Strategies to lower AHI?

Flying_Norseman · Post by **Flying_Norseman** » Fri Sep 28, 2007 8:18 am

Ok, first let me say that I am an impatient person and I only have two days of data. I am going to wait the full 7 days to get a better average before I change anything, BUT...

What are some strategies to lower AHI?

For reference over the last two nights, my AHI was 9.2 and 12.2 for an average of 10.7. That is a little high and I would like to get it down to below 5. So next week when I have more data and if the number stays high what things should I try first?

-- Does changing the C-Flex setting have any affect on AHI? Mine is set to 3 right now.

-- If I go to APAP mode what should I set the range to? The default is 4 to 20. My CPAP level is 10. When the tech set up my machine it tested at 9.8 and he said that was with in specs. I know that CPAP is better for keeping AHI low because of the constant pressure. But what if the sleep study tech didn't come up with the right number? I could need it to be 11 for all I know. That being said, should the range be set to something like 8 to 12 so the pressure stays nearer to the prescribed 10?

-- What role does the mask play in this other than comfort? My leak numbers are low with the mask I have and it is comfortable.

-- I suspect I might be breathing through my mouth a bit, because I have woken up a few times with a dry mouth. I don't want to start taping half way through the first week though.

Any help would be appreciated.

Wulfman... · Post by **Wulfman...** » Fri Sep 28, 2007 8:29 am

Get your mouth leaks stopped before you mess with the pressure settings.
Apparently you've got a nasal mask, so you might as well start taping.
Mouth leakage affects your therapy pressure and allows events to occur.

Den

Goofproof · Post by **Goofproof** » Fri Sep 28, 2007 8:58 am

Nothing works, until you start doing things correctly, fix the mouthleaks or get the FF Mask. Jim

Flying_Norseman · Post by **Flying_Norseman** » Fri Sep 28, 2007 9:14 am

Ok, will do. Gonna try taping tonight. If that doesn't work, I will probably check out the Hybrid mask. Thanks for the help.

Snoredog · Post by **Snoredog** » Fri Sep 28, 2007 11:12 am

if your cpap pressure was 10 cm, and you are currently set for a range of 4-20,
I would set the machine to:

Auto:Min=7 or 8 (don't set it too high until you get used to therapy)
Auto:Max=15 (if your 90% has been 10)
CFlex=2

Using Cflex=3 and a starting pressure of 4.0 cm, I'm surprised you are not starving for air, you probably ARE but using a swift you will simply open your mouth to breathe.

Suggest lowering Cflex=2 and increasing the bottom pressure, this alone may help you get the air you now need and put an end to any mouth breathing. We breathe through our mouths when we cannot get the air we need through our nose.

If your machine is a AFlex, that feature won't function until Auto:Min=6 or higher.

Flying_Norseman · Post by **Flying_Norseman** » Fri Sep 28, 2007 12:06 pm

Hi Snoredog,

Right now the machine is in CPAP mode and set for 10cm and I don't use the ramp feature. I would eventually like to switch to APAP mode and find out my optimal pressure. It's weird but with a setting of 3 on the C-Flex it doesn't feel like I am getting the same pressure. I might set it to 1 since I was ok with the old non C-Flex machine. I don't know at what point I should try out the APAP feature. I will probably wait until next week and see what kind of numbers I get between now and then. I am pretty sure that I am opening my mouth because I have woken up a few times with a dry mouth although it isn't so bad when I wake up. My girlfriend falls to sleep too fast and sleeps to soundly to notice if I am mouth breathing.

FN

[quote="Snoredog"]if your cpap pressure was 10 cm, and you are currently set for a range of 4-20,
I would set the machine to:

Auto:Min=7 or 8 (don't set it too high until you get used to therapy)
Auto:Max=15 (if your 90% has been 10)
CFlex=2

Using Cflex=3 and a starting pressure of 4.0 cm, I'm surprised you are not starving for air, you probably ARE but using a swift you will simply open your mouth to breathe.

Suggest lowering Cflex=2 and increasing the bottom pressure, this alone may help you get the air you now need and put an end to any mouth breathing. We breathe through our mouths when we cannot get the air we need through our nose.

If your machine is a AFlex, that feature won't function until Auto:Min=6 or higher.

RosemaryB · Post by **RosemaryB** » Fri Sep 28, 2007 8:16 pm

I agree with what was said about the mouth leaks. I started taping right away. Once my leaks were under control, I could see from the software that my pressure wasn't right. Otherwise, there's really no way to know. Using the auto I then figured out that my pressure wasn't right.

Thanks to Jim and others for pointing this out.

Flying_Norseman wrote:
. My girlfriend falls to sleep too fast and sleeps to soundly to notice if I am mouth breathing.

Has she been checked for sleep apnea? Seriously. My boyfriend has it and snores like crazy, stops breathing, PLM, etc. VEry dramatic. I ID'd the OSA in him and he got treated.

Then I asked him if I snored or stopped breathing and he said no. Well, I'm a more polite apneac, I'm very quiet with it. But I do stop breathing. It took a couple of years after that before I was DX'd.

One main clue was that I fell asleep "before my head hit the pillow" and slept very soundly. In fact, I slept through thunderstorms and fire engines that woke everyone else up. No wonder, I was sleep deprived.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): auto

DreamStalker · Post by **DreamStalker** » Fri Sep 28, 2007 8:28 pm

Strategy ... hmmm ... CPAP, it's not just an adventure, it's a way of life

Flying_Norseman · Post by **Flying_Norseman** » Sat Sep 29, 2007 8:35 am

She had a sleep study done a few years ago, but she wasn't symptomatic. She is a skinny little thing and is busy all day long so when she goes to bed she is ready to go right to sleep.

RosemaryB wrote:I agree with what was said about the mouth leaks. I started taping right away. Once my leaks were under control, I could see from the software that my pressure wasn't right. Otherwise, there's really no way to know. Using the auto I then figured out that my pressure wasn't right.

Thanks to Jim and others for pointing this out.

Flying_Norseman wrote:
. My girlfriend falls to sleep too fast and sleeps to soundly to notice if I am mouth breathing.
Has she been checked for sleep apnea? Seriously. My boyfriend has it and snores like crazy, stops breathing, PLM, etc. VEry dramatic. I ID'd the OSA in him and he got treated.

Then I asked him if I snored or stopped breathing and he said no. Well, I'm a more polite apneac, I'm very quiet with it. But I do stop breathing. It took a couple of years after that before I was DX'd.

One main clue was that I fell asleep "before my head hit the pillow" and slept very soundly. In fact, I slept through thunderstorms and fire engines that woke everyone else up. No wonder, I was sleep deprived.

Flying_Norseman · Post by **Flying_Norseman** » Sat Sep 29, 2007 8:40 am

It turns out that taping was something I needed to do. Last night I taped and my AHI was 3.9. I feel so much better. The difference between 3.9 and 12.2 is amazing. I had several revelations last night actually. I went back to my original mask because the nasal pillows on my Swift II were tearing up the inside of my right nostril. I tried all three of the different sizes. I need to make a decision on that one because my 30 day trade in is going to be up soon. I may check into a FF mask so I don't need to tape.

I am so glad I found this forum. Everyone here has been incredibly helpful and supportive. I probably wouldn't be using the machine anymore if it wasn't for the advice I got here.

Wulfman... · Post by **Wulfman...** » Sat Sep 29, 2007 11:55 am

Congrats!

Now that your numbers are "in the ballpark", don't get in a big hurry to tweak even more. Give it a week or two at least. Nights can vary significantly.

The UMFF and the Quattro (in my opinion) are two of the best.....if properly sized and adjusted.

Hang in there.

Den

RosemaryB · Post by **RosemaryB** » Sat Sep 29, 2007 12:12 pm

Flying_Norseman wrote:It turns out that taping was something I needed to do. Last night I taped and my AHI was 3.9. I feel so much better. The difference between 3.9 and 12.2 is amazing. I had several revelations last night actually. I went back to my original mask because the nasal pillows on my Swift II were tearing up the inside of my right nostril. I tried all three of the different sizes. I need to make a decision on that one because my 30 day trade in is going to be up soon. I may check into a FF mask so I don't need to tape.

I am so glad I found this forum. Everyone here has been incredibly helpful and supportive. I probably wouldn't be using the machine anymore if it wasn't for the advice I got here.

Congratulations! I'm so happy to hear about your success .

If you are at 3.9 so quickly, my guess is that you may be able to go even lower as you get accustomed to the mask and tweak everything. I do best at 1.0 or lower and feel amazingly well. That's not true for everyone, but it seems to be for me.

But I definitely agree with Wulfman. Don't tweak too quickly. Go slowly and it will work better and make more sense to you.

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CPAPopedia Keywords Contained In This Post (Click For Definition): swift, AHI, Nasal Pillows

Flying_Norseman · Post by **Flying_Norseman** » Sat Sep 29, 2007 3:14 pm

I am gonna give it some time to collect data and then possible check into setting up the APAP to find out my optimal pressure. Taping is a little cumbersome so I think I am going to give back my Swift II and get a FF mask. I have an Ultra Mirage Nasal mask that works well until I get the FF mask.

Flying_Norseman · Post by **Flying_Norseman** » Sun Sep 30, 2007 8:51 am

Ouch last night was not good. Had a 14.6 AHI due I think to me not taping properly. I woke with my bottom lip free. I can't wait to get the FF mask. Taping is a bit cumbersome and not reliable in my case.