Can lowering pressure ever help AHI.

When I did my sleep study my AHI was 10.1 and the first 30 days it went to about 4.5 so the doctor raised my pressures max from 15 to 20 to get the number lower. Since the pressure increase my AHI has stayed at around 4.5. Is it possible that lowering the pressure instead could help or would it just make it worse?

Yes, it certainly has in my case. My AHI at titration was 131 and the doctor prescribed pressures of 17/13. My AHI then ran in the 2.7 to 4.5 range, or thereabouts. It was in an acceptable range and the doctor was thrilled, but my leak issues were terrible. So I decided to try an experiment by lowering pressures on my own in an effort to make the leaks easier to control. Lo and behold each time I lowered my pressures my AHI got better. I'm now down to 11/7 and my AHI is almost always under 1.0, with a 0.0 and 0.2 not being unusual in any given week.

I have no idea why this has occurred, especially given my AHI number at the sleep study-but it has.

caryrae73 wrote:When I did my sleep study my AHI was 10.1 and the first 30 days it went to about 4.5 so the doctor raised my pressures max from 15 to 20 to get the number lower. Since the pressure increase my AHI has stayed at around 4.5. Is it possible that lowering the pressure instead could help or would it just make it worse?

What's your MINIMUM pressure setting? If you're using the Auto in a range of pressures, that's the setting that makes a huge difference. If the minimum is too low, it has too far to go to try to prevent events and they will happen before the pressure can get there.


Den

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When I got my cpap it was set at 10 min 15 max then Dr changed the max to 20 and minimum stayed same.

Doesn't really matter what the max is. The machine will only go high enough to stop an apnea. It may never get higher than 15 even with a setting of 20. Can you see detail with your Icon? Leaks could be stopping you from getting a lower AHI.

This is what my machine can tell me,

11. Sleep Data
Turn the SmartDial to the Sleep Data setting and press to enter. Alternatively, press and hold the SmartDial for 7 seconds. Turn the SmartDial to either the Centers for Medicare and Medicaid (CMS) Report
(US specific) or Patient Report and press to enter.
Turn the SmartDial to scroll through each of the following statistics:
• Total Compliant Hours .
• Average Compliant Hours over the last 30 nights . Press the
SmartDial to access the average for the last 7 nights and again for the
last night.
• Percentage of nights used greater than 4 hours over the last 30 nights
. Press the SmartDial to access the percentage for the last 7 nights.
• The number of nights elapsed since therapy commenced .
• Check Sum .
• AHI for last 30, 7, and 1 nights.
• Leak for last 30, 7, and 1 nights.
• 90th percentile pressure for last 30, 7, and 1 nights.
• SensAwake for last 30, 7, and 1 nights.
• Exit the Sleep Data setting.
NOTE: A symbol will appear on the Home Screen when the sleep data is within the compliance requirements. Once CMS requirements have been met, the data within the CMS sub-menu will stop logging.
• Exit the Sleep Data setting.

caryrae73 wrote:This is what my machine can tell me,

11. Sleep Data
Turn the SmartDial to the Sleep Data setting and press to enter. Alternatively, press and hold the SmartDial for 7 seconds. Turn the SmartDial to either the Centers for Medicare and Medicaid (CMS) Report
(US specific) or Patient Report and press to enter.
Turn the SmartDial to scroll through each of the following statistics:
• Total Compliant Hours .
• Average Compliant Hours over the last 30 nights . Press the
SmartDial to access the average for the last 7 nights and again for the
last night.
• Percentage of nights used greater than 4 hours over the last 30 nights
. Press the SmartDial to access the percentage for the last 7 nights.
• The number of nights elapsed since therapy commenced .
• Check Sum .
• AHI for last 30, 7, and 1 nights.
• Leak for last 30, 7, and 1 nights.
• 90th percentile pressure for last 30, 7, and 1 nights.
• SensAwake for last 30, 7, and 1 nights.
• Exit the Sleep Data setting.
NOTE: A symbol will appear on the Home Screen when the sleep data is within the compliance requirements. Once CMS requirements have been met, the data within the CMS sub-menu will stop logging.
• Exit the Sleep Data setting.

SO? How about following the instructions and seeing what the machine tells you.

caryrae73 wrote:When I did my sleep study my AHI was 10.1 and the first 30 days it went to about 4.5 so the doctor raised my pressures max from 15 to 20 to get the number lower. Since the pressure increase my AHI has stayed at around 4.5. Is it possible that lowering the pressure instead could help or would it just make it worse?

Yes, of course, if you cannot exhale against a pressure of 15 (or 20) then it could be scored as an event (ie. central). In such a case lowering the pressure so you can exhale may make some difference in AHI.

old dude wrote:Yes, it certainly has in my case. My AHI at titration was 131 and the doctor prescribed pressures of 17/13. My AHI then ran in the 2.7 to 4.5 range, or thereabouts. It was in an acceptable range and the doctor was thrilled, but my leak issues were terrible. So I decided to try an experiment by lowering pressures on my own in an effort to make the leaks easier to control. Lo and behold each time I lowered my pressures my AHI got better. I'm now down to 11/7 and my AHI is almost always under 1.0, with a 0.0 and 0.2 not being unusual in any given week.

I have no idea why this has occurred, especially given my AHI number at the sleep study-but it has.

Do you ever look at your sleep data? It could be extra central apneas that are being created as a result of having the pressure too high. As you lower the pressure, you would then get less centrals. Of course, at some point as you lower the pressure, your OSA's wouldn't be treated, so you can only go so low before your AHI would start increasing again as the result of more untreated OSA's.

Just a guess from what you're saying.

May have to try lowering it slowly and see how it works. Every once in a while I get the feeling my stomach is getting bloated slightly and my mask leaks easier which must happen when the pressure goes up. Would it be better to have the high and low pressure the same or keep them different?

Not sure how to look at my sleep data except the little it shows on my machine. I had seen people with some machines can use some kind of software but couldn't find any software to read my info.

RogerSC wrote:

old dude wrote:Yes, it certainly has in my case. My AHI at titration was 131 and the doctor prescribed pressures of 17/13. My AHI then ran in the 2.7 to 4.5 range, or thereabouts. It was in an acceptable range and the doctor was thrilled, but my leak issues were terrible. So I decided to try an experiment by lowering pressures on my own in an effort to make the leaks easier to control. Lo and behold each time I lowered my pressures my AHI got better. I'm now down to 11/7 and my AHI is almost always under 1.0, with a 0.0 and 0.2 not being unusual in any given week.

I have no idea why this has occurred, especially given my AHI number at the sleep study-but it has.

Do you ever look at your sleep data? It could be extra central apneas that are being created as a result of having the pressure too high. As you lower the pressure, you would then get less centrals. Of course, at some point as you lower the pressure, your OSA's wouldn't be treated, so you can only go so low before your AHI would start increasing again as the result of more untreated OSA's.

Just a guess from what you're saying.

I do, every day, although I'm nowhere nearly as sophisticated in interpreting said data as many here. But I got very few CAs before lowering my pressures and still get very few. OAs are even more rare, regardless of the pressures.

In light of Den's post you might try using 12-15 range instead of 10-15. Yes using the software will help you see what is happening.