Need some help reducing AHI

[Airquotes]

Hello everyone,

I've been on CPAP for about 2 months now. I was diagnosed with moderate positional sleep apnea with an AHI around 20. Like most people it took me a couple weeks to adjust to the mask but once I did I found it helped immensely. I've tried the Airfit F10, Amara View, Quottro Air, and just started using the Airfit F20. I definitely need a full face mask as I breathe through my mouth a lot. My machine is the Resmed AirSense 10 For Her.

I've been having trouble recently with higher AHIs. I went for about a month consistently hovering around .5 to 2 but rarely above that. In the last few weeks I've had many nights from 2-4. I definitely feel worse after these nights. I chalked it up at first to mask leaks but I've fixed those and I'm still getting high AHI. My prescribed pressures were 5-15. I've upped 1cm a week over the last couple of weeks to try and lower the AHI. I'm at 7 now.

http://imgur.com/K0E6xjp

Here is my data from Jan 24th with a AHI of 3.33

http://imgur.com/UcfRmF4
http://imgur.com/FhIVslu
http://imgur.com/6scAiUz

And here is some data from Dec 29th with a very low AHI of .54.

http://imgur.com/LlaT3yd
http://imgur.com/H1QsVwp
http://imgur.com/GAyQoaO

Can't tell what I'm doing differently now that is causing the higher AHIs. Most of the low AHI nights were with the Amara View but I found once the silicon wore in I was getting a lot of mask leaks and waking up when it blew in to my eyes. I find the full face masks much more comfortable.

From lurking here I know there are some CPAP wizards who might be able to weigh in and let me know if there is anything I should try or something I'm not seeing.

Thanks!

[LSAT]

I would keep raising your minimum pressure...10 would be my suggestion. An AHI of 2-4 is not bad...especially if you are sleeping well. Watch over time and see if your AHI doesn't come down.

[Airquotes]

OH WOW, going over the data again I just realized that the machine shipped in default APAP mode but on Jan 8th I switched it to the APAP for her mode. That might have a lot to do with it. Going to switch back to plain APAP tonight and see what happens. Still would appreciate anyone else chiming in.

[Airquotes]

I would keep raising your minimum pressure...10 would be my suggestion.

Yeah that's the plan. From reading other peoples settings here it seems like 5 is a little low.

[Pugsy]

See how you do with switching back to regular APAP mode.
It might be that the kinder gentler "for Her" mode simply wasn't doing a good job....it's got a slower response and also it's not as aggressive of a response as the regular APAP mode.

I don't know that 10 cm minimum will be needed when back in regular apap mode. That 7 cm might be enough of a starting point.

[Airquotes]

So far so good going back to regular APAP. All AHIs below 1.5 for the last few nights. Seems like I may have solved my own problem. Guess I'll update if things get worse again.

[Hannibal 2]

Out of interest and in your opinions, how high an AHI reading should we deem acceptable? - I'm asking as I will hopefully be changing from a basic CPAP to APAP in a couple of weeks.

[englandsf]

In theory anything under 5 is "Technically Treated" but agree that 2 or under is just fine. I get up to 4 this time of year as allergies cause me to mouth breathe which seems to be measured as open airway events and adds to the AHI. I do feel a little less "clear" when my AHI is up and sleep less well as I wake when I mouth breathe as my mouth gets very dry. I use a P10 and hate FFMs.

[palerider]

Out of interest and in your opinions, how high an AHI reading should we deem acceptable? - I'm asking as I will hopefully be changing from a basic CPAP to APAP in a couple of weeks.

2.

[Airquotes]

Had a 2.2 the last two nights. Tonight I go up to min 8cm.

[Pugsy]

Be careful when looking at just the AHI and thinking more pressure is needed or wanted.
If there's a sizable percentage of events in the clear airway/central category then more pressure won't fix those.
Make sure what you are wanting to fix is fixable with what you are planning to do.
Always look at the event category breakdown of your AHI when deciding on doing something.

[Airquotes]

Good advice. I'll check Sleepyhead tonight and look at the breakdown. I'm pretty sure it's mostly been obstructives but it could be more of a split than I think.