Cannot lower AHI

[Goofproof]

The more I read about the use of Resmed machines, and setting times and false reading, sure does make me happy I have Remstar, set and forget machines.

[Bob...]

The best part of having a shinny new toy is playing with it.

Bob

[Wulfman]

The best part of having a shinny new toy is playing with it.

Bob

Until it wants to turn corners when you want to go straight ahead.....

I'm with Jim......I like my "set and forget" machines, too.

Den

[Goofproof]

I know the first month of use on the Remstar APAP, I had some bad numbers, they were self[inflicted... Jim

Now I've got the controls tight! I would like to run some more experments, with the F&P 431, but I don't want to mess up my numbers again.

[Snoredog]

your BEST result was seen on 8/14 when you had ZERO mask leak, all the other days you are having a bit too much leak as those values are L/s.

Your Min. pressure can stay at 6.4 if you are comfortable there. Max. pressure needs to be set at 12.0cm, your avg. 95% is hovering around 10.4 to 10.6 but you still have a few AI's. The Max. pressure impacts the AI's.

You are listing a bunch of parameters that are not effective in the AutoSet mode, such as starting pressure, EPR and Ramp settings, so don't confuse them those would only come into play in cpap mode(s).

Leave your range set to:

Min. 6.4cm (pressure used during Settling timer)
Max. 12.0cm
Settling time: 30-minutes**

**Forget trying to match up this timer with how long it takes you to fall asleep, set it to 30-minutes and see if your AHI score doesn't fall as a result of using 30-minutes.

If you are using a nasal only mask, those leaks can be from mouth breathing. You need to determine which.

[lennyten]

[quote="Snoredog"]

Leave your range set to:

Min. 6.4cm (pressure used during Settling timer)
Max. 12.0cm
Settling time: 30-minutes**

**Forget trying to match up this timer with how long it takes you to fall asleep, set it to 30-minutes and see if your AHI score doesn't fall as a result of using 30-minutes.

[maskjkie]

I have tried various changes to my pressures, as suggested, but have not been able to get my AHI below the 6 -7 range.

Lennyten,
Are you sure you are not leaking/breathing through your mouth? I see that you are using the Breeze but if you leak/breathe through your mouth, you need a FF mask or a mask like the Hybrid.

[lennyten]

I have tried various changes to my pressures, as suggested, but have not been able to get my AHI below the 6 -7 range.

Lennyten,
Are you sure you are not leaking/breathing through your mouth? I see that you are using the Breeze but if you leak/breathe through your mouth, you need a FF mask or a mask like the Hybrid.

[maskjkie]

My average leak rate with the Breeze has been .11, which is an improvement for me (over the Swift). Is that leak rate still considered high? I tried the Hybrid for a couple of nights, but did not get good results. However, that could have been because of the settings on my machine. What is the maximum leak that is considered ok?

Lennyten,
I'm guessing you got a high leak rate with the Hybrid. Are you aware of the generous vent/exhaust flow rate of the Hybrid that causes a "false" high leak rate to be displayed?

I suggest you use the "full face" setting on the machine and use the Hybrid if you breathe/leak through your mouth. As long as you cannot feel leaks around the oral cushion and nasal pillows, ignore the high leak rate the machine displays. With the Hybrid, even a leak rate of 1.3 l/s that a machine (like the Resmed S8 Vantage EPR) displays is acceptable if your pressure is above 14 cm.

[JamesCPAP]

Hi Lennyten, I have an S8 AutoSet Spirit and I was never titrated by my hospital, they just said "Try 6" although I find 6 is too lower setting for me. My hospital suggested 8cm didn't understand autotitration machines and how to modify the machine and put me in touch with ResMed and speaking with ResMed gave me access to the admin panel to up the setting. I frequently noticed that my pressure on checking the LCD was around 12 so talking with ResMed and people here on the forum, it was suggested I try upping my min pressure to 8. This didn't have much affect so after a month I upped it to 10cm and still left the max at 20cm and I started getting better AHI (AI+HI) readings.

My AHI would be no higher than 8, AI no higher than 0.3 and HI no higher than 7.7.

Then came the drastic change. I'm large, 343 pounds, and I love sleeping on my back. I've found that forcing myself to sleep on the side using my S8 and Activa mask and propping a pillow up behind me to stop me rolling onto my back has dropped my AHI to less than 3, and in most cases 1.6 every single night I've tried this for 3 weeks. The big drop is in the HI reading which as in yours is high. On the odd night I feel restless and want to sleep on my back, I'll let myself do so on the odd occasion, but everytime I wake up in the morning and check the LCD I notice my AHI shoot up between 5 - 8 again (primarily the HI causing the increase).

I'm not sure if that'll help you lower your AHI, maybe it's just a personal experience, but it's one way I've found at reducing my AHI successfully to <3 and an average of around 1.6-2.

My mask leaks vary on the Active (it has a large exhaust vent and lets a lot of air out) but varies from anything like 0.08 to 0.36 but the average is always around 0.24.

I hope this helps! My AHI prior to CPAP therapy was around 145 AHI (very severe!), so anything below 8 is significant improvement, but fine tweaking to get your AHI lower is always good if you can accomplish it. The main thing is that you feel better on CPAP therapy than previously (e.g. less tired).