New CPAP user with OSCAR data---High AHI

[pcdvd.buyer]

Hi There I am a new CPAP user.

I dunno how come my AHI is always high, Could any one tell me unless leak reason (I will change L size to M size tomorrow)

any other reason cause so high AHI? and flow rate and mask pressure is normal? other opinion for me to improve AHI? thanx a lot


AHI as below:

[LSAT]

Raise your minimum pressure to 15 and maximum to 20...Your AHI should come down

[Pugsy]

Please review this thread for image posting examples
viewtopic/t158560/How-to-post-images-for-review.html

The zoomed in view isn't particularly useful without the original for reference.

Why are you limiting the max to 17? Any particular reason?
It wants to go higher and can't...so it can't prevent the airway from collapsing.

Without seeing the overall detailed report I don't know if you need more minimum but you for sure need more maximum.
Your current minimum might be enough to get the job done if the maximum was higher.

[pcdvd.buyer]

I try to Organised my OSCAR chart like this, please comment on this, thanx

圖片 46.jpg (202.41 KiB) Viewed 16546 times

[Miss Emerita]

I will leave it to the experts to advise you about your pressure settings, just noting that your EPR seems to be set for ramp only.

You have several big clusters of events. Clusters could be caused by REM sleep, sleep position (e.g., on your back), or tucking your chin down toward your chest, which can restrict your airway and make it easier for it to close. Given that the second cluster follows pretty closely on the first, REM seems less likely as a culprit.

What position(s) do you sleep in? And do you happen to know whether you tuck your chin?

[Pugsy]

Your machine desperately wants to go higher than 17 cm....so much so it essentially has set a new minimum itself as it never really goes below 14 or 15 once it goes up.

Why are you limiting the max to 17? Any particular reason?

[Miss Emerita]

P.S. Could you fill out your profile with your machine and mask information? That way it'll be right there in case other people need to know it.

[pcdvd.buyer]

P.S. Could you fill out your profile with your machine and mask information? That way it'll be right there in case other people need to know it.

ok, thank you all to answer my question. i will do something to lower my AHI.

[pcdvd.buyer]

I will leave it to the experts to advise you about your pressure settings, just noting that your EPR seems to be set for ramp only.

You have several big clusters of events. Clusters could be caused by REM sleep, sleep position (e.g., on your back), or tucking your chin down toward your chest, which can restrict your airway and make it easier for it to close. Given that the second cluster follows pretty closely on the first, REM seems less likely as a culprit.

What position(s) do you sleep in? And do you happen to know whether you tuck your chin?

Dear all:

I use cervical collar's cover already, but still need very high pressure value, is it normal? or I need to change to Vauto due to vauto can raise pressure to 25,

Please advise , thanx a lot

REM (2).jpg (258.8 KiB) Viewed 16409 times

[zonker]

I use cervical collar's cover already, but still need very high pressure value, is it normal? or I need to change to Vauto due to vauto can raise pressure to 25,

Please advise , thanx a lot

REM (2).jpg

it's the minimum pressure right now that we are trying to get you to raise. whether your pressure is "very high" is relative.

my pressure, on your same machine, is set at 17.8 as minimum and 20 as the maximum. i don't go near 20. and you are only there part of the time as your graph shows.

raise the minimum to 17 as pugsy has mentioned. then leave it there for a few nights and see how it goes.

notice that your ahi is going down, at least in the graphs you've chosen to share with us. this process can take time, so please stick with it.

you can do this.

good luck!

[pcdvd.buyer]

I will leave it to the experts to advise you about your pressure settings, just noting that your EPR seems to be set for ramp only.

You have several big clusters of events. Clusters could be caused by REM sleep, sleep position (e.g., on your back), or tucking your chin down toward your chest, which can restrict your airway and make it easier for it to close. Given that the second cluster follows pretty closely on the first, REM seems less likely as a culprit.

What position(s) do you sleep in? And do you happen to know whether you tuck your chin?

For my understanding is if I setting ramp only then my EPAP can set higher to deal with OA events,

like I have wrong concept. You mean enable EPR is better for AHI, right? thanks

[Pugsy]

When EPR is used the pressure on exhale drops by whatever setting is used. For some people that drop during exhale can mean the pressure drops below a level where the exhale pressure can continue to stent the airway open. The job of the pressure....hold that airway open and prevent collapse which ends up with some sort of apnea event occurring.

So does using EPR always mean that the drop equals a higher AHI because it allows apnea events to happen....no not always...but it can depending on how close a person is to that pressure setting where a person finds that below that line in the sand the airway cannot stay stented open.

When you use EPR set to ramp only then all it means is your pressure doesn't drop during exhale after ramp has ended. Your pressure still has to be high enough to hold/stent the airway open with or without any exhale relief.

Your pressure needs to hold your airway open are at time extremely high...at other times not quite so high.
When we see wide changes in pressure needs we wonder why there is a difference and there are a few usual reasons.
Supine sleeping...big common reason because it is well known to worsen OSA.
REM stage sleep...again very common because it is also well known to worsen OSA. I have this myself. Now REM normally comes in cycles and is fairly predictable....yours doesn't follow a typical REM pattern so that leaves sleeping position as being a likely culprit.

There are times when you need pressures above what your current machine can deliver...that's when you see the pressure maxed out at 20 cm. There are times when the machine doesn't have to go so high and does a decent job holding the airway open.

In your situation adding in that drop in exhale pressure by using EPR all night instead of ramp only would likely result in a higher AHI because I believe you are already very near the line where any drop during exhale will result in the airway collapsing.

[pcdvd.buyer]

When EPR is used the pressure on exhale drops by whatever setting is used. For some people that drop during exhale can mean the pressure drops below a level where the exhale pressure can continue to stent the airway open. The job of the pressure....hold that airway open and prevent collapse which ends up with some sort of apnea event occurring.

So does using EPR always mean that the drop equals a higher AHI because it allows apnea events to happen....no not always...but it can depending on how close a person is to that pressure setting where a person finds that below that line in the sand the airway cannot stay stented open.

When you use EPR set to ramp only then all it means is your pressure doesn't drop during exhale after ramp has ended. Your pressure still has to be high enough to hold/stent the airway open with or without any exhale relief.

Your pressure needs to hold your airway open are at time extremely high...at other times not quite so high.
When we see wide changes in pressure needs we wonder why there is a difference and there are a few usual reasons.
Supine sleeping...big common reason because it is well known to worsen OSA.
REM stage sleep...again very common because it is also well known to worsen OSA. I have this myself. Now REM normally comes in cycles and is fairly predictable....yours doesn't follow a typical REM pattern so that leaves sleeping position as being a likely culprit.

There are times when you need pressures above what your current machine can deliver...that's when you see the pressure maxed out at 20 cm. There are times when the machine doesn't have to go so high and does a decent job holding the airway open.

In your situation adding in that drop in exhale pressure by using EPR all night instead of ramp only would likely result in a higher AHI because I believe you are already very near the line where any drop during exhale will result in the airway collapsing.

yes, I enable EPR and Using an EPR of 3 to overcome the flow limitations, also I put on cervical collar's cover already, still high AHI.

How to improve it? What I can do? please advise, thanks

chang.jpg (257.32 KiB) Viewed 16295 times

[Pugsy]

More minimum pressure to hold the airway open better and prevent the collapse in the first place.
Unfortunately you are fast coming to the point that your machine can't go any higher. You may need a bilevel machine that can go higher than 20 cm.

yes, I enable EPR and Using an EPR of 3 to overcome the flow limitations, also I put on cervical collar's cover already, still high AHI.

How to improve it? What I can do? please advise, thanks