Higher AHI with Dreamwear?

I tried my new Dreamwear mask last night. It was pretty good (didn't quite live up to the hype) but I noticed my AHI's were higher. I thought the seal with the new mask might not be quite as good as with the nasal pillow mask. Could this be the reason for the higher AHI?

Just how much higher are we talking about and what is the breakdown into each category for those AHIs?

From 6.1 to 10.1. I don't know what you mean by your 2nd question.

AHI is composed of 3 sub index categories.

ClearAirway/Central Index
Obstructive Apnea Index
Hyponea Index.

add all 3 of them together and you have AHI.

You would need to use the available software to see each category index.
https://sleep.tnet.com/equipment
It's not available on the LCD screen.

The reason it is important is that if the AHI is composed primarily of ClearAirway Events we can't fix them with more pressure using your machine.
Now if the AHI is made up of mainly OAs and hyponeas then you need more pressure.

You'll need to see if this is a permanent situation or just an adjustment issue. If it's the former, you might want to consider going back to your prior mask.

Note that your AHI should not be greater than 5 (lower is better), so even the old way you had an issue.

D.H. wrote:You'll need to see if this is a permanent situation or just an adjustment issue. If it's the former, you might want to consider going back to your prior mask.

Why...go back to a mask just because of AHI?
Maybe a person sleeps so much better with one mask over another mask...maybe all is needed is a slight pressure change.
I think it is more important to choose a mask for comfort and sleep quality...if the AHI needs fixing then that's a separate issue. You gotta get the good sleep first. It's usually easier to fix the AHI than it is to struggle through various masks.

Besides...AHI of 6 could maybe stand some improving on anyway.

I have an auto CPAP. I thought it was supposed to adjust the pressure automatically. I guess I need to read up on this some more.

KTinTexas wrote:I have an auto CPAP. I thought it was supposed to adjust the pressure automatically. I guess I need to read up on this some more.

that's the myth, in reality, it needs tuning.

KTinTexas wrote:I have an auto CPAP. I thought it was supposed to adjust the pressure automatically. I guess I need to read up on this some more.

Sometimes you need more pressure than the machine can get to in time to prevent the airway from collapsing.
These machines don't increase the pressure in the link of an eye. Instead they can take several minutes to get to where it might need to be to better hold the airway open and by the time it gets there the apnea event has come and gone and flipped it's little middle finger to the machine while coming and going.

We have to help the machine out by fine tuning things a little. Usually just means a little better/more optimal starting minimum pressure to give the machine a better head start to get where it needs to be.

A lot of the time these machines are dispensed with pretty much wide open settings like 4 min and 20 max or 6 min and 20 max.
With the assumption if a person needs 14 it can just go to 14 but it simply can't go from 4 to 14 or 6 to 14 quickly enough to prevent the closure of the airway.
They think the maximum pressure setting is the most important when in reality it is the minimum pressure that is the most critical setting.

I don't know where your machine wants to go or needs to go because I haven't seen any reports to get a feel for what is going on but if your AHI is mainly OAs or hyponeas then you need more minimum pressure. How much more I don't know without seeing the reports.

As for why the increase with the DreamWear....I dunno what it might be.
Maybe you are sleeping better and getting more REM sleep where often we need more pressure because it's common for OSA to be worse in REM. Maybe you are ending up sleeping more on your back and you need more pressure because it is also common for OSA to be worse when on our backs for some people.
Maybe you have a little bit of both going on...more REM and on your back in REM.

I wouldn't worry so much about why but instead would worry on fixing the pressure so it doesn't matter which mask or what sleeping position or REM or not. If you have optimal pressure settings you can do what you want and let the machine sort it out.

Back when I first started therapy my RX per the titration sleep study was for 8 cm fixed...but I only got 6 minutes of REM and it wasn't enough to get a good idea of what pressure I might need in REM. My OSA is 5 times worse in REM than in non REM. So I started with an apap machine set in auto mode with a small range...8 minimum and 10 maximum...low and behold I found I was spending quite a bit of time maxed out at 10 cm...so I increased the max to 15...didn't max it out so much but still way to many OAs and hyponeas.
Then I increased the minimum to 9...helped a lot but not quite enough to suit me..AHI was running around 7 I think it was. So then I increased the minimum to 10 and that was the trick. AHI dropped to 2 ish.
The machine couldn't get to where it needed to go fast enough if I had the pressure lower than 10.
Once I gave the machine a bit of fine tuning and a head start with the 10 cm minimum my AHI improved dramatically and that was also when the nocturia ended and the morning headaches also ended.

After my 2nd might I can see that the Dreamwear mask is not the answer to my problems. I started out adding a headband to try to hold the mask on. That messed with the way it fit so it came off immediately. I tried the smaller nosepad to see if it would improve the seal and I felt like I was suffocating, so I went back to medium (which was what the sizing said I needed). In the night I woke and the headgear had moved around. I fixed that and went back to sleep but soon enough I took it off as I have been doing.

Hope you are not using the side pads. I've had about every emotion possible with Dreamwear. When I started I had to go through a ritual of adjusting. Everything had to be perfect. Two months ago I thought it was getting too old and wouldn't conform to me. Now I just slap it on and hit the pillow.

LoBattery wrote:Hope you are not using the side pads. I've had about every emotion possible with Dreamwear. When I started I had to go through a ritual of adjusting. Everything had to be perfect. Two months ago I thought it was getting too old and wouldn't conform to me. Now I just slap it on and hit the pillow.

No I am not using the side pads. What is wrong with them? Last night was better. I got in 6.3 hours which is a lot for me, The AHI was back down to 6.1. Still high I guess but I hope it gets better.

Looing again at comments and mention was made of sleeping on my back. I am normally a side sleeper but since the rotator cuff surgery I have been sleeping almost exclusively on my back because I will have terrible shoulder pain if I do not. I can prop my shoulder up with a pillow if I sleep on my side (as I used to do before my surgery0 but it just isn't enough. I have to lie on my back on a wedge pillow and even have a narrow pillow under my right shoulder to keep it from falling back. I imagine the sleeping position is affecting my apnea treatment.

I went back to my Swift nasal pillow mask after Dreamwear just to compare and now not sure which I like better. Probably going back to Dreamwear for a few days. When I went back to Swift I felt like I was suffocating at first. I thought I'd try wearing it when I am reading before bed some but I find I can only wear it lying down. The search continues.

KTinTexas wrote: No I am not using the side pads. What is wrong with them?

Dreamwear only comes in three sizes, two inches length between them. I must fall between them. I use the adhesion of the frame to the skin to keep the nose cushion in place. Otherwise it rides up. I had worn Dreamwear for a couple months before I noticed the side pads. There were no side pads on the headgear in my sleep study so I didn't expect any when I opened the package. I thought this was great so I tried them. Not sure if it made my headgear even smaller or I had just lost the adhesion that kept the mask in place. Only a couple of hours into sleep I had to remove the pads in order to stop the leaks. These pads may actually help if the mask is slightly oversize. Initially I was doing a lot of adjusting to keep the leakage down. Now I almost can adjust it in my sleep. I wish they had sizes available in inch increments. You can get used to wearing anything. If spending a good portion wearing something. It should fit better at these prices.