Nightly AHI question

I wouldn't consider it a trend just yet but I started CPAP 3 nights ago and my first night AHI was 7.2 the second and third night are averaged in with all 3 nights but the averages went up to 7.6 and 10.5 respectively. Now I understand it will take awhile but I am wondering if my pressure is not high enough. I was tritrated on a nasal pillows mask and chinstrap because I am a mouth breather. But I decided to get a Resmed Quattro FF mask for home. So does switching mask types effect the pressures required to keep the AHI below 5? Should I switch my CPAP to Auto mode and will the doctor be able to tell if I switched to Auto vice the 8 cm h20 that he set for me? Thanks for any replies.

PS. The treatment does seem to be working as I am starting to feel better and I have been able to keep the mask on all night with no leaks!!!

SleepyGrant wrote:I wouldn't consider it a trend just yet but I started CPAP 3 nights ago and my first night AHI was 7.2 the second and third night are averaged in with all 3 nights but the averages went up to 7.6 and 10.5 respectively. Now I understand it will take awhile but I am wondering if my pressure is not high enough.

If you were using a ResMed machine, I'd say those numbers were fine. But with a Respironics machine, it's worth some tweaking to see if you can get the AHI under 5.0.

SleepyGrant wrote: I was tritrated on a nasal pillows mask and chinstrap because I am a mouth breather. But I decided to get a Resmed Quattro FF mask for home. So does switching mask types effect the pressures required to keep the AHI below 5?

It could.

SleepyGrant wrote: Should I switch my CPAP to Auto mode and will the doctor be able to tell if I switched to Auto vice the 8 cm h20 that he set for me?

If he bothers to give more than a glance to verify compliance (that you're using it regularly) he could see what mode the machine is set for, or changed to. Very few doctors or DMEs look past the "green bars" showing good compliance.

But anyway, before I tried Auto mode, I'd simply try another cm or two of straight pressure in CPAP mode. I'd raise the single pressure to 9 for a few nights, then 10 for a few nights, to see if more pressure is the answer (it usually is) to preventing events (apneas and hypopneas) better, and thus bringing down the AHI.

If I were going to set the machine to auto mode, I'd use one of these ranges, depending on whether I had the software to see detailed results:

Without software:
8 for the minimum, 12 for the maximum

With software:
8 for the minimum, 20 for the maximum

As you can see, no matter what, I'd set the min pressure at 8. There's nothing to be gained by setting the minimum pressure lower than 8, since you already know that a straight CPAP pressure of 8 is allowing apneas/hypopneas through to the tune of an AHI over 5.0.

SleepyGrant wrote: PS. The treatment does seem to be working as I am starting to feel better and I have been able to keep the mask on all night with no leaks!!!

Very, VERY good, Grant!