Apap pressure setting plan

Hi, a 2 night at home sleep study indicated that I have a Hyponea Index of 14.4 and 17.4. One treatment option given wass Cpap or Apap with a predicted initial setting of 5 cm H20. I am using a Res-Med AirSense AutoSet 10. I started with a range of 4 cm - 6cm and have worked my way up to 10 cm - 11 cm. I have been using the Apap now for 11 days but didn't start tracking AHI events until the past 6 days. AHI events are as follows. 5.3, 7.7, 6.6, 4.8, 5.9, 7.4. I have the following questions:

Am I increasing the pressure too fast?
As I increase pressure shouldn't I be getting a more steady AHI event improvement instead of the ups and downs?
Should I continue to increase the pressure, as I am currently doing, until my AHI events are near zero or have I plateaued already?
Should I decrease the pressure since lower pressure is showing similar results as higher pressure?

Thanks in advance.

Open your settings to 8-16 and leave it for a couple nights to see where your AHI goes. AHI will not get to zero. Download Sleepyhead software.

There's no reason to keep the higher setting so low at all, and min. should not need to be at 10 yet either. I'd set as LSAT recommended or do 7 and 15-20, but hold for a few days to get consensus rather than 1 night.

I changed the setting to 7 - 15. I already took a one hour nap with that setting and the machine is showing 21 events for that one hour which is the highest yet. (Even higher than the sleep study) Within 15 mins I dozed off but was awaken as the machine revved up. I suspect that was my first event. However, I don't believe I fell back to sleep so I don't understand why it's showing 21. Is there anything that would cause false events? Like maybe taking deep breaths? All of my highest events have occurred during naps but not all of them have been high. I will try the 7 - 15 setting tonight and see what happens. Thanks.

SteveBR wrote:I changed the setting to 7 - 15. I already took a one hour nap with that setting and the machine is showing 21 events for that one hour which is the highest yet. (Even higher than the sleep study) Within 15 mins I dozed off but was awaken as the machine revved up. I suspect that was my first event. However, I don't believe I fell back to sleep so I don't understand why it's showing 21. Is there anything that would cause false events? Like maybe taking deep breaths? All of my highest events have occurred during naps but not all of them have been high. I will try the 7 - 15 setting tonight and see what happens. Thanks.

What are the events? Apneas, Hypopneas, Centrals?????? Are you using Sleepyhead??????

SteveBR wrote:I changed the setting to 7 - 15. I already took a one hour nap with that setting and the machine is showing 21 events for that one hour which is the highest yet. (Even higher than the sleep study) Within 15 mins I dozed off but was awaken as the machine revved up. I suspect that was my first event. However, I don't believe I fell back to sleep so I don't understand why it's showing 21. Is there anything that would cause false events? Like maybe taking deep breaths? All of my highest events have occurred during naps but not all of them have been high. I will try the 7 - 15 setting tonight and see what happens. Thanks.

Event data when you are not fully asleep (which the machine has no way of knowing) is false.
Summary statistics (AHI) are only good (at most) for binary analysis - good or bad. The complete data is needed.
Follow the three links below.

Don't remember what mask you said(?) you have but if you're a mouth breather once asleep and you use a nasal (only) mask, you may need a full face one to keep from losing therapy air out your mouth instead of it going down your airway to be effective.

LSAT wrote:

SteveBR wrote:I changed the setting to 7 - 15. I already took a one hour nap with that setting and the machine is showing 21 events for that one hour which is the highest yet. (Even higher than the sleep study) Within 15 mins I dozed off but was awaken as the machine revved up. I suspect that was my first event. However, I don't believe I fell back to sleep so I don't understand why it's showing 21. Is there anything that would cause false events? Like maybe taking deep breaths? All of my highest events have occurred during naps but not all of them have been high. I will try the 7 - 15 setting tonight and see what happens. Thanks.

What are the events? Apneas, Hypopneas, Centrals?????? Are you using Sleepyhead??????

I'm waiting on a SD card reader so I can use Sleepyhead.

TedVPAP wrote:

SteveBR wrote:I changed the setting to 7 - 15. I already took a one hour nap with that setting and the machine is showing 21 events for that one hour which is the highest yet. (Even higher than the sleep study) Within 15 mins I dozed off but was awaken as the machine revved up. I suspect that was my first event. However, I don't believe I fell back to sleep so I don't understand why it's showing 21. Is there anything that would cause false events? Like maybe taking deep breaths? All of my highest events have occurred during naps but not all of them have been high. I will try the 7 - 15 setting tonight and see what happens. Thanks.

Event data when you are not fully asleep (which the machine has no way of knowing) is false.
Summary statistics (AHI) are only good (at most) for binary analysis - good or bad. The complete data is needed.
Follow the three links below.

This makes me wonder if my high false events during napping is distorting my overall nightly event count since I read that when you nap that data is combined with the nighttime data.

Julie wrote:Don't remember what mask you said(?) you have but if you're a mouth breather once asleep and you use a nasal (only) mask, you may need a full face one to keep from losing therapy air out your mouth instead of it going down your airway to be effective.

I tried the nasal pillow for the first several days but I was losing therapy air as you describe. Now I'm using a full face mask.

Okay I have been using Sleepy Head software for close to a month and would appreciate some input from the experts on here. I think I'm on the right track but want to be sure. Thanks in advance.

It looks to me like you put your low setting back to 4 (from 8?) - why?
And what are the large gaps on the graphs about - bathroom breaks?

And which particular FF mask do you have?

Initially I was using a ff mask (Airfit f20) and when I turned the minimum pressure up I was experiencing leakage so I reduced the pressure.

Now I've been using pillows for several weeks and taping my mouth with minimal leakage. Should I go back to a minimum of 8?

The large gaps are naps.

I'd go back to e.g. 8 for a few nights. Has no one told you Cpap for naps is just as important as overnights? Sleep is sleep and without Cpap you can be worse off when you wake up than before you napped.

SteveBR wrote:Hi, a 2 night at home sleep study indicated that I have a Hyponea Index of 14.4 and 17.4. One treatment option given wass Cpap or Apap with a predicted initial setting of 5 cm H20. I am using a Res-Med AirSense AutoSet 10. I started with a range of 4 cm - 6cm and have worked my way up to 10 cm - 11 cm. I have been using the Apap now for 11 days but didn't start tracking AHI events until the past 6 days. AHI events are as follows. 5.3, 7.7, 6.6, 4.8, 5.9, 7.4. I have the following questions:

Am I increasing the pressure too fast?
As I increase pressure shouldn't I be getting a more steady AHI event improvement instead of the ups and downs?
Should I continue to increase the pressure, as I am currently doing, until my AHI events are near zero or have I plateaued already?
Should I decrease the pressure since lower pressure is showing similar results as higher pressure?

Thanks in advance.

I am confused. The data shows that the machine is set to a minimum pressure of 4 and the maximum pressure has been varied between 6 and 8.4. I don't understand your statement about working your pressure to 10-11. Your maximum pressure should be set much higher (15). Your minimum pressure should be set to 6.

The AHI charts you show are very good; much better than the values you stated in your OP. What changed?
Get a few days of data using 6-15 and then we can evaluate.