Mostly Hypopneas-Do I even Need to treat this???

I've been using my CPAP for 5-6 months now. I check the numbers every morning and no matter what the AHI is, it's alway 90-95% hypopneas. My pressure is at 8.2 and my AHI fluctuates from 6.0-12.8 on a day to day basis. I'm just wondering if I even need to treat this? It's a low pressure (I'm told) and the AHI's don't seem very high either. I do know that only a fewdays during this time I've had an AHI of 2-3 and those days I felt better than I have in years. I have no idea how to get the 2-3 AHI on a regular basis. Any thoughts? Thank You

Kemosabe2 wrote:I've been using my CPAP for 5-6 months now. I check the numbers every morning and no matter what the AHI is, it's alway 90-95% hypopneas. My pressure is at 8.2 and my AHI fluctuates from 6.0-12.8 on a day to day basis. I'm just wondering if I even need to treat this? It's a low pressure (I'm told) and the AHI's don't seem very high either. I do know that only a fewdays during this time I've had an AHI of 2-3 and those days I felt better than I have in years. I have no idea how to get the 2-3 AHI on a regular basis. Any thoughts? Thank You

What you see on your software data is data after treatment, not before treatment. So you may be treating apnea events that are not on the data because they were prevented. What was the results of your sleep study with regards to apnea events? Pressure is not correlated to AHI, it's correlated to the amount of pressure needed to treat your OSA.
Is there something discouraging you about using your CPAP otherwise?

elg5cats

What's discouraging is that other than 2-3 days since I began Using the CPAP machine, I really don't notice any difference in how I feel. I thought I was going to feel better. It seems like I'm going through a lot of trouble for not any benefit. I had my original sleep study 1 1/2 years ago (and 40 pounds ago!) and even then my results were mostly hypopneas. I've actually increased the pressure myself because of the weight gain thinking it must need to be increased, but I'm not sure how. I've called my sleep doctor and he's reluctant for some reason to have me go for another sleep study. I'm sure I need to figure out what pressure is best for me, but don't know how to do that. I've been trying to gage things by the AHI's I get.

You said " Pressure is not correlated to AHI, it's correlated to the amount of pressure needed to treat your OSA." I don't understand what that means?
I assumed that the higher the AHI, the more pressure needed and vice versa.

Yes, you do need to treat the hypopneas.

My AHI is almost always hypopneas. I don't remember the last time I had an actual apnea on my chart.

One thing I have noticed is that leak rate can affect things significantly. A couple weeks ago, I was not aware of any significant leakage during the night, but woke in severe pain. (If my therapy isn't going well, there are certain areas that hurt, badly, rather than my being specifically tired.) When I checked my data, apparently, I'd had a restless night and my leak rate was up significantly from what it should be -- and so were the number of hypopneas.

Thank you Kiralynx. I'm happy to report that the ONLY thing that seems to have gone smoothly for me is my leaks. Every morning it says 0.0. In the respect, I'm very lucky. Can you please tell me if you ever feel "great"? That's my problem, I've been through a lot with this whole thing already and just want to give up because I'm not feeling any better. I still sleep 10 hours a night and feel tired all day. I don't get it.

It took probably well over a year and a half before I began to feel much difference.

I believe the longer you have had sleep problems, the longer it takes to begin recovering.

Kemosabe2 wrote:Thank you Kiralynx. I'm happy to report that the ONLY thing that seems to have gone smoothly for me is my leaks. Every morning it says 0.0. In the respect, I'm very lucky. Can you please tell me if you ever feel "great"? That's my problem, I've been through a lot with this whole thing already and just want to give up because I'm not feeling any better. I still sleep 10 hours a night and feel tired all day. I don't get it.

Nice to know you've mastered the leak rate! That can be a tough one for many of us! So can sleeping with the mask on for as many hours as you've succeeded in doing -- you can be proud, not dismayed!

Bear in mind that (as I understand it, and, as always, I ask people who have been here longer than me to correct me if I'm in error!) your exhalation pressure (EPAP) is what handles your apneas, and your inhalation pressure (IPAP) is what handles the hypopneas.

I'm not familiar with your machine, but you have listed an APAP. Are you using it in CPAP mode?

Do you have exhalation relief on? Some people find that it is necessary to bump their pressure up a bit to compensate for the exhalation relief.

Once I found the right pressures for me, I slept like a log -- sometimes as much as twelve hours. I've been on the hose for just over a year. My improvement was dramatic in one respect -- the pain issues that resulted in my diagnosis of apnea decreased significantly within days of starting treatment. And then, ironically, I was feeling more tired than I was before treatment, which was really perplexing. I have other health issues which are having to be addressed, though -- lymphedema after my cancer surgery, obesity, undiagnosed IBS. It took me months of long sleeping to begin to catch up on my sleep debt. Then again, based on my pain symptoms, I had been not-sleeping for over six years (possibly significantly more, but I'm sure of the six years) when I began therapy.

Please understand that while I can speculate on some of this, I'm not nearly as knowledgeable as some of the other folks hereabouts.

But what it seems to me is that your 8.5 is fine for dealing with apneas. However, you might need a higher pressure to handle the hypopneas.

Are you reading your data from the LCD screen, or with software?

My machine is an APAP/CPAP combo. I tried using the APAP but had to switch to CPAP because there's no exhalation relief with the APAP and I was constantly burping all night and again during the day. It was uncomfortable. The CPAP part of the machine does offer exhalation relief and that feels MUCH better, so that's why I'm using that instead.

I've tried turning up the pressure and sometimes it makes the hypopneas worse. Apneas too. I turn the pressure down and both increase. Of course, usually I increase or decrease by .2 each time. I've read that too much pressure can cause central apneas and don't want that!

I'm reading from the LCD screen. Don't have the software.

What did your sleep study say with reguards to where the pressure should be set?? I've tweeked my pressure a few times to see if it would make any difference in how I felt etc and it didn't work--I keep going back to the 9cm that the sleep study dictates. When I try to increase it, the AHI goes up --down it does the same thing. plus I tend to wake up more

My original sleep study said a pressure of 5. Of course, I only slept 1 1/2 hours the night of titration and never got into REM sleep. I'm actually mad that we didn't do another one since that one seemed useless. When I started on pressure 5 not only did it feel as though I couldn't get enough oxygen, I also experienced a lot of chest pain. I assume that was my heart...??? Enough to wake me up and scare me a lot. So I called the sleep dr. and convinced him to increase the pressure to 7. I could breath okay and no more chest pain. It didn't make me feel any better though. Since then I've tried changing my pressure myself but keep coming up with the same issues. No relief of daytime sleepiness.

Why not ask doc for a run to collect data with pressure range of say 7-16? Ask to borrow a recording oximeter and sleep with it to collect overnight oxygen levels. Then, you and doc can assess what you need to do.

I did this over July 4th holiday with a loaner APAP (set 4-20) resulting in reducing my pressure and identifing that I had signicant leaks so moved from my beloved OptiLife pillow mask to the RespCare Hybrid mask so I wouldn't lose therapy air. Doc recommened an APAP as I sleep so much better on APAP than CPAP and the reduced pressure was likely due to my 53#s wt loss...as my wt loss is ongoing, it's likely my pressure requirements will change and the APAP adjusts automatically to deliver the appropriate pressure to keep my airways open.

Muse-Inc. First, congratulations on your weight loss! What do you mean by "a run to collect data"? I'm happy to do that. My dr. is in China until mid-Dec., so I can't co anything until then. I actually left a message with is secretary that I'd like to switch to the same APAP machine that you're on because it gives exhail relief in APAP mode and I need that. I don't know if he'll let me do that though. My weight has gone up and down over the years and that's why I want an APAP in the first place. I had lost 73 pounds and unfortunately I have gained 40 of that back! Of course, I'm hoping to lose it again!

I was on straight CPAP and challenged exhaling against pressure. Then, I lost about 45#s and simultaneously dealing with central nervous system side effects (multiple, scariest was the breathing challenges) from a drug I'd been on and losing therapy air thru my loose lips (tiny puffs on exhalation)...I was so clueless about apnea that I didn't know what it was and my CPAP was data-less so no way to know what was going on when I slept (joined here and got educated quick!). Doc wanted to do a second sleep study but I'd been laid off and couldn't afford the co-pay. He loaned me an APAP and recording oximeter to collect sleep data over the holiday.

Muse-Inc. Thanks for the clarification. As soon as my doctor gets back from China I will speak to him about this if he doesn't authorize the new APAP machine. Thanks for your help!

My pressure range is 6-15 with reported pressures so far of 8.8 to 10.8. I don't have a card reader yet so cannot determine what my max is but this morning I woke up following an event and pressure was 12.4, so I'm glad I'm on the APAP. On CPAP, I was set to 9 and had lots of wakeups from what I presume were events; the APAP is likely aborting many that were occurring before as I am sleeping much better and wake up feeling more rested. Recovery is once again occurring.