Need help understanding

[Gryffandor]

For my first month on apap my settings were 12/5 EPR3 & my average API was 0.3 almost all OA. My Dr. had me change to 14/7 EPR3 & my average API is now 1.2, again almost all OA. I know from the manual that the S9 will not go below 4 so in effect my EPR has stayed the same. I would have thought the IPR increase should prevent more incidence. My tracking also shows a 95% IPR of 10.2 & never has gone above 11.9. Any ideas why the API has gone up?

[kaiasgram]

For my first month on apap my settings were 12/5 EPR3 & my average API was 0.3 almost all OA. My Dr. had me change to 14/7 EPR3 & my average API is now 1.2, again almost all OA. I know from the manual that the S9 will not go below 4 so in effect my EPR has stayed the same. I would have thought the IPR increase should prevent more incidence. My tracking also shows a 95% IPR of 10.2 & never has gone above 11.9. Any ideas why the API has gone up?

Looking back at your first post (and if I can do math!), the doc changed your pressures only about a week and a half ago, is that correct? So your post-change AHI average is based on only a week and a half of data, compared to the average for the first four weeks. To be honest, I'm not sure you can make a meaningful comparison at this point. The difference between 0.3 and 1.2 just doesn't seem that significant to me in any case, unless you start having symptoms again as the next few weeks go by.

If the AHI increase had been due to centrals popping up then we could speculate (maybe) about the connection between the pressure increase and the AHI increase. But that's not the case. Any other changes besides the pressure increase? Like, are you sleeping deeper now than when you started therapy? Any mask changes or adjustments along the way? Seasonal allergies causing some congestion recently?

If you're feeling fine I'd just keep an eye on things and see where the averages are in another few weeks.

[djhall]

Over the short term a 0.9 difference isn't necessarily significant. That kind of variability is common from night-to-night. However, the link between increased pressure and decreased OAs is absolutely certain, so if your increased AHI is all OA events then backing the pressure range back down is not the way to go.

[Gryffandor]

Thanks for the advice. At these numbers I am not too concerned. After the increase I did have 2 days with lots of centrals but they have since settled down. I am having increased nasal congestion the past few weeks so I do need to take that under consideration. Thanks for pointing me in this direction.

[djhall]

Thanks for the advice. At these numbers I am not too concerned. After the increase I did have 2 days with lots of centrals but they have since settled down. I am having increased nasal congestion the past few weeks so I do need to take that under consideration. Thanks for pointing me in this direction.

Increased centrals following a change is rather common. For many, what they changed isn't what triggers the centrals so much as the mere fact that something changed. Once the change settles and becomes the new normal the increased CAs often go away.

Definitely give the nasal congestion time to clear up and give yourself time to acclimate to the change. I really don't see that change making anything worse over the long-term.

[LSAT]

Thanks for the advice. At these numbers I am not too concerned. After the increase I did have 2 days with lots of centrals but they have since settled down. I am having increased nasal congestion the past few weeks so I do need to take that under consideration. Thanks for pointing me in this direction.

How do you define "lots". You say that your ahi is just over 1. Even with all centrals there would only be 8 over 8 hours. You also said that most events were OA.

[Gryffandor]

What I meant by lots was 9 on the first day & 6 on the second after I raised my pressure. Prior to that I only had 5 total in the preceding 4 weeks. They have settled down now & I've had one day with 2 otherwise 0.
None of this is germaine to my original question. After being a systems analyst for over 40 years I tend to be interested in anomalies. When my pressure was raised I logically expected my AHI to go down, not up. The numbers were never high enough to make me concerned. I was just seeking a logical explanation. I got that from the first few posters (thank you much).