Using fixed pressure -- higher AHI but better sleep?

[Doublev]

I haven't touched my settings in over six months as I have been getting good AHI numbers (as good as it gets)

I do find that I wake up a lot during the night, tossing around, and while my AHI is many times 0 or very close to it I am sometimes very tired.

I had a feeling that maybe using the auto mode on my bilevel aircurve and the changes in pressure as the resmed ramps up are enough to gently wake me up.

I recently switched to fixed pressure taking my 90% max on Sleepy head as the fixed pressure level. My AHI has gone up to about 1.0 each night.. But I feel I am getting better sleep because I do not wake up as frequently (I do not remember waking up at all, so i think I never wake up.. but who knows, right?).

I think it is worth it, though. I was always fixated on getting the AHI down to 0.. but I dont think that necessarily means good sleep. So I am focus now on comfort with the aircurve and what I need to do to not toss around and wake up.

I just wanted to share and hear experiences of others... I dont know if APAP is necessarily always better than a CPAP based upon my findings.. The APAP is valuable for the new user trying to figure out where the pressures need to be, but once you know what numbers you want if you are experiencing what I am (waking up due to pressure changes) maybe setting it to something fixed will result in higher AHI but better sleep results.

[Sheriff Buford]

Too many people spend time chasing numbers. When I get a zero AHI, which I do probably 2 or 3 times a month, I don't feel as well as I do when I get measureable AHI's. I'm assuming you feel better with fixed cpap pressure settings as opposed to using the machine in the autoset mode. Goodness..... this is an old argument here, and if I remember right, the argument ended up in name callin' the last time this argument was discussed here. As I read your statement, your numbers were low enough either way... so... you should run the mode in the mode that makes you feel better during the day. Your choice.

I feel better in the straight cpap mode, but I have been using the autoset mode for years. People here are gonna say "I prefer autoset mode because...." or "you are crazy for using the cpap mode because...." Do what you feel better using. Both modes give you good enough numbers that will allow you to choose what is best for you.

Sheriff

[D.H.]

What do you trust, the "objective" numbers, or the very subjective "how you feel?"

Actually, I'm kidding a bit, the numbers aren't exactly divine revelation.

What you might want to try is to set a max lower than you had before, but higher than the min. If not, it's more important to feel rested than to chase a 0 AHI.

[Pugsy]

My number one goal...good quality restful sleep and NOT a math score. It's nice when they go together but it doesn't always work out that way but without good quality restful sleep and feeling better during the day then that nice math score doesn't really mean much does it?

My AHI has gone up to about 1.0 each night.. But I feel I am getting better sleep because I do not wake up as frequently (I do not remember waking up at all, so i think I never wake up.. but who knows, right?).

An AHI of 1.0 ...which is an increase from near 0.0 ...I wouldn't even bat an eye over that small of an increase.
Now if you were reporting an increase to 10.0 we would be having a different discussion.

Some people report that they feel better with a fixed pressure...some need auto adjusting pressures for various reasons to feel better.
There's no right or wrong to either. There's only what works for the individual.
Heck... if sleeping on your head standing up lets a person feel great and sleep great...hey go for it.

I really don't care how a person reaches whatever goals they have...be it with whatever mask or whatever mode of operation like fixed vs auto adjusting. I just care that they reach their goals and they get to decide what their goals are and they might not be the same goals I have.
I have never chased the "numbers" because I learned a long time ago that numbers by themselves mean pretty much nothing.
Low numbers don't guarantee great sleep or feeling great and higher numbers don't necessarily mean crappy sleep quality.
For me I have found that an AHI of 0.0 usually means I didn't get much deep sleep or REM sleep because of some reason or other...just a crappy bad night of sleep. I get great numbers but still feel like crap because of the bad sleep itself (usually from pain related stuff or pet related stuff).

So do whatever it takes for YOU to meet your goals and don't worry about what someone else might be doing or thinking.

[Omne]

Go with what you feel. I had similar issues when I used a bi-pap machine, I wasn't getting as rested.

I switched to an APAP machine and worked my way up to a minimum of 18 which seems to work well. My AHI went up some but like you I feel better.