AHI and what it means

right now the range is 11.0-13.0 So maybe a range of 10-14 or 9-15? just as an example of course

Burner

I don't think I would be dropping the minimum to make a bigger range.
The reason being is that the minimum pressure is the most critical setting and you are already having some little clusters of OAs and hyponeas.
What I would do if it were me would be open up the maximum more...then see what happens with the clusters.
It was real hard to see the pressure graph line on your images but it looked like you maxed out the pressure for a short period of time but you had clusters occur without even maxing the pressure.
I have been down the cluster road on an M series machine.
For some reason or other the pressure is not quite sufficient enough (we are talking baseline/minimum pressure) during those times for the machine to do an optimal job of holding the airway open and giving the machine a good enough starting point for the increased needs.
2 most common causes of seeing time frames where clusters are telling us that the pressure needs have changed are changes in sleeping position (usually means we are on our backs) and REM stage sleep (often our OSA is made worse in REM sleep and/or pressure needs increase in REM).

Some people prefer a tight range when in APAP mode and other prefer a more wide open approach but the minimum pressure is the most critical setting. These machines can't/don't increase the pressure in the blink of an eye. Instead they go up in stages over a few minutes and if the minimum doesn't give the machine a good enough head start then the airway collapses and opens back up all before the machine can get to where it needs to be to better hold the airway open.

If it were me I would open up the max probably 2 or 3 cm...see what happens and if the clusters are still present then I would increase the minimum either 0.5 cm or 1.0 cm and see what happens with the clusters.
The goal isn't necessarily total eradication of all events but instead just breaking up the clusters somewhat.
If there is a problem with more pressure then back up....and by problems I mean worse leaking or aerophagia or just general discomfort.

There's no urgent need that I see on these reports to change anything but the clustering would bug me and I would try to break up the clusters if it was me. I had these clusters myself...my OSA is much worse in REM sleep than in non REM sleep and sometimes I need a LOT more pressure in REM sleep.
My AHI overall wasn't bad because the sleep time in non REM sleep where nothing much happened would reduce the overall averages but I would still maybe have 30 to 45 minutes of apnea riddled time where the number of events during that short period of time was significant enough to perhaps impact how I felt.

Thanks Pugsy, I'll give it a shot and see what happens. I'll post the after action report soon.

Burner

So I am at the Dr today related to my upcoming surgery. I tell dr about poor sleep he says to change settings 10-20cm which seems a bit low and high so we'll see.

Don't worry about the 20 cm maximum. The machine won't go there unless it has a reason.
Just because it can go there doesn't mean it will go there and if it doesn't go there it hurts nothing to have it set higher.

It appears the Dr. might have been right on the top number. it spiked close to 15 last night. I need to keep this setting for a few days and see what happens
thanks for all your help Pugsy

Burner

That report is pretty meaningless.
You need to post the "Sleep Therapy Daily Details" section.


Den

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