still a bit confused

Hi everyone this has probably been done to death but. My weekly average figures are HI 8.9 AI 1.8 and AHI 10.3. I know when the AI figure is low say .7 I feel great but when it is 2 or higher i feel like crap for the whole day. my question is which reading should i be concerned about when making changes to my apap settings, because i swallow a lot of air i have had to back off the min setting back to 6 cm. at 7.8 its to painful the next morning. the max is at 15 cm.
regards to all pete.

Peter East wrote: my question is which reading should i be concerned about when making changes to my apap settings, because i swallow a lot of air i have had to back off the min setting back to 6 cm.

Pete, I hope someone has a good solution for this dilemma, because I'd like to know it as well.

I had a similar problem and found that raising the minimum pressure on my APAP brought events down. However, raising the minimum pressure also worsened aerophagia.

With this dilemma, what I did for a while was to keep the minimum pressure low enough to avoid gut-wrenching cramp-inducing aerophagia. I can't say it was a good solution, but it was a lot better than no xPAP.

Most recently, I've switched to using a BiPAP machine. The BiPAP allows pressure to be lower during exhalation which seems to help considerably with aerophagia. I wish I could say it's a lot better than APAP, but sadly it's not. It has been enough better for me though to make a noticeable difference in my sleep quality.

In terms of AI, it appears to have cut the AI to less than half of what it was with the APAP. My AI used to run between 1 and 2 on APAP, but now is consistently around 0.5 on BiPAP. My HI has also dropped a little, from around 3 to around 2 with a little less aerophagia than I had before. I'm trying to fine-tune the settings now and finding that as I make small changes to reduce the residual apneas, the aerophagia begins to go up very quickly.

Just my experience, of course. I've also read that physicians routinely prescribe BiPAP to reduce aerophagia, so you might consider the possibility. It has improved things for me, although I'm not satisfied with the current situation.

Regards,
Bill

Thanks nighthawkeye i am glad i am not alone. thought i might start slowly raising the pressure over the next few weeks and see what happens.
pete

Pete,

Since you have an auto machine, you might want to narrow the gap between the high and low settings. I don't understand all the differences between the AI and HI stuff, but your goal should be to get the total AHIs down below 5.

I would go back to the basics and concentrate on lowering the total AHIs first of all. I would narrow the range of the Auto to 2-3 below your titrated pressure (or your 90% pressure), and 2-3 above it. Later, you can focus on the difference between AIs and HIs.

Just my opinion.

Another thought might be that you have a major mask leak causing your pressure to go up to 15 during the night. That might be causing you to swallow air and have apneas. Make sure you have a really good seal on your mask.

Thanks for the replys, no my mask is not leaking, i am using a nasal pillow and have a very good seal. My titrated presure was 15 cm, but at that pressure or anything above about 8 i blow up like a ballon. I will just have to live with the lower pressure. Thanks for the ref. to what the AHI fig. shoud be ,I now have something to aim for.
pete

Peter East wrote:My titrated presure was 15 cm, but at that pressure or anything above about 8 i blow up like a ballon. I will just have to live with the lower pressure.

Pete, in my case, if I set my minimum much above 5 cm I start to blow up like a balloon. However, on BiPAP, I'm now OK with 9.5 IPAP / 6.5 EPAP, and have somewhat less aerophagia than I had with 6 cm straight CPAP.

A BiPAP is at least an option you might want to consider. It's not necessarily a cheap option, but then how many medical options are?

Regards,
Bill