High AHI- need some help!

Geoff33 · Post by **Geoff33** » Sat Apr 20, 2019 7:45 am

I am new to the CPAP world. Diagnosed with severe OA. I am using a Resmed 10 autosense with F30 mask. I would really appreciate some help and advice moving forward. I did not have good luck with Insurance/DME; pretty much going this alone. I started at the factory settings 4-20, but have increased to 10-20 in hopes of eliminating more "events". Here is a screen shot. Am I having central apneas related to increase in pressure? With time, does the body adjust to the pressure and the number of CA's goes down? I am totally open to everyone's knowledge and experience for reducing my AHI which has been trending (6-14). I am just trying to form a solid game plan moving forward. Many thanks!

Pugsy · Post by **Pugsy** » Sat Apr 20, 2019 7:55 am

Welcome to the forum.

First of all figure out if those centrals are real in that you were asleep or if they are related to arousal/awake breathing.
http://freecpapadvice.com/sleepyhead-free-software
Watch all the videos especially the last one.

And yes...even if they are all real and you were asleep (which I doubt is the case because I see breaks in therapy where I know you were awake) sometimes centrals will go away or reduce significantly once the body gets better accustomed to cpap pressures.

Now if they are awake/arousal related centrals you can't fix them with pressure changes...instead you have to fix whatever the problem is that is causing you to wake so much.

djams · Post by **djams** » Sat Apr 20, 2019 8:42 am

Geoff33 wrote: ↑
Sat Apr 20, 2019 7:45 am
I am new to the CPAP world. Diagnosed with severe OA. I am using a Resmed 10 autosense with F30 mask. I would really appreciate some help and advice moving forward. I did not have good luck with Insurance/DME; pretty much going this alone. I started at the factory settings 4-20, but have increased to 10-20 in hopes of eliminating more "events". Here is a screen shot. Am I having central apneas related to increase in pressure? With time, does the body adjust to the pressure and the number of CA's goes down? I am totally open to everyone's knowledge and experience for reducing my AHI which has been trending (6-14). I am just trying to form a solid game plan moving forward. Many thanks!

Welcome to the forum. You're officially not doing it alone anymore.

How long have you been using your APAP?

And if that 14 AHI occurred with your current pressure settings, it'd be a good idea to post that night's chart.

palerider · Post by **palerider** » Sat Apr 20, 2019 3:10 pm

First... I absolutely LOVE the avatar.

second, yes, you're not alone... you're in good company.

Third please check out the guidelines in my sig about how to format your screenshot to make it better when you post another one.

I'd raise your start point on the ramp, if it were me, so that you get effective pressure sooner.

katestyles · Post by **katestyles** » Sat Apr 20, 2019 4:00 pm

palerider wrote: ↑
Sat Apr 20, 2019 3:10 pm
First... I absolutely LOVE the avatar.

I love the avatar too!

Gerryk · Post by **Gerryk** » Sat Apr 20, 2019 4:29 pm

Just out of curiosity what was your machine originally set at? From my experience having a wide pressure range doesn’t work well. As long as your machine isn’t going over a certain pressure, drop that upper max pressure down. If you find your lower setting comfortable to start but that the machine begins to react to events and increases pressure, raise the lower pressure up and use the ramp feature.

Dog Slobber · Post by **Dog Slobber** » Sat Apr 20, 2019 4:45 pm

Gerryk wrote: ↑
Sat Apr 20, 2019 4:29 pm
From my experience having a wide pressure range doesn’t work well. As long as your machine isn’t going over a certain pressure, drop that upper max pressure down.

There are reasons to drop the max pressure, but that's not one of them.

Drop the max, if you're reaching it and:

You are suffering from aerophagia
You can't tolerate such high pressures
You start experiencing excessive mask leaks at higher pressures

Right now his max pressure is 20cm. He never goes beyond 14cm. What do you suggest he lower it to? 18cm? 16cm? If he did absolutely nothing would change on his charts.

Gerryk · Post by **Gerryk** » Sat Apr 20, 2019 4:59 pm

I suggested it so the range isnt so wide. Why have it set so high if it’s not needed?

katestyles · Post by **katestyles** » Sat Apr 20, 2019 5:03 pm

Gerryk wrote: ↑
Sat Apr 20, 2019 4:59 pm
I suggested it so the range isnt so wide. Why have it set so high if it’s not needed?

While one is still discovering where the pressure is needed, it might need to stay open. Here is one of my early graphs. I could have pulled down my maximum to 12 before this night, but, well....

: screenshot-20190420-185923.png (124.24 KiB) Viewed 987 times

djams · Post by **djams** » Sat Apr 20, 2019 5:06 pm

Gerryk wrote: ↑
Sat Apr 20, 2019 4:59 pm
I suggested it so the range isnt so wide. Why have it set so high if it’s not needed?

If it ever becomes necessary, the machine is able to go to 20. If it's never necessary, it never will.

Remote chance of benefit, completely harmless otherwise.

Gerryk · Post by **Gerryk** » Sat Apr 20, 2019 5:14 pm

I have never let my machine that wide. If you watch your pressures and it goes up then change it.

Dog Slobber · Post by **Dog Slobber** » Sat Apr 20, 2019 5:24 pm

Gerryk wrote: ↑
Sat Apr 20, 2019 4:59 pm
I suggested it so the range isnt so wide. Why have it set so high if it’s not needed?

My car has a speed governor that prevents it from going over 180 Kph (110 Mph), I rarely go over 120 Kph (75 Mph). I think the fastest I've gone is 130 Kph (80 Mph).

Do you think I should have my mechanic lower the governor to 140 Kph (85 Mph)?

Why have it set so high, if it's not needed?

Gerryk · Post by **Gerryk** » Sat Apr 20, 2019 5:46 pm

You guys really are no helpful at all. Just because someone has a different idea or thought than you doesn’t mean they are wrong or have nothing to add. Keyboard warriors in this world have gone nuts. I am not able to
Look at the data is my phone but a pressure that is to high can cause a central apnea. Closing the pressure gap could help determine the problem.

palerider · Post by **palerider** » Sat Apr 20, 2019 5:59 pm

Gerryk wrote: ↑
Sat Apr 20, 2019 4:59 pm
I suggested it so the range isnt so wide. Why have it set so high if it’s not needed?

There is nothing at all wrong with a 'wide range'.

The *only* problem for the vast majority of people is when the minimum pressure is too low, and while technically, that does mean the range is too large, that is all too often misinterpreted to mean that the high end pressure should be changed... however, under normal circumstances, the high pressure setting should not be lowered.

Lowering the high pressure, for most people, will do nothing other than preventing the machine from taking care of your needs should you need more pressure than usual.

Gerryk · Post by **Gerryk** » Sat Apr 20, 2019 6:09 pm

Have you ever heard that higher pressures can cause central
Apnea’s?

High AHI- need some help!

High AHI- need some help!

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