Question on AHI and settings

[attachment=1]screenshot-20181207-110147.png[/attachment]It seems my ahi varies from day to day and I can't seem to get consistent results. I know it should vary but should't it eventually get more consistent? The day I had the ahi of 5.55 I woke up refreshed and did not even know about the leaks I had at night.
Should I raise my pressure support to try and reduce my flow limitations? Also does it seem my pressure range is good even though I still am getting a lot of obstructive apneas?
Thanks for your time.[attachment=2]screenshot-20181207-110140.png[/attachment][attachment=1]screenshot-20181207-110147.png[/attachment][attachment=1]screenshot-20181207-110147.png[/attachment][attachment=0]screenshot-20181207-110159.png[/attachment]

When we have nights where the pressure looks like it needed to be higher because of obstructive apneas or hyponeas being more numerous than we would like...compared to other nights when those obstructive types of events are much lower...
it's almost always going to be related to sleeping on one's back more or maybe REM sleep and the person is getting more REM.

Sometimes the minimum pressure just can't get job done of going up fast enough (when using auto adjusting modes) to take care of some special needs situations.
It's quite common for our OSA to worsen when on our back or during REM.....I have the REM thing myself as I often see the machine go 6 to 8 cm more in what is probably REM sleep and I already know my OSA was about 5 times worse in REM from my sleep study.

I don't know if you just need more minimum or just more maximum for when your pressure needs change.
It's obvious from your rather ugly report that the machine tried but couldn't go higher because of your limit on the max to 16.
First thing I would do is open up the max and see if just allowing the machine to do its job would be enough to prevent those clusters..
Easy fix...the machine won't go anywhere without a good reason. Might be all you need.

And yes...sometimes we feel great despite some ugly numbers. It's because we just slept better even though the report looks ugly.
One of my best days ever followed a night where the AHI was 10.2 ....go figure that one.

As a start, your maxIPAP should be set to 25, you're preventing the machine from responding to your needs for more pressure.

Thanks Pugsy and Palerider for taking the time to answer. Pugsy can you try if it is apparent in my screenshots where the rem sleep is possibly taking place? Is there a particular time in my data that you might guess where rem sleep is taking place? If not are there any screenshots you can post to try and show me where and how to look for possible rem sleeping?
Thanks also do you agree with palerider to increase the MAX IPAP TO 25? Won't the pressure just rise higher due to flow limitations being present? Also do you recommend keeping ps where it is?

REM sleep stage can't be seen with 100% accuracy on the data the machine gathers. There's nothing that we can see that can really help us identify any sleep stage with any certainty. The machine can't tell if you are even asleep much less the sleep stage.
You can get a rough idea when it should happen by googling "sleep stages" and looking at the hypnograms for normal sleep stages and compare to yours. It's really hard to do when the sleep is highly fragmented though because with a lot of awakenings there's a lot of potential resets in the cycling of the sleep stages.

Normally first REM happens about 90 minutes after sleep onset and it's fairly brief in duration.
As the night goes on REM happens more frequently and lasts longer each time with the greatest amount of REM occurring in those wee hours of the morning.
When you have multiple wake ups (and the breaks in therapy show a significant wake up or you wouldn't have turned the machine off and back on again) then we don't always go back to where we were in the sleep cycle. You may or may not have to simply start over with the normal cycles which will mean fewer REM stages and those that do happen will be of shorter duration.

Clues might be found in the sleep study if sleep stages and sleep positions are documented.

For me...it doesn't matter..REM or supine...if it's REM you can't do anything about it anyway.
Even if you knew for sure it was REM....what are you going to do about it?
Now we can try to stay off our backs but even that is easier said than done.

For me I decided to let the machine sort it out...and not worry about REM or position...that's why auto adjusting comes in so handy.

Increase the max IPAP and let the machine do what it was designed to do. It won't increase without a good reason and if you don't need more pressure it won't go anywhere. There's a good chance that is all that you need to do.

mets123 wrote: ↑

Fri Dec 07, 2018 12:56 pm

Thanks also do you agree with palerider to increase the MAX IPAP TO 25? Won't the pressure just rise higher due to flow limitations being present? Also do you recommend keeping ps where it is?

Yes, pressure will go up to try and stop flow limitations... Hopefully it will reduce them, because they reduce the effectiveness of your sleep. Try breathing through a straw for a few minutes, that's what flow limitations are like... More work to breathe.

Nor sure about ps, yet, let's see what the pressure can do first.

Thanks again Pugsy and Palerider. Will increase the max ipap and leave everything else alone and will post again next week after a few days.
Have a great weekend.