Newbie - should I worry (high AHIs)

[tspisak]

I just started with CPAP six days ago and the AHI readings from my SleepStyle are 9,6,11,14,7. I have worn my mask all night, every night. I haven't felt any different (not my best nights sleep, not horrible). Should I just keep on going or do I need to call the doctor and see if he would like to make some changes.

[Jersey Girl]

How is your leak rate? Is your mask sealed REALLY WELL?

Also, it takes a little time to get used to all of this. My AHI goes up whenever I try a new mask. So, give yourself a little time. The main thing is to make sure that your mask is sealed well and that air is not escaping. Are you sleeping through the night?

Best regards,

Jersey Girl

[DoriC]

Great job on compliance for your first week! Do you have a copy of your sleep study? What was your titration and what are your machine settings? Can you point to any discomfort you're having? Leaks, etc. I think your Dr might want to raise your pressure a bit. An AHI of <5.0 is considered therepeutic therapy but most patients don't feel really rested unless it's lower than that.

[cobra4x4]

indeed good job on staying compiant

Are you by chance opening your mouth while asleep? (assuming your not using a full face mask) because that would also affect your therapy and AHI rate.

As suggested already are you sure your mask is sealed well while your sleeping?

It does take some time for the body to adjust to the therapy and you'll have good & bad nights, I found that around the 3-4 week mark you'll most likely start feeling worse than before you started cpap (No worry its part of the body adjusting).

[Hawthorne]

You indicate you have the software for that machine. What does it tell you about leaks and events?

[tove]

can you check if the seal of your machine is good before you sleep? I do this and it helps.

[tspisak]

90th % leak rate was 42-57l/min. The settings are set 5-20 cmH2O with the max reached 10-14. 90th% pressure was ~10. I do have leaks are the higher pressures. My AHI was 52.4 during my sleep study. I think they wanted me on CPAP right away since my test results where so bad. I'm still waitng for the formal results for my sleep
study.

[jweeks]

I just started with CPAP six days ago and the AHI readings from my SleepStyle are 9,6,11,14,7. I have worn my mask all night, every night. I haven't felt any different (not my best nights sleep, not horrible). Should I just keep on going or do I need to call the doctor and see if he would like to make some changes.

Hi,

When getting started, the priorities are to (1) use the thing, (2) get to the point where you can sleep with it the entire night, and (3) let your body adjust. It looks like #1 and #2 are a pretty big success for you. After 6 days, your body should be well on its way to adjusting. If it was adjustment, I think we would have seen this start to trend down.

My instinct is to give it a few more days, and see if it does trend down. In the mean time, since you appear to have the software, take a look at the graphs. You are looking for periods of large leak and seeing if you can correlate the events to either leaks or pressure changes.

I don't like to see APAP machines set wide open, ie, 4 to 20, or 5 to 20 as yours appears to be. The machine takes time to increase the pressure, so it can take too long to react when you are having events. I'd consider raising the bottom number to be within 2 cm of your 90th percent level, perhaps starting with 8 to 20. You might find the 90th number go up a bit when you do that, so you might end up at 10 to 16 or something of the like.

Your sleep study info would also shed some light on this. I am curious if you have any degree of positional apnea. One experiment that you can run is to try sleeping on your side for a night as opposed to your back. There are also a class of people where the APAP pressure changes causes issues, and those folks find that running in CPAP mode works better.

If you don't see the AHI dropping by day 14, then you certainly want to follow up with your sleep doctor.

-john-

[jonquiljo]

The settings are set 5-20 cmH2O with the max reached 10-14. 90th% pressure was ~10. I do have leaks are the higher pressures. My AHI was 52.4 during my sleep study.

You show in your profile that you have software. If you have a detailed report that you can generate and post for a typical night it might help people here look at what is going on. It is great that you can sleep the night with the thing on. I bet there are just slight changes that may lower your AHI better than ever. But only the software can give a report that can help.

One thing that strikes me as a bit odd - why are you starting with a lower limit of 5.0cm? If your AHI was 52.4, it is safe to assume that you are starting way too low. In fact, can you even breathe well at 5.0? If you post the detailed report it may shed light on what is happening with this too. Good luck.

BTW - if my AHI was even 2.0 - I would be miserable the next day. So I think you will feel a lot better than now when you get that number down.

[nancyd589]

Hello, I now became a member of this community here and I would love to be a part of it. Just enjoy the environment here.




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[Hawthorne]

With a 90% pressure of about 10 cm (which means you spend 90% of the night at 10 or lower), your minimum pressure (5 cm) is set way to low. A lot of events will happen while your machine works up from 5 to 10 cm. In my opinion, you do need to raise that lower pressure to 8 or 9 anyway. Below that means it a long time before you get any therapy. You don't need to worry about the maximum pressure just yet although you may want to lower that after a week or so with the minimum raised. Often a narrow range, in auto mode, is more effective. You do need to find the right narrow range for you though.

A minimum of 10 cm is not that high since 10 cm is about the average pressure for some effective therapy. Do you know what your titrated pressure was? Your minimum should be clsoe to that in auto.

I'm not sure but it looks like your leak rate is a little high as well. You will have to work with adjusting the mask - not too tight and not too loose (both can cause leaks). It's just something you have to work at. It may be that a different mask may work better for you. It takes some trial and error to get a suitable mask. Everyone is different.

It would be helpful if you could post a night's data here. I'm not the one to explain how to do that. . I can do it but trying to explain it to someone else is another thing. You need a site like Photobucket. You need to register there but it is free. Your reports need to be in jpeg format to use Photobucket so you will probably have to change the format. Maybe someone else can take it from there.

Not many on this forum have your machine but it is a good one.