Need suggestions on how to reduce my AHI

[jules2010]

Hi,

My AHI has increased over the past several weeks, although last week it was fine, I've really no idea why. I do feel more tired at the end of the day. I know AHI isn't a great indicator, but it seems to match how I feel that day. I thought the differences may be due to weight gain, but I've lost nearly 10 pounds in the past couple of weeks.

I thought the higher AHI was due to leaks caused by the weight loss, but I've tightened my mask and it hasn't helped.

I've attached my basic details from Oscar.

I've been on cpap a year but I've AHI has never been as high as this. Earlier this year I got the F20 msk which is much better than the Philips full face mask.

I'm not really sure where to start with analysing my results.

Thanks in advance.

Jules.

[LSAT]

Start with raising your minimum pressure to 6.

[jules2010]

Thanks.

However I’ve tried increasing, but even at 4.5 it always wakes me up around 2am.

I’ve also tried higher.

I don’t quite understand why I wake up.

I’ve tried several times.

[LSAT]

Without raising your pressure you will not lower your AHI...Your machine will go from 4-20. Sitting at 4 you will need to be happy with minimal therapy.

[jules2010]

I will have another go at the weekend.

Thanks.

[jules2010]

One thing I forgot to mention I also use a mouthpiece.

I keep notes on the amount of turns I’ve made, I’ve just seen that I had the same problem in May, anyway trying more turns aka jaw further apart.

I’ve found the mouth piece has always helped to reduce AHI.

Do you think higher minimum pressure might reduce the need for a mouthpiece?

I have to say the more I think about it, the more concerned I am about not sleeping with higher pressure as I’ve tried several times to increase it.

Do you have any tips on how I could tolerate it?

The only thing which occurs to me is to sit with it while watching tv on an evening. But obviously I will be awake.

Maybe I will just get use to it?

[zoocrewphoto]

Thanks.

However I’ve tried increasing, but even at 4.5 it always wakes me up around 2am.

I’ve also tried higher.

I don’t quite understand why I wake up.

I’ve tried several times.

When the pressure is too low to prevent events, you still have them. The events are probably what is waking you up. You may be sleeping on your back, or in REM sleep. A lot of people need more pressure during those times. Your machine is set for 4-20 which is wide open. If your pressure is at 4, and you need a pressure of 7 (as an example), it will take several minutes for the machine to get from 4 to 7, so events will continue to happen. Ideally,your machine will be set at a pressure that will prevent events most of the night so that it only needs to go up when you need a little more.

You will probably need a minimum of at least 6. Once you try that a few nights, you will be able to see if that prevents most of the events or if you need a bit more as the minimum.

[jules2010]

OK, I managed to sleep through the night, I think I woke briefly at one point, but I managed minimum pressure set to 6.

However my ahi 5.5, which I was expecting to be lower. It did seemed a lot nosier but that may have been when I first woke up, maybe there were leaks. I do feel more tired that I would have expected.

Can you guys have a look at last nights readings and suggest when I might be further ?

Thanks in advance

[Pugsy]

Were you awake from about 5:45 on? Wake up fighting things and tried to go back to sleep? Toss and turn?

Did you wake up at other times during the night?

[jules2010]

No I don’t think I was awake at 5:45.

I think I did wake during the night briefly possibly around 2am.

As I say when I woke up, I felt like there may have been air leaks, the mask seemed noisier than usual.

Thanks.

[Pugsy]

Okay...not much if any wake ups so not much chance of SWJ sleep/wake/junk false positive flagging.

If that were might report I would increase the minimum pressure 1 cm to 7 and see what happens.
For some reason it didn't want to do anything until 5:45 in terms of movement to address anything and then it wasn't able to do much.
Better option is more minimum and try to prevent what is happening from ever starting in the first place because you aren't also having whatever the machine needs to be more aggressive with the pressure increases.

You might need more than 7 cm but I would start with a simple 1 cm increase first. Easier to adjust to for one thing and the bulk of the AHI is hyponea...and they are usually fairly easy to kill with a small increase in minimum.

Any chance you were maybe on your back at 5:45...that might explain things for what happened then.

[jules2010]

I’m not sure, I don’t normally sleep on my back.

When you say cm you mean pressure?

Thanks so much.

[Pugsy]

Yes when I say cm I mean pressure.
The official unit of measure is cm to water. I abbreviate it to just cm.

[jules2010]

I tried it at 6.5 but I woke up during the night feeling really full of air and had to turn it back to 6. Ahi was 6.1 this morning

Any thoughts?

It seems to be getting worse not better

[RogerSC]

I tried it at 6.5 but I woke up during the night feeling really full of air and had to turn it back to 6. Ahi was 6.1 this morning 🙁

Any thoughts?

It seems to be getting worse not better 🙁

Instead of moving the minimum pressure from 4 to 6 or 6.5 in one big step, I'd suggest easing it up a step at a time over a longer period. Like .5 cm per week and see how it goes. You might be surprised that you get used to the higher minimum pressure over a period of time, where it's just too much all at once.

Just a thought...