"please keep me updated about oximeters "
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Do I need higher pressure if my AHI is still high?
I have been using my CPAP for 5 months now and the AHI is averaging 10.5 / 11. This is still higher than the recommended range.
I have no problem with mask leaks. The leakage is 0%.
Does it mean I need to get my upper limit pressure adjusted even higher (currently at 14)?
I have no problem with mask leaks. The leakage is 0%.
Does it mean I need to get my upper limit pressure adjusted even higher (currently at 14)?
Views: 7946
Replies to This Discussion
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Permalink Reply by Mary Z on
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Snoozebabe, sounds like you do need a pressure adjustment. If you can, make an appointment with your doc to have the data read and your pressure adjusted if neccesary. You can also send your data Card to your DME to be read and send a report to the doc, but this does not always get the action you need. I see you have an AUTO machine- what are your limits set to -IPAP AND EPAP? If you are familiar with the machine and adjusting your own pressure, depending on your high pressure you may raise it yourself. But I would not leave the doc out of the loop. If your IPAP is set high, some other intervention would be in order. In fact the more I think about it see your doc, since you are using an AUTO machine something else may be going on. Good leak # by the way. I'm assuming you are using the machine all night every night, and naps. Good Luck.
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Permalink Reply by Neal Buckner, LRCP on
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Snoozebabe. It all depends on the type of events you are still having. The AHI is influenced by Hyponeas and central events as well. If the number of events are still high and it's due to straight forward obstructive events, then yes. An increase of pressure maybe recommended. However, if the number of events are Central or hypopnic in nature then you may need your pressures to be decreased or have your therapy changed to either BiLevel or ASV ventilation. Increasing pressures, when centrals are the issue, may cause more problems. Talk with your provider and ask if your machine flags central verses obstructive and talk with your prescribing physician.
Neal
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Permalink Reply by snoozebabe on
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Thanks both for your advice. Well, Neal, I haven't got any software to track what type of events I am suffering from. I will get my hands on the software soon, so I can have a clearer picture.
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Permalink Reply by Brian Katzung on
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It's also possible that the lower pressure limit is too low. Having an "auto" machine does not mean that it should be set to a range of basically 0 to 14.
Also, as previously alluded, it is not as simple as more pressure = lower AHI.
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As I understand it the EPAP on an AUTO should be set at your titrated pressure, not below. This is from Dr. Rapoport in one of his videos at the Manhatten A.W.A. K. E. meeting last year. SO if yout titraed pressure was 10 that is what the lowest number on the AUTO should be set at. Also, A Brian said more pressure does not equal lower AHI.
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Permalink Reply by Ross Ryan on
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You may want to think about and oral device to help optimize your upper airway. This may also lower the pressure need to keep the airway open. Check with your dentist.
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Another possibility is that even minor leaks can appear as apneas - in my case, as central apneas. My sleep doc's practitioner pointed that out to me when she looked at the printouts. It's shocking until you see that most of the centrals coincide precisely with mask leaks, even minor ones.
Odd that my machine screen shows zero leaks, but the software shows a bunch. Could that be happening to you too?
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Yes, now that I've gotten the software, it is odd that the screen on my machine shows 0% leakage but my software shows a bunch of leakage too.
Marcia Herman said:Another possibility is that even minor leaks can appear as apneas - in my case, as central apneas. My sleep doc's practitioner pointed that out to me when she looked at the printouts. It's shocking until you see that most of the centrals coincide precisely with mask leaks, even minor ones.
Odd that my machine screen shows zero leaks, but the software shows a bunch. Could that be happening to you too?
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My pressure range is now 14.5 to 18.5. My AHI has dropped but is still averaging 7 to 8 and sometimes it still goes beyond 10.
I hesitate to adjust my pressures any higher. I can't track if I'm having Central Apnea. The software report is only showing hypopnea events. Those are quite frequent.
I do not have a doctor to consult locally as medical care in my area is not so advanced. Perhaps I might need to seek medical advice in another country and until then I would have to live with the numbers.
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snoozebabe, it may mean the exact opposite. You may need a lower pressure. What is your prescribed pressure?
I changed docs when he put my pressure to 27/30 (yes, they do make a machine that goes that high) and going up and up had not improved my AHI. Another doc, another sleep study, a new prescription 4/8. That still didn't work so I experimented with the AUTO mode- the higher the pressure went the higher my AHI went. This was over a four year period of trying and trying to get my AHI down. I would go back to my recommended range and start titrating again. I found it to be easier to titrate in CPAP mode making small changes once a week. Good luck. Great on the leaks and commitment.
I have ended up needing ASV (don't have it, yet). As I said, it was a four year process.
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snoozebabe, my doctor told me that even though I have a high AHI (in the severe range recently) since I do not desaturate (O2 levels remain normal) I am not having any heart damage. Perhaps while you are just living with the numbers you could purchase a pulse oximeter and check your O2 levels. If they are going below 90% I think the high AHI becomes more serious. My sleep doc is a pulmonologist.
snoozebabe said:My pressure range is now 14.5 to 18.5. My AHI has dropped but is still averaging 7 to 8 and sometimes it still goes beyond 10.
I hesitate to adjust my pressures any higher. I can't track if I'm having Central Apnea. The software report is only showing hypopnea events. Those are quite frequent.
I do not have a doctor to consult locally as medical care in my area is not so advanced. Perhaps I might need to seek medical advice in another country and until then I would have to live with the numbers.
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