What should I do?

[toddl1962]

Followup with sleep doctor. I still wake up at night and I notice my machine reports average AHI of 3.5 (but my sleep efficiency is probably no better than 75% so the true AHI is probably higher). I also have read the SmartCard and have seen that sometimes I wake right after an apnea event. I know this because I always adjust my mask when I wake and I can see the leak spike on the graph. Doctor says no pressure adjustment is necessary because titration study showed 0.0 AHI. He didn't read the data off of my SmartCard and I didn't tell him I had read it.

Is it possible these apnea events are waking me? Would a pressure adjustment on my machine be worth trying in order to get my machine to report close to 0.0 AHI? I do have anxiety issues which cause me problems going back to sleep when I do wake up. I could also believe anxiety may be a reason I wake up but would it hurt to try a .5 cm increase in pressure?

[Pugsy]

Are you using the auto unit in Cpap mode with straight pressure of 7 cm? If not what are your settings?
Can you post one of your daily graphs showing what you are seeing?

Yes, it is possible for an event to occur and then for you to wake up especially if it is bad enough. The body will react to the stress of the event just like it did before the therapy. One night's titration may or may not be the most ideal pressure for you. 7 cm is relatively low pressure and an increase of 0.5 cm wouldn't hurt to try if you are using straight cpap mode. If you are using auto mode, where is the average tending to fall?

And yes, overall sleep efficiency matters greatly and there are often other factors that tend to make that goal much harder than simply hooking up to the machine and mask. Light sleeper? Anxiety? Pain or discomfort? Busy mind? Toss and turn? Using auto mode pressure variations causing to wake?

I was titrated to 8 cm but have found that I do better with the minimum at 10 cm and I just leave the max wide open because I sometimes have some really nasty events that need 15 cm and up. Doesn't happen every night. Last night I never got above 12. The increase in pressure doesn't seem to wake me up unless it gets up around 18 cm and then the pressure blows the nasal pillows out of my nose so the leak wakes me up.

[Wulfman]

Followup with sleep doctor. I still wake up at night and I notice my machine reports average AHI of 3.5 (but my sleep efficiency is probably no better than 75% so the true AHI is probably higher). I also have read the SmartCard and have seen that sometimes I wake right after an apnea event. I know this because I always adjust my mask when I wake and I can see the leak spike on the graph. Doctor says no pressure adjustment is necessary because titration study showed 0.0 AHI. He didn't read the data off of my SmartCard and I didn't tell him I had read it.

Is it possible these apnea events are waking me? Would a pressure adjustment on my machine be worth trying in order to get my machine to report close to 0.0 AHI? I do have anxiety issues which cause me problems going back to sleep when I do wake up. I could also believe anxiety may be a reason I wake up but would it hurt to try a .5 cm increase in pressure?

Absolutely! In reality, you probably won't achieve an AHI of 0.0 very often, but you should most likely be able to get yours lower. You're at a relatively low pressure anyway, so bumping it up 1 cm. for a few nights shouldn't hurt. When they give a person an APAP with a range of pressures, it will go up and down through a lot of different pressures......so, a 1 cm. change isn't likely to have any ill effects on you.....and in fact will probably improve your therapy.

Your doctor is quite possibly an idiot.
YOU need to take control of YOUR therapy.


Den