food logs =)

_________________

Machine: S9 AutoSet™ CPAP Machine

Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear

Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control

Additional Comments: I swap out the Swift FX as needed with the Mirage Quatro Full Face with Headgear.

[Kohkie]

Loving how my numbers are doing. Currently I have the pressure a little higher because I am using a bacteria filter. Current pressure settings are Max/Min 16/12.5 Auto 2. Unless something weird happens I'm pretty happy with everything as it stands at this point. Tried going on straight CPAP and that didn't work for me at all. Had my worse 2 weeks since beginning CPAP, so went right back to auto settings. I don't use the ramp at all. No need. It takes me about 3 breaths to be totally comfortable with the pressure. One funny thing I've noticed. If my numbers start to go up, it's time to change my nasal pillow, which I just did yesterday after 4 days of 1.X AHI, with one 2.3 thrown in for good measure. Last night with new nasal pillow, it was back down to 0.3. Oh and one thing that helped tremendously was when I started using Lasinoh on my nose every night before putting on the mask. Makes for a GREAT seal with the nasal pillows and I was able to use the pillows for a longer time than usual.

Monthly Average AH1 & RERA

Month AHI RERA Dates
Nov - Dec 3.1 0.8 11/20/11 - 12/19/11
Dec - Jan 2.7 0.8 12/20/11 - 01/19/11
Jan - Feb 1.6 0.8 01/20/12 - 02/19/12
Feb - Mar 1.7 1.8 02/20/12 - 03/19/12
Mar - Apr 1.2 2.1 03/20/12 - 04/19/12
Apr - May 1.1 1.0 04/20/12 - 05/19/12
May - Jun 0.8 1.0 05/20/12 - 06/19/12
Jun - Jul 0.7 0.8 06/20/12 - 07/19/12

_________________

Machine: PR System One REMstar Auto CPAP Machine with A-Flex

Mask: Swift™ FX For Her Nasal Pillow CPAP Mask with Headgear

Humidifier: PR System One Heated Humidifier