My first Sleephyead report, AHI trending up

I'm 3 weeks in to my new APAP, after a month long trial. Same machine type (Respironics) in both cases. I've just done my first Sleepyhead report, and would definitely appreciate any help in deciphering it - I'm still really confused about all the acronyms, meanings, and so on. One thing I do notice on my noob own is that my AHI is trending up.

It may be worth noting that during my trial, I tested a few different masks, and didn't think to note which mask was on which night. So that could explain some variation. But I believe I've used the same mask (Brevida) for all of the Sleepyhead period. If there was any other mask used, it was in the first couple of days only.

Any feedback, thoughts, information, suggestions, or recommendations?

Trial period








Since then

It's easier to analyze the daily Sleepyhead chart, but off hand all I can suggest is to increase your minimum pressure to 7. That should drop your AHI a bit. Are you using nasal or pillow mask and possibly mouth breathing a bit?

LSAT wrote:It's easier to analyze the daily Sleepyhead chart, but off hand all I can suggest is to increase your minimum pressure to 7. That should drop your AHI a bit. Are you using nasal or pillow mask and possibly mouth breathing a bit?

I knocked the minimum up to 7, and got rid of ramp (which I actually thought was already off). Last night my AHI was down to 2.7, which was definitely nice to see! Thanks for the suggestion.

I'm using the Brevida nasal pillow mask, and I don't *think* I'm mouthbreathing, though I can't guarantee anything, obviously. If I'm *seriously* mouthbreathing, I wake up with a dry tongue and teeth, which I'm not. But that doesn't preclude a little here and there. Though generally, if my nose is clear (ie, not stuffed up), it's my main breathing source.

Hopefully, the number will stay down from here on.

You are using a Respironics DreamStation machine and SleepyHead default set up for large leak calculation statistics is for the ResMed machine.
So you probably need to make a correction in SH so that the statistics for % of time over red line leak threshold is more accurate (though it isn't bad now).
Go to Preferences/CPAP tab and on the right side you will see 24 L/min as the red line threshold number...change it to maybe 60 L/min which is more in line with what the actual threshold is for your Respironics machine. They never tell us exactly where the line is because it varies with pressure and mask...so it can vary quite a bit. 60 L/min is a nice conservative number.
Or just turn that statistic off by removing the check mark if you wish.

Your summary report shows very minimal time spent over the threshold (and that's likely the ResMed threshold which doesn't work for you anyway because your threshold is higher)...so probably not a big deal.
I seriously doubt if you are doing any mouth breathing unless it is very brief. Look at the daily events graph...see the LL on the top of the events graph?
That's large leak and if there aren't any flags for large leak you didn't have any large leaks....and mouth breathing of any significance will show up as a large leak.
Leak is leak no matter what the cause...open mouth or ill fitting mask.

As to your original question about the AHI trending upwards...can't offer much because there's some stuff on the detailed graph that we can't see on these summary graphs. Maybe you are sleeping more on your back where you maybe need more pressure than you used to...maybe you are getting more REM sleep for some reason where again sometimes we need more pressure. It's quite common for our OSA to be worse in REM or when sleeping on our backs and/or need more pressure for whatever reason.
In this situation I don't worry so much about why ....I just would want to fix it and that means a little more pressure. We can't do anything about REM and staying off our backs is easier said than done and unless there's a huge difference in pressure needs with side vs supine sleeping I wouldn't do anything but set the minimum optimally and let the machine sort it out. If it's REM related you can't control it anyway. Sleep however you want and let the machine do what it is designed to do.