High AHI with the F30 mask

mets123 wrote: ↑

Wed May 01, 2019 7:38 am

Thanks Pugsy for your feedback. Besides flow limitations which tend to make my pressure rise I have suffered from aerophagia and that’s another reason for limiting the maximum pressure. I guess I can go up slowly and see what happens.
Makes sense?

Ahhh....now you mention the aerophagia monster as a potential reason for limiting the maximum.
That's a very good reason and if more max causes aerophagia then we simply limit the max and make a mental compromise to accept the fact that sometimes the AHI might be a little higher than we would like to see.

Sit back and evaluate your goals...is it good quality sleep and feeling decent or is it just some nice pretty low numbers that don't make any difference in how you feel and the process of getting those low numbers causes discomfort????

Sometimes we just trade one problem for another problem and when that happens we have to sit back and decide which problem is the worse problem to deal with. Sometimes we have to make compromises.

Pugsy wrote: ↑

Wed May 01, 2019 7:43 am

tyrone747 wrote: ↑

Wed May 01, 2019 7:33 am

What's the reason for letting the pressure drop then? If you can tolerate 15 with no aerophagia Pugsy why not just set CPAP 15? Is there a reason to want less pressure at times? Does it hurt sleep quality having pressure above the amount required at a certain sleep stage?

Because 15 all night long isn't much fun in terms of comfort.
Greatly increases the chances for aerophagia with the constant higher pressure against the LES....put enough pressure on anything and eventually it blows.

I have done a fixed pressure experiment....my sleep quality went in the toilet simply from a comfort aspect.
My AHI was pretty much non existent at 11 EPAP and 15 IPAP fixed....but my sleep quality wasn't so great. Lots of arousals from just a comfort aspect. Numbers don't mean much if you wake up a gazillion times getting those low numbers.

My primary goal....because my sleep is so fragile from outside factors....decent sleep quality.
I don't want to use 15 all night just to deal with the 20% of the night I might be in REM and need 15. It's simply not comfortable.
Most people don't find that comfortable. Some people do but most won't.

Thanks. I run CPAP of 9 and experience some awakenings at night. Do you think it could be due to the pressure or is 9 so low that it's not likely to be causing arousals. It feels perfectly comfortable when I'm awake. I know I don't need 9 all night because when I use APAP it drops to as low as 7.

tyrone747 wrote: ↑

Wed May 01, 2019 7:57 am

hanks. I run CPAP of 9 and experience some awakenings at night. Do you think it could be due to the pressure or is 9 so low that it's not likely to be causing arousals. It feels perfectly comfortable when I'm awake. I know I don't need 9 all night because when I use APAP it drops to as low as 7.

It's normal to have a few awakenings....like after REM cycle is completed it's normal to wake up. Most of the time we wake up, roll over and go back to sleep and don't remember the awakening.
So to have a goal of zero wake ups...unrealistic.
Just too many other things that can and will cause awakenings.
Some people think that they sleep better with a fixed pressure than they do with an auto adjusting pressure. That's fine.
Whatever works for an individual is what they should be doing.

Treating the Sleep Apnea related stuff...piece of cake.
Figuring out the other stuff unrelated to sleep apnea that messes with our sleep....totally different ball game and it's much more difficult to isolate not only the cause but to implement a fix for the cause of the problem.
Main problem is that people tend to expect that once they figure out an ideal setting in terms of cpap/apap that all their sleep problems should magically disappear and that's an unrealistic expectation.
A night with 20 arousals is a "good" night for me....but my arousals are caused by something the machine can't be expected to fix.
I know this and accept it and move on.

Too many arousals from any cause though....will trash sleep quality and when sleep quality gets trashed we feel like crap.

There's a thing called spontaneous arousal....awakening unrelated to breathing issues and those are a bitch to deal with.
Best cpap therapy in the world won't help spontaneous arousals.

Thanks Pugsy for your excellent advice and comments.