I'm using straight CPAP - 12 mm H20. Limiting pressures was the appearance of post arousal central apneas. BIPAP was tried with marginally poorer results (i.e. a few more central apneas than CPAP by 12 mm). APAP was never tried.
Pressure is actually measured in Centimetres H20. I think you need a copy of your sleep study report, also the titration report. The introduction of Centrals needs to be addressed.
My machine has a memory card recording first-order compliance only (e.g. how often and for how long I use the unit). Minor leaks are not recorded however.
Your comments regarding possible leaks are interesting. I have been told in the past that I tend to "mouth breath" and my mask is of the pillow only type. Hence, it could be possible that I'm mouth breathing while "asleep" defeating somewhat my CPAP. Yet, I notice that when I try opening my mouth under CPAP that the sensation is most unpleasant and I would be somewhat surprised if that action while sleeping didn't fully awaken me. Further, I note no excess mouth dryness in the morning (and why wouldn't the lab tech. have noted "mouth breathing" during CPAP titration?). Still it's worth looking into. Perhaps I might try a chin strap or a full mask as a check. (As asides, I do notice under CPAP when still awake that I tend to want to move my lower jaw forward. Perhaps a full mask or dental appliance is suggested. I also experience with CPAP vivid dreams - awakening 2x nightly (REM rebound?).)
I think your mouth breathing might be the problem. Nasal Pillows and mouth breathers are not good bed fellows. You mentioned a 'limiting pressure'.....is that a pressure reduction ? If so there may not be enough pressure to keep the airway open.............hence the high AHI. Again, Centrals...........must be addressed.
The sleep doc. hasn't reviewed my results with me yet. She has only sent me a report and ordered my hardware. I've been only on my CPAP machine now for 7 nights. I'll certainly bring up concerns w.r.t. my present titrated CPAP of 32 when I see her in October. I need to keep trying - I also have Type 2 diabetis. I suspect that I've had OSA most of my adult life - 30+ years. On the positive side, since starting CPAP I do feel more alert during the day and calmer and believe my short term memory has started to improve a little (hopefully not all a placebo effect).
Try and get an earlier appointment. She should not be letting you hang in limbo.
Type 2 diabetes is a common side effect of untreated apnoea.
The fact that you are seeing improvements is good.........in truth probably the best gauge of how things are going. Not calling your competency into question.........but is your reading of the AHI of 32 correct..........maybe its 32 events during the night (total), rather than the hourly average...........promise not to laugh if that is the case
If it does represent the total number of events, and say you sleep for 7 hours, then your AHI would be below 5, which is considered 'normal'.
Your reported improvements indicate a certain amount of 'success' with cpap........so just maybe your reading might be incorrect. If this is the case you may not need to see your sleep doctor as quickly as earlier advised.
Best of luck.
Thanks again. Suggestions welcome.[/quote]