Newbie: ISO lowering hypopneas & when to adjust pressure

Hello all and again my thanks to those who contribute to this web site. My question: I just started cpap on 15 August 2013, and my overall AHI index has consistently been 5 or higher, often hovering around 8.x. The component of that score attributable to apneas for the most part has disappeared, averaging perhaps 1 or a fraction, AHI. I know from reading this site to ignore the central air events for now (they've never been above 5 AHI I believe, and are mostly around 2 to 3). Hypopneas seem to be the problem. Do these go down simply with time as I get used to the machine? Or is it already a good idea to increase my pressure and see what happens? And, when you make an adjustment in pressure, how many nights should you give it before making any further adjustments? I'm using an automatic cpap machine with a range of 7 to 20, and I understand that adusting the first number is what matters. Based on the information below, should I move the lower number to 8 and wait a few days, or give the current settings a few more days to see what happens? I know there are no hard and fast rules with any of this, but would appreciate suggestions. Also, could moving to higher pressures ever INCREASE hypopneas (I initally started with a pressure of 5 and got two nights of 3.57 and 3.72 hypopneas [that is, these were the numbers for the hypopnea component of AHI], while the rest were 5.x; my three days on the full face mask with 7-20 pressure has brought two nights of 5.x and only one night of 3.64 hyopneas). Thanks!

My home study testing box (forgot what you call it) suggested mild to moderate sleep apnea. Then I did the full-tilt, split-night titration sleep study on 2 August 2013 that showed moderate sleep apnea (AHI index of 16), and recommended a pressure of 6 cm H20. But sleep studies are a snap shot, of course; I think that night was an unusually short sleep for me; and I’m guessing that it may have missed REM AHI in large part.

I started on 15 August 2013 with the LT Swift nasal pillows and was miserable, given my mouth breathing, even with a chin strap. So on 22 August 2013 I moved to the Resmed Quattro Air full face mask, and seem to be sleeping a bit better than my first days on cpap with the nasal pillows (at least in terms of how I feel in the morning, though part of this is probably just getting a little more used to the machine overall). Also, my doctor ultimately moved the automatic CPAP prescription from 4-6 cm H20 to 7-20 cm H20.

Here's data for 22 August 2013:



Here’s data for 23 August 2013:



Here’s data for 24 August 2013:

The only thing I can comment on is that your settings are 7 - 20 cm while your 95% is hovering between 9.3 and 11.5 and maxing 9.3 - 11.8

What could be happening is that it is taking to long to get the pressure where it needs to be form 7cm. The change is not instantaneous.

Others can comment more on the graphs.

If it was my therapy I would be bumping the min up to 8.5 at least - in increments of .5 cm every few nights.

Thanks, Blackspinner. Pressure is now 10-20 and AHI is moving lower and lower. I'm going to keep it there for a while and give myself time to adjust....