Help getting my AHI down a bit

[jessplease]

Hi all, I was diagnosed with sleep apnea and have been using therapy for almost 6 weeks. I have adjusted pretty well to therapy and I'm starting to feel a lot better. I don't NEED to have a nap every day and I don't spend my whole day pining for the next time I can sleep. (AMAZING!) However, I do notice a difference in my sleepiness/energy levels when I have a night with an AHI that is under 2 versus when I get one in the 2-3-4 range. So I would like to see what tweaking could be done to try to get that less than 2 AHI more often.

I've done a lot of reading and am doing my best to understand the Sleepyhead reports. I'm wondering if I should increase my pressure a bit and see what happens? Currently my "prescription" is 10. Here is my chart from last night.
Thanks for the help!

2018-08-14.jpg (341.54 KiB) Viewed 449 times

[LSAT]

raise your fixed pressure to 12...no ramp

[jessplease]

Ok I will try that tonight. Just for my own learning, why do you suggest getting rid of the ramp?

[zonker]

welcome to the zoo, jess!

do you spend much time sleeping on your back?

[jessplease]

Thanks Zonker! I am mostly a side sleeper. I will occasionally sleep on my back if I'm sore or something but I don't think I did last night. I am also a pretty still sleeper - I only change position if I'm awake. I think that's why I've had pretty good luck with CPAP. I don't envy anyone who tosses and turns!

[zonker]

Thanks Zonker! I am mostly a side sleeper. I will occasionally sleep on my back if I'm sore or something but I don't think I did last night. I am also a pretty still sleeper - I only change position if I'm awake. I think that's why I've had pretty good luck with CPAP. I don't envy anyone who tosses and turns!

your welcome. it was a guess on my part because you have some obstructives there. and i've learned from this forum that sleeping on your back usually leads to that.

[palerider]

Hi all, I was diagnosed with sleep apnea and have been using therapy for almost 6 weeks. I have adjusted pretty well to therapy and I'm starting to feel a lot better. I don't NEED to have a nap every day and I don't spend my whole day pining for the next time I can sleep. (AMAZING!) However, I do notice a difference in my sleepiness/energy levels when I have a night with an AHI that is under 2 versus when I get one in the 2-3-4 range. So I would like to see what tweaking could be done to try to get that less than 2 AHI more often.

Me too! < 2, I feel better than 2 or above... though i don't notice much difference as long as it stays under 2.

I've done a lot of reading and am doing my best to understand the Sleepyhead reports. I'm wondering if I should increase my pressure a bit and see what happens? Currently my "prescription" is 10. Here is my chart from last night.

Yes, bump it up a cm, let it sit for a few days and look at the average... repeat as necessary.

[palerider]

Ok I will try that tonight. Just for my own learning, why do you suggest getting rid of the ramp?

You might want to start the ramp at a higher pressure, some people have trouble breathing at that the level yours starts at... you're not getting therapy pressure till the end of the ramp, but, if it helps you get to sleep, feel free to use it.... many people decide they don't need it after they've gotten used to the machine, and the pressure.

[jessplease]

Ok, I turned the pressure up to 11 last night. I had a higher AHI and feel my usual more sleepy self. Should I give it a few more days at 11 to see if it improves? Or go up to 12 tonight?

I don't know if it's necessary but here's my chart from last night. I do like the ramp feature. Not quite comfortable starting out at 10 or 11 pressure as soon as I put the mask on. I also like to read a bit with the mask on before I fall asleep so it's ok with me that I'm not at therapy level right away. Thanks for the advice!

2018-08-15.jpg (349.08 KiB) Viewed 373 times

[Pugsy]

If using the ramp helps you relax and ease into the pressures...go ahead and use it. We need to be comfortable to fall asleep.
Now of course with using ramp the pressures aren't necessarily therapeutic until you reach your pressure and while this doesn't matter if you are awake or reading...we don't always stay awake. Sometimes we fall asleep and not know we are just about there.
Happened to me last night. I was on the couch and let the dogs out to go pee and was going to go let them back in...and the next thing I knew it was 3:15 and the dogs were still outside and it was raining.

Now what you might do to cover your butt just in case you fall asleep while reading and the ramp hasn't made it up to full pressure yet is switch over to a different ramp function that is available on your machine.
It's called Auto Ramp (Respironics DreamStation machines have a similar feature called Smart Ramp)...if the machine thinks you are asleep it will go to full pressure rather quickly.

https://sleep.tnet.com/home/files/resme ... -guide.pdf

page 10
You would need to be in the clinical menu setup area to change the ramp from the regular ramp to the Auto Ramp.

Give the new setting a few more days....we don't sleep the same each night and we don't know if last night was a fluke or not.

[jessplease]

Thanks Pugsy. I do have the ramp set to auto although it doesn't seem to be doing the greatest job guessing when I'm asleep. It is ramping up before I'm asleep - not sure why. I turn it off and back on again if I'm uncomfortable but I think I'm starting to get used to the pressure. That's funny about the dogs! That NEVER happens to me... I have to maintain really good sleep hygiene to get to sleep. Drifting off is the hardest thing for me. Even before my sleep apnea was treated, I never just fell asleep by accident no matter how tired I was.

Anyway, slight improvement last night. I think I'll keep it at 11 for one more night and may bump it up to 12 after that if I'm still over 2. I took a nap yesterday afternoon so I just highlighted my night time sleep here. No events during my 45 minute nap.

2018-08-16.jpg (349.71 KiB) Viewed 331 times

[palerider]

Thanks Pugsy. I do have the ramp set to auto although it doesn't seem to be doing the greatest job guessing when I'm asleep. It is ramping up before I'm asleep - not sure why. I turn it off and back on again if I'm uncomfortable but I think I'm starting to get used to the pressure. That's funny about the dogs! That NEVER happens to me... I have to maintain really good sleep hygiene to get to sleep. Drifting off is the hardest thing for me. Even before my sleep apnea was treated, I never just fell asleep by accident no matter how tired I was.

Anyway, slight improvement last night. I think I'll keep it at 11 for one more night and may bump it up to 12 after that if I'm still over 2. I took a nap yesterday afternoon so I just highlighted my night time sleep here. No events during my 45 minute nap.


2018-08-16.jpg

Why do you keep highlighting part of the events? is it because of a short session at the start? you can turn off short sessions down at the bottom of the left panel.

[jessplease]

Sweet - thanks for the tip. I didn't know I could do that.