One week down, and frustrated with numbers

Hi all. I'm a newbie, having just had my machine for one week. I think that I'm adapting to using it pretty well, but my numbers are not good at all. At my sleep study last month, my AHI was 16 without cpap, and 2 with cpap. My titration was set at 11.

I started the first night on straight cpap set at 11. The next morning, I checked my AHI, and it was 13.4 (7 day average, but only one day, so the average is the number). The next day, I got a call from my RT at the DME saying he had gotten ahold of my doctor, and wanted to switch me to auto. He said he would send me a new card to make the change, but since I had watched him set it up, I just went ahead and changed it myself. When the card came, it was set to min=5, max=20. I went in yesterday, and he set the min up to 8.

I have kept up each day with figuring out what my daily numbers are (from the averages, working mathematically backwards). This is what I have so far:
AHI
13.4
8.8
19.8
14.0
8.5
18.3

I think the worst part is, the two nights I "thought" I slept well, my AHI was the highest (19.8 and 18.3). I don't think I have any/many leaks. I have not noticed any of the symptoms, and my husband has not noticed any leakage. Of course, the "large leak" number is still zero on my machine.

I have ordered the software, but am still waiting for it to come. Why are my numbers so bad, most nights coming close to what I was at without cpap?

And one more question, if you don't mind me asking....My RT told me yesterday that the straps do not need to be tight--that they are just there to keep the mask in place if you move. He explained that the air coming into the mask should be enough to inflate the mask and create a seal, so that is why you do not need the straps so tight. He is a cpap user himself, so I was tempted to believe him, but it just doesn't sound right based on what I've read here. Has anyone else been told that the straps should NOT be really tight?

Thanks in advance for any help you wonderful people can offer me. I have learned SO much from all of you here already!

Well, as another newbie, my guess is that you are doing some mouth breathing during the night. You could try taping to see if that brings your numbers down whilst awaiting the arrival of your software. I am sure more experienced folks will be along soon to offer their help.

First of all, you're doing well as a beginner, just keeping the mask on, and sleeping all night are challenges for many who are starting. Sounds like some fine tuning is needed to bring your AHI down, but without the data from your software, it's difficult to guess. It would be useful to know the leak data and the breakdown of AHI. Are you sleeping on your back? Many of us have higher obstructive apneas if on our back.

Yes, the straps should be loose. By loose, I mean you can insert 1 or 2 fingers between the lower strap and skin. The upper straps are snugger, but not tight. If you have strap marks, they are too tight. If you have a small head, the headgear may be too large, see if your DME has a smaller one. Have the straps very loose, then lie down, turn on your cpap, then adjust the mask so it doesn't leak anymore. With mine, if I pull it off my face just a little (1/4 inch), it will inflate with air, and when it settles down again, I adjust the straps, just a little at a time.

The most common issue for beginners is leaks--either mask or mouth. So read up about them, in the Wicki or previous threads, for suggestions on how to deal with them, eg. mask fitting, hose management, head pillows. If you need to, ask for a better fitting mask. There usually is a 30 day return policy, so ask about that.

It sounds like your DME is responsive to adjusting your therapy, and I would utilize them to help you, since they are willing to work with you (and many are not).

And if you don't have it, get a copy of your sleep study and titration.

Thanks for the responses. As far as I know, I do not breathe through my mouth. I suppose anything is possible when I sleep, but my husband has not noticed it. I'm actually a side sleeper, and rarely sleep on my back. I try to position my head so the mask is off the side of the pillow, but I'm looking into different pillows, too. I have always been picky on my pillow, so it's proving to be a little tricky to find something I like that won't interfere with the mask.

I'm VERY anxious to get my software, and see if I can figure out what is happening. I keep reading about leaks being such a big issue, but without the software, I guess there isn't any real way to know for sure. I don't know how people do it without any feedback from their machine or software. My RT actually said I was the FIRST person to ask how I could see my numbers on my machine. I'm hoping that getting the software will lead to better responses, and improved numbers. I was really hoping that once I started cpap therapy, I would start to feel refreshed and awake during the day, but that hasn't happened yet.

When I saw my doctor last week, he only had a preliminary, oral report from the sleep study. He told me it could be another two weeks before the final report is done. I plan on asking for it as soon as I know it is done. I'm assuming since they did the titration the same night, that the titration information will also be included with the sleep study.