my ahi is 8

[ainsle14]

hello evebody: a few years ago i tied the cpac and could not tolerate it. well, my sleep apnea has advanced from mild to moderate so i am back trying to learn how to toloerate. i seem better at it now , since i have started meditating. i can stand it for 4 to 5 hours. but i cannot get my ahi below 8 . i would attach last night report but i can't see where to attach something with the message. thanks

[Sleeprider]

It looks like you have an older M-series machine that is discontinued, and thus doesn't show up in your profile. It would help to know what the pressure settings are. To post reports to the forum, you need to use an image hosting site like Imjur which is free. You can find a tutorial on how to do this here: https://sleep.tnet.com/docs/imgur

[ainsle14]

i have a remstar auto/ a flex m series. my auto mask is 12 ,auto min 7.5. i am auto

[Pugsy]

I would really need to see a report to get some sort of idea what is going on but off hand considering the M series way for reporting things...the minimum pressure is probably not quite optimal and the machine can't do the best job of holding the airway open and can't respond optimally at the lower setting.

[ainsle14]

[Julie]

Your report is so tiny it's almost invisible - you have to find someway to make it bigger.

[ainsle14]

if you click on it , a magnify icon will appear to make it larger

[Pugsy]

Julie the images can be enlarged to full size by clicking on the first image and then using the magnifying thingy.

Actually what I expected to see..clusters of events at times and some times nothing exciting going on.

When you see the clusters forming the starting pressure minimum wasn't enough to prevent the collapse.
The 2 most common causes of needing more pressure in situations like this..either sleeping or your back or going into REM stage sleep where our OSA can worse and/or we might need more pressure. I have first hand experience with REM stage sleep OSA and markedly different pressure needs and my early M series APAP reports looked just like yours do here when I was using 8 minimum pressure and my AHI was running around 6 to 9 with clusters at time and nothing at times.
Easily remedied for the majority of people who have reports like this with just a little more pressure minimum ( I would think 8.5 might get you real close) and maybe opening up the maximum a little just in case the machine wants to go higher.
It won't go to where it doesn't think it needs to go without a good reason. Your leaks aren't excessive so I don't think that leaks are hurting you unless they are waking you up. Certainly not bad enough to be much of a negative impact on therapy pressures themselves.

If you are sleeping on your back and that's the sole cause of the clustering...if you can stay on your side that might be enough to fix things and not change the pressure.
I found that sometimes we simply have to move around a bit and staying solely on one's side is often easier said than done.
If the clusters are related to REM stage sleep then we can't do anything about it.
REM sleep normally starts around 60 to 90 minutes after sleep onset and then comes along more frequently and lasts longer as the night progresses with the most REM happening in the wee hours of the morning. Unfortunate these reports don't last long enough in terms of hours asleep to be able to evaluate what might have been needed if you had been asleep for 4 to 6 hours.
Finally...some people have a good dose of both supine and REM stage sleep affecting their pressure needs.

My preference for either is just adjust the pressure so that either cause is adequately protected against because we can't control REM anyway nor would we want to prevent it from happening because the body needs all the sleep cycles for the restorative powers of sleep to work for us. Covering REM needs will cover sleep position needs by default and then not worry about sleep position unless we find that massive differences in pressure are needed when sleeping supine.
Like I know one person who needs 18 to 20 cm when on their back and only 9 cm when on their side ...in that case I totally agree on really working on staying on one's side if possible.

Any special reason why the short hours? It would be really nice to see a report with 6 to 8 hours of fairly solid sleep with cpap use.

[ainsle14]

unfortunately i can only have it on for 4 to 5 hours and i take it off, most times i do not remember even taking it off. thanks for the advice, very helpful

[Sleeprider]

Ainsle14, you need to turn off the ramp. You're starting at 4.0 cm and by the time theraputic pressure kicks in, you're way behind the ball and having repeated apneas. Consider raising minimum pressure and turning off the ramp to limit the snores and flow limitations near the beginning of therapy.

If you had an updated machine, you could actually differentiate between central and obstructive apnea. It's kind of odd that the events go ballistic as pressure rises

[Pugsy]

Taking the mask off and not even knowing we are doing it is not uncommon at all. Lots of people do it. I have done it myself but it doesn't happen often. I wake up and the mask is laying on the machine and I have no recollection of anything to do with why it came off.
If this were something that was happening often and thus causing me to sleep unprotected I might try something to make it harder to remove the mask so that I would either not remove the mask or wake up while I was trying to remove it and thus stop the unwanted behavior.
Some people have worn mittens or socks...others have used just a little tape to a couple of areas on the face and mask so that the discomfort associated with pulling the tape on the skin (when the mask gets pulled off) causes them to wake up and stop the unwanted behavior.

Eventually the brain learns that it is supposed to leave the mask alone and people stop removing it (for the most part anyway).

[ainsle14]

thanks everybody. i am going to try all the suggestions.i will post how I did