XPAP somewhat controls apnea

[rick2057]

I have been on APAP since November 2008.  I have only "missed" one or two nights using my machine since starting, and those were because I was staying with my dad in the hospital.  So, you can say I am very diligent about my therapy.  I am also very involved in it as well (have to be becasue I have not seen or heard from Dr since I got the results of my study and my machine).  I check my numbers regularly, and have modified my settings based on the numbers (originally set at 7-13, now at 10-13.5).

When I first started therapy I was maintaining an AHI of 6-8, and running near my max pressure almost all of the time.  After several months I increased my minimum pressue and my AHI dropped to 3-5.  After another few months I raised my max pressure .5 and my AHI dropped to 2.1-3.5.  Now, several months later, my AHI is fluctuating more that I think it should - it has gotten as high as 6.5, and as low as 2.8 in the past few weeks.

My questions are: 1) do you see a problem with minor modifications to my pressure(s) since my Dr is not an active participant in my therapy?  2) should I be concerned about this recent fluctuation in my AHI?   3) could this simply be related to a new mask? (never had fulctuations like this before with a new mask)

[rick2057]

Dr. Park,

Thank you for your reply.  I would follow-up with my sleep doctor if I really had one.  The dr that ordered the sleep study is my ENT, and the dr's that reviewed it and the tirtration are an ENT, a PCP, and a PHD.

I have called the sleep lab to ask questions and have been told that none of the dr.s are full time employees - they simply review results and make recommendations/write RX's.

[Steven Y Park, MD]

It's normal to have fluctuations depending on your sleep position, nasal patency, mask issues, and atmospheric pressures. It sounds like you're doing well overall, so I wouldn't worry too much. You should follow-up with your sleep doctor and voice your concerns. There's always fine tuning involved.