40.14 AHI with the Resmed airsense 10, need some advice please

[Richflu]

The My Air data says that i had 20 events the first night and 38 last night. What's wrong? shouldn't this be much lower???

I've been reading as a NUBE that I am unable to post any of my graphs for you yet. But I can give you any of the info from Sleepyhead that you ask for. My history is that I have been using a machine for three and a half years. I had a Resmed S9 initially but it stopped working a couple months ago and it took awhile to get a replacement but as of a couple days ago I now have an Airsense 10. I really do like this machine but I am VERY surprised that I still have such a high AHI. Shouldn't it be less than 5 while using a machine? Perhaps this still explains my tiredness during the day that never really went away.

Anyway, I am hoping that I can change some settings and fix this but I have no idea how to proceed. As mentioned above I did download the Sleepyhead software and I uploaded the last couple days of data from my machine to Sleepyhead this morning. Some advice and suggestions would be greatly appreciated! Thank you

[PoolQ]

FYI AHI is average per hour not per night, so if you sleep 8 hours and have 5 per hour that's 40 a night. That said you should be able to lower your level, it takes 4 posts to be able to post links. you can always out "DOT" instead of a "." in the link and we will figure it out.

[Richflu]

This is a copy and paste of the date that uploaded. Does this make enough sense to be of value to you?



4 days of CPAP Data, between Wed Jul 6 2016 and Sat Jul 9 2016
Details Most Recent Last Week Last 30 Days Last 6 Months Last Year
CPAP Usage
Average Hours per Night 07:25 06:19 06:19 06:19 06:19
Compliance 100% 100% 100% 100% 100%
Therapy Efficacy
AHI 38.42 40.14 40.14 40.14 40.14
Obstructive Index 12.40 11.98 11.98 11.98 11.98
Hypopnea Index 0.54 0.16 0.16 0.16 0.16
Clear Airway Index 21.97 22.11 22.11 22.11 22.11
Leak Statistics
Average Leak Rate 10.57 13.30 13.30 13.30 13.30
90% Leak Rate 34.80 36.00 36.00 36.00 36.00
% of time above Leak Rate threshold 15.71% 18.95% 18.95% 18.95% 18.95%
Pressure Statistics
Average Pressure 9.86 9.88 9.88 9.88 9.88
Min Pressure 4.02 4.02 4.02 4.02 4.02
Max Pressure 15.00 15.60 15.60 15.60 15.60
90% Pressure 12.72 12.58 12.58 12.58 12.58
Average EPAP 7.63 7.50 7.50 7.50 7.50
Min EPAP 4.02 4.02 4.02 4.02 4.02
Max EPAP 12.00 12.60 12.60 12.60 12.60

Changes to Prescription Settings
First Last Days AHI FL Machine Pressure Relief Mode Pressure Settings
Wed Jul 6 2016 Sat Jul 9 2016 4 40.14 0.00 AutoSet (37028) EPR: Full Time 3cmH2O APAP Min 4 Max 20 (cmH2O)

[PoolQ]

Yep it sure does. This is what was confusing me " i had 20 events the first night and 38 last night". The data you posted says indeed you had AHI in the high 30's and low 40's. This is way too high and something is set wrong OR you are on the wrong machine-
"Obstructive Index 12.40 11.98 11.98 11.98 11.98"
"Clear Airway Index 21.97 22.11 22.11 22.11 22.11"
This is classic mixed apnea and both are too high. Me thinks you should be using ASV to treat this.
It "could" be from pressure changes though and you min setting of 4 could be causing it. Your machine is set "wide open", 4-20. I would change my min pressure to 8 (2 below average), perhaps in steps and see if that brings down your centrals, if it does not I would talk to my Doctor about mixed (complex) apnea.

[trish6hundred]

Hi Richflu,
WELCOME! to the forum.!
You might talk to your doc about this, you might need a different type of machine.
Hang in there for more suggestions and answers to your questions.
Much success to you as you continue your CPAP therapy.

[justMongo]

Suggestion: Also, reduce EPR setting.
Why: At 3, CO₂ washout may cause central apnea.

And, let's get the proper machine name in your profile -- I wager it says Autoset in the lower right of your machine.
If so, please put Airsense 10 Autoset in your profile.

[green wings]

Richflu, do you remember what pressure settings you were using with the S9 and what your typical AHI was?

[Richflu]

Thank you everyone for the great info! My machine does say Autoset and I updated that on my profile.

I'll try changing the lower end of the settings to 6 or 8 tonight and see what happens if one of you can explain to me just how to do that I can't seem to find how to make that change.

As far as my S9 was set, I believe it was set the same. When I picked this up the other day they said they were setting the same parameters as before according to my doctors orders. However, I haven't seen the sleep disorder Dr for 3 1/2 years and I got the new machine through my family doc that just ordered a copy of my sleep study to justify to the insurance company that I needed it. I can talk to her as well but I would imagine she'll just refer me to the sleep Doc which is fine.

I really have no idea what kind of readings I had with the S9. I remember taking the data card to the Dr's office once a week for the first month and then they gave me a green light to just use it. Nothing has been checked since then and the only reason I know this info now is because the new machine provides it so I can see it. I never knew I could see it before. This is all new vocabulary to me and a new problem. I'm not surprised though because I still feel tired even when wearing the mask.

[green wings]

If your S9 had an SD card, you can import the data from it into SleepyHead and see what your old pressure settings were and what kind of AHI values you were getting with them.

[OpalRose]

Richflu, You can order the Clinicians Manual for your machine. This will tell you how to get into the Provider Menu to change your pressure.
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

You can also change the EPR setting. A high EPR setting triggers Clear Airway Events in some folk, so if you move from 3 to 2 and eventually to 1, you may see a decrease in the Clear Airways.
Raising your minimum pressure will help with the Obstructives. The minimum should be around 2 to 3cm below the 90% pressure number, but move it up slowly so you can get used to that.