Just re-started therapy - Tips for lowering AHI

My AHI have been running between 15-20 each night. Just re-started therapy 4 days ago. Pressure is set at startup at 9.5, going up to as high as 14. Avg nightly pressure is 12-13, Leaks are at about 5%.Lots of apneas and a few hyponias.

Any recommendations? I was thinking of raising both the startup and upper limit of pressure to a range of 11-15cm. In the past I have had a problem with painful early morning trapped gas from swallowing air at night.

Thanks in advance!

If those events are not clear airways, edging up the lower number a bit would be my best guess. It may be if there is more prevention there will be less need for pressure increases. In the end, you may be able to stay at a lower pressure by starting a bit higher and not really have any more issue with air in the belly. The goal is to get the best treatment with the least pressure, so increase the lower number in small increments, like trying it at 10 and see if your AHI is any better. Let us know how it goes. Check your sleep study to see if your events are worse on your back. If so, taking steps to assure you stay off your back could help your AHI. Some use a cervical collar to keep from tucking their chin, which can narrow the airway. Good luck with things this time around.

Jason. Before recommending a change we like to see your graphs from sleepyhead.

Likely we would agree with you. But the graphs tell us what happened thru the night

Jason S. wrote:My AHI have been running between 15-20 each night. Just re-started therapy 4 days ago. Pressure is set at startup at 9.5, going up to as high as 14. Avg nightly pressure is 12-13, Leaks are at about 5%.Lots of apneas and a few hyponias.

Any recommendations? I was thinking of raising both the startup and upper limit of pressure to a range of 11-15cm. In the past I have had a problem with painful early morning trapped gas from swallowing air at night.

Thanks in advance!

What made you stop it 3 years ago?

kteague wrote:If those events are not clear airways, edging up the lower number a bit would be my best guess. It may be if there is more prevention there will be less need for pressure increases. In the end, you may be able to stay at a lower pressure by starting a bit higher and not really have any more issue with air in the belly. The goal is to get the best treatment with the least pressure, so increase the lower number in small increments, like trying it at 10 and see if your AHI is any better. Let us know how it goes. Check your sleep study to see if your events are worse on your back. If so, taking steps to assure you stay off your back could help your AHI. Some use a cervical collar to keep from tucking their chin, which can narrow the airway. Good luck with things this time around.

Thank you for the response. Yes, they are obstructive events. Its been awhile since my sleep study, but it did reveal severe OSI on my back, and moderate OSI on my side. Its possible I have been sleeping on my back. In the past, even using CPAP on my back, my airway would close and I would wake up. But that hasn't happened of late. I will start out on my side tonight. Leaks tend to get worse on my side, since the mask hits the pillow. And I will bump up the low end to 10.