First 5days on CPAP - AHI headed in the wrong direction?

[CuredApnea]

This is my first week on CPAP, the 2nd day I felt great and it's been downhill since. I'm not sure what's going on, I've been rotating between 2 sizes on the mask I got (XS and M) but the AHI is headed in the wrong direction. Is this the doc adjusting my APAP or something?

Day 1 - 2 (Sept 19th)
Felt a slight difference, no more fog in the morning

Day 3 - 4
No fog in morning, waking up feeling tired but better on 6 hours w/ CPAP than 9 hours without CPAP

Day 5
Back to tired and daytime drowsiness


Thanks in advance

[palerider]

http://cpaptalk.com/wiki/index.php/Oscar:organize

[CuredApnea]

Post updated

[jbgilm]

Are you cleaning the mask/pillow/whatever you use each night? I find that AHI goes up if I neglect to clean the nasal pillow.

[CuredApnea]

Haha about all I've done is wash it with water... I don't think it's that since its the first few days?

I tried the Small sized piece today and AHI was 6 something today

[chunkyfrog]

It gets easier the second week, and the week after that, ad infinitum.
(Never thought I'd get to use that Latin phrase)

[CuredApnea]

Thanks, does that mean this is within the realm of normal and expected?

[Miss Emerita]

Thanks, does that mean this is within the realm of normal and expected?

There can be a lot of ups and downs at the best of times, and most definitely at the beginning of CPAP usage. It's a lot to get used to. I would say you're actually adapting well, with consistent night-time use.

Your doctor isn't changing your settings, which you can see in the left-hand side-panel. You have a good machine, but it has a fairly conservative algorithm that doesn't adjust pressure upward in response to obstructive events as aggressively as ResMed machines do. That means that your minimum pressure needs to be higher so you can head more obstructive stuff off at the pass. In addition, most adults feel somewhat air-starved at a pressure below 6.

So, my own recommendations would be for you to turn off the ramp and set your minimum to 6 or 7. Are you comfortable making those changes yourself? With the revised settings, we could then see how your responded if you could post more Oscar charts.

I feel certain you will get to a place where the fog is a thing of the past. It may take a little time, but it will come.

[CuredApnea]

i'm open to trying that but everything is locked on my machine and I have a doctor call this Monday, so I probably will wait for that first before trying to change the settings. I haven't felt air-starved at 4, or maybe I am and won't realize it until I change the ramp and minimum. Since I practice jiujitsu, that could be a factor.

I feel like the mask is not fitting proper? When I use the machine's face mask test, it's below the bar and appears to fail with an X. However I got that ~1 - 2 AHI day 2 and 3, so the mask is probably working?

Thanks, I think I'll get there too. I have a good feeling after that 2nd day that I'm trying to get back to. I had something around 5 hours of sleep and felt less foggy than I had in a while.

Question: If my doctor were to change my settings, I'm guessing the pressure minimum in the left column would be different?

[CuredApnea]

Update: Decided not to wait, bumped min pressure to 7 and my AHI last night was a 3! I feel really crappy this morning because I slept from 4AM to 12PM and had bathroom interuptions (Quesadilla from last night had to go), but im super happy the AHI is down to a 3

Thank you

[palerider]

Update: Decided not to wait, bumped min pressure to 7 and my AHI last night was a 3!

Progress, go for a min of 8

[zonker]

Update: Decided not to wait, bumped min pressure to 7 and my AHI last night was a 3! I feel really crappy this morning because I slept from 4AM to 12PM and had bathroom interuptions (Quesadilla from last night had to go), but im super happy the AHI is down to a 3

Thank you

this right here is why we strongly urge folks to take control of their own therapy!

good work.

[Dog Slobber]

Thanks, does that mean this is within the realm of normal and expected?

Here are charts of my first three nights on CPAP vs my last three nights of CPAP.

My first 3 nights are similar to yours.

My AHI was huge, I hardly slept, frequent awakenings, volatile pressure trace, I felt like hell.

Compare that to my last three nights, two nights of 0.0 AHI, fairly flat pressure trace, but the pressure will increase to take care of events. Sleeping well and ~8 hours a night.

CPAP_improvement.png

[CuredApnea]

I see your minimum pressure went up over time. Looking forward to getting to a 0 AHI! I think where I missed out was my titration study failed (couldn't sleep and sleep tech was giving me a lot of attitude / hostility / wouldnt let me try masks because she's lazy and short and can't reach). My friend who has a similar body size to me has an APAP configured in CPAP mode with a pressure of 10.

Update on the settings, I bumped up the pressure to an 8 and my AHI went up to 5 point something. Going back down to 7 tonight and maybe will try 7.5 tmrw?

[Dog Slobber]

...
Looking forward to getting to a 0 AHI!
...

Oh oh, my motivation was not for you to set a 0.0 AHI goal..

My motivation was to show you not to be discouraged by your initial poor results and feeling bad.

A lot, are number chasers and are severely disappointed when there numbers aren't consistently low, some never hit 0.0

Throwing a no hitter is a terrific feeling, appreciate it if you do, but it may not be a realistic target.