Recently chanced upon this forum, would love some help to lower AHI

[captainmud]

Hello! It's been 8 months since I started being treated for OSA and brought my AHI down to 3+ on average. Definitely feel a better quality of life with regards to waking and tiredness, thought there are still certain days where I just feel extremely tired, not wanting to get up and end up oversleeping an extra 2 hours after taking out cpap mask.

Recently chanced upon this forum and i'm really grateful for the advice given here! Have been following the default settings my doctor set for me, which is min 4.0 max 15.0 ramp 4.0, 5 minutes, and that got me 3+ AHI.
Days with 2+ AHI are not common but I do feel a big difference.

First major tweak i followed here was increasing my min pressure from 4.0 to 5.0 then to 6.0 over 2 weeks. AHI still averages at 3+.

Bought a SD Card reader today, was hoping I could please request some help to look at my oscar data and advice on what I should change to lower my AHI. Attached 3 different days, 1 at 5.0 and 2 at 6.0 min pressure.

5.png (110.71 KiB) Viewed 1956 times

6 wk 0.png (107.17 KiB) Viewed 1956 times

6 wk 1.png (107.71 KiB) Viewed 1956 times

[Julie]

Any particular reason your max. setting isn't at e.g. 20? It could be 'capping' the min. pressure from rising higher when needed.

And do you mostly sleep on your back (which may be keeping your snore level higher than you'd like it)?

[ChicagoGranny]

1.

Days with AHI of 2 are quite rare, but i feel a huge difference. Yet some of you mentioned a daily AHI of <1? Insane!

If that were my chart and I had your symptoms, I would raise the minimum pressure to 8.0 as a first step. The machine is hardly spending any time below 8.0 anyway. A higher minimum pressure will reduce the time the machine needs to get to the therapeutic level during certain stages of sleep.

2.

oversleeping an extra 2 hours after taking out cpap mask.

If I slept without CPAP for two hours, I would feel like crap all day. Either keep the mask on or get up.

3.

Any particular reason your max. setting isn't at e.g. 20? It could be 'capping' the min. pressure from rising higher when needed.

The maximum setting caps the maximum pressure not the minimum. But, as a matter of practice, the maximum pressure can be set to 20. The machine will not go any higher than needed.

Of course, after any settings are changed, the data and symptoms should be monitored daily for a few days.

[LSAT]

Hello, it's been 8 months since I started being treated for OSA. It brought my AHI down to 3+ on average and I definitely feel a better quality of life with regards to waking and tiredness.
With that said, there are still certain days where I just feel extremely tired, not wanting to get up and end up oversleeping an extra 2 hours after taking out cpap mask.
Maybe i'm impatient/have high expectations about changing my sleep life, but I still get this nagging feeling that my sleep isn't supposed to be this bad. Days with AHI of 2 are quite rare, but i feel a huge difference. Yet some of you mentioned a daily AHI of <1? Insane!

Recently chanced upon this forum. I'm really shocked and grateful that this forum exists, it's definitely important to have a support team and veteran users who can advise on optimising the cpap treatment...
First major tweak i followed here was increasing my min pressure from 4.0 to 5.0 and humidity from 4 to 5. That brought AHI lower to 2.5 avrg, but when I increased min pressure again to 6.0, it jumped right back to AHI 3+.

So I bought a SD Card reader today, was hoping I could please request some help to look at my oscar data and advice on what I should change to lower my AHI.

Also, I didn't manage to find this being mentioned in this forum, for some reason I feel that my humidifier is wonky. At fixed mode, it's crazy warm and I have a hard time falling asleep. At adaptive mode, I don't feel any warmth at all, feels like normal air-con temp (i sleep with the air conditioner on), is it just me?

screenshot-20200608-163029.png

Change your minimum pressure to 8...Maximum is fine, you never went higher than 13.5. You should be able to change the humidity..it is not fixed.

[captainmud]

Alright, will change to min 8.0, max 20.0 and report back in a few days time, thank you!

@Julie, somehow I can only fall asleep on my sides but I usually wake up sleeping on my back in the mornings

Updated the first post to make it more succinct and with more oscar examples.

[ChicagoGranny]

@Julie, somehow I can only fall asleep on my sides but I usually wake up sleeping on my back in the mornings

With a properly adjusted CPAP system, you can still achieve good therapy sleeping on your back. Your pressure requirements may be higher on your back, but the auto machine can take care of that.

Welcome to the forum!

[captainmud]

Alright, will change to min 8.0, max 20.0 and report back in a few days time, thank you!

UPDATE: Results have been quite varying this week but overall there were improvements! Also found out two things that have affected me.

1) there were two events, where i woke up in the middle on wednesday and thursday night. I noticed my mask wasn't fitting, as my chin was more tucked in than usual, causing a gap.
Have since tightened the mask to fit that tucked in position instead of just neutral laying on my back.

2) found out I have allergic rhinitis, most likely due to dust mite droppings since pollen count is low. Since young, I have a reaction around once a week, causing me to be sickly and tired for that whole day, which I always attributed to a lack of sleep. Took antihistamines and recovered immediately, which more or less confirms it. Decided to get an air purifier to solve this.

Looking forward to better health/sleep with these two fixes! Below are the results of the past 3 days after making my mask tighter.
.

5.png (99.06 KiB) Viewed 1872 times

6.png (94.15 KiB) Viewed 1872 times

7.png (98.28 KiB) Viewed 1872 times

[zonker]

1) there were two events, where i woke up in the middle on wednesday and thursday night. I noticed my mask wasn't fitting, as my chin was more tucked in than usual, causing a gap.
Have since tightened the mask to fit that tucked in position instead of just neutral laying on my back.

will let others comment on the charts. just wanted to mention that a firm foam cervical collar works wonders to prevent that tucking of the chin.

good luck!

[captainmud]

Sorry for the bump! However, it wasn't getting any feedback other than @zonker

Is there anything else that should be changed based on my graphs? Would appreciate any feedback, thank you!

[ChicagoGranny]

Due to the high pressures you are requiring at certain times of the night, a foam cervical collar might be a big help.

You could also try a minimum pressure of 10.0. But, you are running below that a good part of the night. A collar might allow you to leave the pressure settings where they are now.

[captainmud]

Due to the high pressures you are requiring at certain times of the night, a foam cervical collar might be a big help.

So the high pressure is due to the tucking of the chin? A foam collar might be a tad too much of an adjustment I think
Beyond that, seems like my AHI is stable at 2+ nowadays after tightening the mask. That's definitely a huge plus! If there's nothing else besides the collar, guess i'll stick to 8.0 min pressure!

[ChicagoGranny]

So the high pressure is due to the tucking of the chin?

There is no way to know without some trials. We all have individual cases. It is known that a properly sized and fitted cervical collar will hold the head/neck in the best position for airway patency.

If I could get a low AHI with moderate pressure settings, I wouldn't wear a cervical collar.

[Dog Slobber]

Due to the high pressures you are requiring at certain times of the night, a foam cervical collar might be a big help.

So the high pressure is due to the tucking of the chin?

She said *might*.

Beyond that, seems like my AHI is stable at 2+ nowadays after tightening the mask. That's definitely a huge plus! If there's nothing else besides the collar, guess i'll stick to 8.0 min pressure!

You moved it up to 8, experienced some benefit, but then decided that you'll stick with 8. Why not try moving it up again for a few days.


When I was at a minimum of 7.0, I bumped it to 8.0 my AHI dropped from 3.04 to 2.15.

I kept bumping it until I stopped improving, I finally settled in at 11.2 with my AHI at 0.36. I also did it slowly to ensure I wasn't looking at anomalies.

AHI_improve.png

[Miss Emerita]

I'm with Dog Slobber here. Try creeping that minimum pressure up, little by little. Change it just .5 cm at a time, and let it settle in each time. If you have discomfort or see your CAs shoot up, reduce the minimum by .5.

You wrote this: "my chin was more tucked in than usual." Did you mean that you tucked it toward your chest, or that your lower jaw dropped down from your upper jaw, or that it moved backward? It could be useful to clarify that.

It's great to hear you're feeling better.

[captainmud]

You moved it up to 8, experienced some benefit, but then decided that you'll stick with 8. Why not try moving it up again for a few days.

I see, that's my bad! I had thought that "You could also try a minimum pressure of 10.0. But, you are running below that a good part of the night" meant that I shouldn't increase my min to 10 since i'm spending much time below 10.
Thank you so much for posting that picture though, i'll definitely try going up 0.5 per week and see how I feel.

So that I could understand it better, could you please explain more on the above portion? If i'm below pressure 10 most of the time, wouldn't setting min 10 be detrimental?

I'm with Dog Slobber here. Try creeping that minimum pressure up, little by little. Change it just .5 cm at a time, and let it settle in each time. If you have discomfort or see your CAs shoot up, reduce the minimum by .5.

You wrote this: "my chin was more tucked in than usual." Did you mean that you tucked it toward your chest, or that your lower jaw dropped down from your upper jaw, or that it moved backward? It could be useful to clarify that.

It's great to hear you're feeling better.

Thank you So CA here means central apnea right? How should I look out for it based on the graphs?
Also on the chin part, I meant that it started dropping and tucked towards my chest. That caused me to push against the upper area of the mask, creating a gap in the lower area where air leaked out. Have already fixed it though, by tightening the lower half of the mask.