AHI increasing with higher CPAP

Started on CPAP 3 months ago.AHI 17 improved to 2-3. Was still having episodes of obstructions that came in groups sometimes lasting 23 sec maybe 10-15 times.hours several times during the night. Since I was still feeling tired in the morning, my Endocrinologist/Internist suggested increasing pressure. Sleep Doc never returned call. Went up to 10 cm then 11 cm and AHI now creeping up to 4.5 with actual increased episodes of obstructions sometimes 20/hr. Some lasting 30 sec. Waiting to be referred to a sleep clinic closer to my home for another sleep study. Leakage of mask minimal.
Has anyone had a similar experience as the pressure increasing so does the apnea?

I've had a similar experience. My AHI is higher than I like (6-7, sometimes 9), minimal leaks.. I bumped up the pressure for a few days, and my AHI went up! I posted here, no solution:

viewtopic.php?f=1&t=54658#p510566

I hope that someone has an answer

lbw wrote:Has anyone had a similar experience as the pressure increasing so does the apnea?

For some xPAP users with complex SDB conditions, increasing pressures may decrease Obstructive apneas but increase Central apneas.

This is not something that I suffer from, so I can't comment further on it. It has been covered here in depth so you might want to do search on Central apneas and Complex apneas.

Cheers,

Bill

The S9 differentiates between central and obstructive apneas. The S8 does not. If raising pressure doesn't work, then I would stop raising it.

If your obstructive apneas are going up, then I would guess: leaks, positional--sleeping supine or dropping chin, or REM sleep. If it's REM related, I found that it eventually gets better with no changes.

Or, it could be meds, diet, exercise, stress, lifestyle. Examine all aspects of your sleep hygeine, not just your cpap.

lbw wrote: Has anyone had a similar experience as the pressure increasing so does the apnea?

Definitely my AHI/AI goes up with too much pressure. You need to find the sweet spot - not too much, not too little. If all you need to do is increase pressure than we all would be on 15CM or more.

As strange as this sounds you may want to drop the pressure a little from where you got the best results and see if your AHI improves further. If your obstructions come in clusters it probably means you are sleeping on your back during the cluster or are in REM during the cluster. Force yourself to sleep on your side or stomach with backpack or jamming pillows or whatever you can make work. See what the results are.