How to reduce my events while using my Cpap

@alanbruce, There are a few reasons I can think of right off. Apneas do tend to be worse when you sleep on your back. The nights it is higher may have to do with your position. Another possibility-apnea can also be higher when you are in REM sleep. My next thought is you may experience a short period of mask leakage before you realize and readjust your mask. If the fit of your mask is off, just turning your head alittle could cause more leak. My final thought, if you are using a nasal mask (one that does not cover your mouth) you could possibly be having times you are breathing through your mouth, which causes you to not get full benefit of the PAP pessure. (JMO-from a Sleep tech in Kansas City MO)

Thank you. I generally sleep on my back and use a full face mask. Strange but the higher number is usually every 4th day. I will pay attention to how I sleep and the seal score to see if any trend.

Hi, @alanbruce - @thankful @johnhans and @johnbishop may also have some thoughts about your events while using a CPAP going up to 8 or 9 for a day at times and how you might reduce your events.

@tanap1 - welcome to Mayo Clinic Connect. I'm guessing that you also have a history of sleep apnea? If so, how have things gone with your treatment?

Hi Alan @alanbruce, My AHI is not real steady either. Just when I think it's staying down I get a spike in my AHI. It does appear to be gradually going down so I keep trying to answer the same question you asked. I sleep mostly on my side but my bad knee keeps me changing sides multiple times during the night. Sleeping on my back just doesn't work for me but I do try it at times.

If you decide to sleep on your side, make sure your head is part way off the side of the pillow so the face mask is not touching the pillow. Otherwise the pillow will push up on the mask, causing it to leak. Sleeping on your side is recommended. Make sure your mask is the proper size. Too small or too big can cause leakage. Be aware if you have an automated machine that switches on and off without you pushing a button, just putting the mask down with the mask facing down can cause the machine to think you are still wearing it and that it is leaking.

@johnhans I've tried multiple CPAP pillows, all with no success due to not being comfortable. I use a small MyPillow on top of another MyPillow and have my head on the edge of the small pillow. Biggest problem I have is keeping my cat from biting the hose connector on my mask where the air comes out...she doesn't like it ☺ or maybe she does and she wants more air.

Such a cute kitty. I used to have a ginger tabby and he liked to chew the hose too. I kept a bottle of spray water on my nightstand and one squirt was enough to keep him from chewing on the hose.

@lisalucier Thank you for the welcome! I personally don't have sleep apnea. I have been a registered sleep technologist for about 9 years. I run sleep studies and do PAP titrations when indicated. I speak from observation. When patients return with breakthrough symptoms it is often an issue with the mask. Either the mask is not the proper size, not tightened with a good seal, or there is oral breathing while using a nasal mask. Apneas, in general, tend to be worse during REM sleep and also while sleeping on your back. It is a possibility during the titration study, minimally REM or back sleeping was seen. It is also very important to note the original amount of apneas before treatment compared to the number after therapy. The goal of PAP therapy is a great improvement rather than "perfect"...if that makes sense.

@alanbruce- I would agree with others about different positions while sleeping and keeping the mask off the pillow. I did have similiar issues with my AHI and it seemed that over the years the one thing that corrected that problem was to adjust the pressure accordingly. After working with the sleep Dr. I have learned how to adjust and sometimes just a small amount will make a big difference. I also agree with @lisalucier that perfect may not be attainable, but anything close is doing us a world of good compared to what we were getting before. Jim @thankful

Alan, I have been using a CPAP for over 4 years. I, as you do, track my events, pressure, etc. every day and try to correlate it with something - diet, alcohol, degree of tiredness. So, my AHI and pressure needed is more when I am really tired, have a sweet dessert after dinner, or have foods high in sodium. If I eat a little earlier in the evening, this seems to mitigate the number of events. Maybe some of these variables would be related to you.