3 months into therapy...

[The Mule]

...And I do feel a little better.
However, my average AHI is still running at about 7.5 with most of the number being Hypopnea events. My AI is rarely over 2.
For example, last night my AHI was 10.5 but the AI was only 1.9 and the night before my AHI was 5.4.

So, why does it flucuate sooo much or is this fairly normal? What can I do to bring my average AHI down to 5 or less?

As info, I am running on APAP (I originally started on CPAP), my average pressure is usually 10-10.5. I am averaging very close to 8 hours per night. And my leak average is very low.
Until recently, I slept most of the night. Starting about a week ago, I have been waking up around 2-3am and having a hard time getting back to sleep. Sometime it takes me 30-45 minutes. I don't know why this is occurring. No major changes in my life (stress related).
Any hints or suggestions would be appreciated.

[SleepyT]

I am not one of the "experts"...perhaps one of them will chime in. Seems to me they sometime advise apap folks to try straight CPAP. apparently the machine ramping up or down to accomodate your needs can arouse one out of sleep. the changing pressure disturbs some people. might be worth a shot to try the machine on a straight pressure of 10...and see if you can get your AHI down that way...

[The Mule]

Interesting idea. I hadn't thought of trying it.
Thanks, I will give it a try!

[bdp522]

The resmed machines seem to show more hypopneas than other machines. If the AI stays nice and low I wouldn't worry too much about the HI. I think if you 1/2 the HI, it would equal the same average as any other machine. I think it was Rested Gal who ran a little experiment to check this out and found the HI was double any other machine.
Do you have the software? It might give a clue as to what's happening at 2-3 am that is causing a problem. Could it be an 'outside' issue? We had a neighbor that changed shifts and woke me every morning at 4 am until I got used to the noise.

Brenda

[pdean44]

I have been halving the hi and adding that to the AI. Wit those numbers i have been doing good most of the time.

[jmelby]

A couple of thoughts... what is your pressure range set to? You say you are averaging 10-10.5... is that your 95% pressure, median, or what? Do you use EPR and what is that set to?

The reason I ask about your pressure range and 95% pressure is that if you have the range wide open (e.g., 4 - 20), you may be seeing hypopneas and apneas as your machine gets you close to your actual pressure needs. Setting the minimum closer to your 95% pressure would help fix that. On the other hand, if your maximum pressure is set too low, your machine may be hitting the ceiling and not adjusting upward when it maybe would be indicated. Finally, I ask about EPR because I have found that EPR had a negative impact on my AHI. When I used it, my AHI was much higher than not using it--presumably having apneas when the pressure drops for exhale. If you are comfortable without it on at all, there is no reason to use it. If you feel you need it, then going with the lowest setting possible may be best.

[The Mule]

I had read that the Resmed HI were notably higher because of the way they calculate that type of event. It's a rare night when my AI is higher than 1.5 and it's usual below one.
I'll keep that in mind when reading my results for the night.

My pressure settings are 8.0 - 15.0 and my EPR is set at 2.
If, based on my settings, you still think it would be a good idea to turn the EPR off, I'll try it for a few night and see how it goes!

I don't have the software but check my results every morning. Unfortunately, that doesn't help with events through the night!

[bdp522]

Withy such a low AI, I wouldn't bother turning off the EPR if you feel more comfortable with it. Of course you could turn it off and then if you feel you need it, just turn it back on. I think your doing fine as is.

Brenda