Newbie's AHI higher than at sleep study

It's looking to me like my results from the change to 5-15 pressures haven't helped much. I am still having problems with mouth leaks and mask seal. I guess it's time to make some changes to my min. pressure?

Yeah...it goes up and stays up anyway....might as well give it a head start.
Gotta do something with the leaks...they are pretty bad.
Going out on a long skinny limb here but maybe some of that mouth breathing is gasping for air from the untreated apneas....and if the apneas were reduced then maybe some of the mouth leaks would reduce...
That's a long skinny limb though and when I say that ...it means I am really stretching things in an effort to not blame it on plain old mouth breathing.

Have you ever taped your mouth? I am not saying you gotta do it all the time but maybe for just one night so we can make sure if the leaks are mouth breathing/opening or maybe mask movement.
If you tape your mouth and the leaks significantly improve then we know mouth breathing is the culprit.
But if you tape your mouth and the leaks don't really improve then we know the mask is moving around a lot.
I would hate to spend a lot of time trying to fix mouth breathing leaks if the problem was mask moving leaks.
I would try to isolate for sure the cause of the leaking and then you know better how to try to fix it.

I did try the vertical taping for a couple nights. I didn't see much difference, still woke up feeling air escaping from the corners of my mouth. Maybe I should try horizontal.
Do you think I should start with a min pressure of 11 and see how that goes?

Yes...try horizontal and pray it doesn't come off and mess up the experiment. We just need one good night with the tape for sure sealing things to know for sure if those are mouth leaks or mask movement leaks.

Yes..try minimum of 11 if you can do it. It's going to be a big jump from 5 to 11 and I don't know how comfortable you will find it. Maybe use the ramp in this situation if 11 is just too much of a jump...otherwise start smaller and work up.

I suspect I will have some problems with the increased pressure because I already have been having trouble with the increase from the straight 10. Do you suggest maybe starting at 8 or thereabouts and working upward? I will try the horizontal taping tonight.

Yes, start lower (whatever is comfortable) and work up in stages. Watch your reports...might get lucky and not need as much as we originally thought...stranger things have happened.
If you can't sleep that defeats the purpose of the experiment.

The jump from 5 to 10 or 11 is likely going to be uncomfortable especially since you have been using the lower for some time now. They body gets used to one thing and rebels when you want it to get used to something else.
I would have a problem with that big of a jump in one fell swoop so that's why I mentioned it ahead of time.
Some people are gutsy and they can deal with that big of a jump but I know I couldn't.
Back when I was a newbie and doing 1 cm increases I noticed a significant difference with just 1 cm.

I will start lower and work up gradually or try ramp.
Thanks Pugsy. Your assistance has been valuable to me. I admit it can be discouraging when your numbers aren't decreasing, and are in fact increasing.

I know it's frustrating and discouraging especially when you see people who take to this therapy like a duck to water.
You just drew the short ugly straw. Whatever is going on here...it's fixable but it takes time to sort it all out and then implement whatever needs to be done to fix it. Gotta try to figure out what is going on first though...can't fix it if we don't know for sure what needs fixing.

Watch those centrals...if they pop up in truck loads we need to re-evaluate things. I don't think they will because while you are having more than we like...your pressure is already going up and staying up so I don't think changing the minimum is going to be a big trigger but you never know for sure...so just watch them with one eye.

Pugsy, I'm happy to see my numbers look better this morning. I'm surprised to still see the large leak score, because the tape stayed on all night and I didn't think there was much mouth leak, but I did wake up a few times to air trying to leak against the tape. I didn't think I had much mask leaking last night, but I must have. I like this Dreamware mask but sometimes when I lay against the pillow, it causes leaks. I always wake up, and try to adjust, since I'm a light sleeper and have always awoke at the drop of a pin.
I was a coward and only moved my min pressure up one number, to 6. Should I move up again to 7? I noticed the change, but it wasn't too bad. I'll post my report from last night.

Well...that AHI is a very pleasant surprise.
And we learned that the mask is moving which is causing the leaks and not so much mouth breathing as we first thought.
Centrals were way down.
About a little less than half that AHI was central.
Try 7 tonight if comfortable...if not maybe something in between.

The DreamWear mask needs to be snugged up just a little bit....not a lot..most likely the back strap.
And have you tried different sizes of those cradle cushions?
I have used this mask...it needs to be a little snugger than we first think to handle tossing and turning and laying against the bed pillow. It can be done though. I sleep primarily on my side and it can be snugged up enough to not move and not be uncomfortable. It took me 3 or 4 nights to get the tension just right.

20% if the night in large leak...while not ideal..a lot better than what you have been doing and actually would earn you a smiley face for mask fit. Mr Frowny doesn't show up until you hit 30% or more.

All in all...I would count last night a big success.
AHI way down.
Leak way down
Centrals way down

dorilu wrote:I was a coward and only moved my min pressure up one number, to 6. Should I move up again to 7?.

based on your pressure chart, I'd say 10 or 11.

palerider wrote:based on your pressure chart, I'd say 10 or 11.

I agree but since she's been using much lower for so long she's afraid of a big leap. It's for this reason we are going a bit slower. If she hadn't been using lower for a while it wouldn't likely be that much of an issue.

For everyone:
I once went up to 13 cm minimum..went up slowly from a 10 cm minimum...a week at 0.5 cm increases...experiment to see if the AHI changed or I felt different (didn't change either). So I had about 6 weeks with varying stages of above 10 cm starting. Once I decided to abandon the experiment I went back down to 10 cm in one drop and to my surprise I had a lot of difficulty feeling like I was suffocating at 10 cm.

I figure that if I (who had been quite comfortable with the 10 cm) would perceive such a marked difference in comfort with a drop in pressure that it isn't unreasonable to think that someone using lower would maybe have a problem with a big jump. I know she's been sleeping at 10 or 11 for the bulk of the night but while awake it might be too uncomfortable initially.
So it is for this reason I often say "go up slowly if you need to". We gotta be comfortable to fall asleep and we have to be asleep for cpap to do its thing.

Besides...we might get lucky and while the machine still wants to stay up around 10 or 11 once asleep...hey, maybe a lower minimum (like maybe 9) might just work quite well.

Thanks Palerider and Pugsy. I think you are both right that my min should be around 10 or 11. Pugsy, you make a good point about being comfortable enough to fall asleep. I always lie awake for at least an hr, sometimes 2, before falling asleep, so that much pressure during that time might be a challenge.
My DME set my machine to ramp of 45 min at initial set up after I told him how long it takes me to fall asleep.
I got used to the ramp, but it felt like I was suffocating sometimes during the full time it took it to build up to the 10 max.
They took the ramp off when they switched to Apap mode. Do you think maybe using ramp up to 11 min would be better than going up a little each night?

My DME had trouble deciding if I needed a small or medium and kept going back and forth at the fitting. He decided the small worked best and it did feel better, but of course, that was sitting in a chair.
When I snug it up it squishes my nose and cheeks up toward my eyes. I don't know if this is usual, or if I may need the med. He only gave me the small, as the pack they have did not come with the different size cushions.