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AHI A Month In (and other newbie questions)
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dclaryjr Offline

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Machine: ResMed Airsense 10 (Autoset)
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Location: Texas U.S.A.

Post: #1
AHI A Month In (and other newbie questions)
I’ve been lurking here about a month now—time to jump in with a couple questions. First, my ResMed MyAir reports have consistently shown my Events Per Hour to be between 7 and 10. I’ve tried searching (and even called ResMed) to get a definition of an “event” without much luck. The tech at my DME company doesn’t seem concerned. However, I have an office mate who is also on a ResMed machine, and his events are a flatline < 1.

The other question concerns acceptable leak rate. The graph on the MyAir report shows 24L/min as being the threshold. Mine stats are usually below 10, but sometimes go over a little. Is that something to be concerned about?

I guess the bottom line is how do I feel, and I can say I’m experiencing less daytime sleepiness but it’s still there. The urge to nap is still present but not as strong.

Finally, I’m going to get retested because my wife said she heard me snoring a couple times even though I had the mask on. I’m not positive that was the case, but the sleep center wants to have their most experienced tech test me (I got a rookie last time). So we’ll see…..
08-03-2016 07:58 AM
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justMongo Offline

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Post: #2
RE: AHI A Month In (and other newbie questions)
First, if I may ask, which specific Airsense 10 do you have? Look lower right and it may say CPAP, Autoset, VPAP or ....
Since you list a fixed pressure on 10, it likely says CPAP.

The AHI is the Apnea Hypopnea Index. It's an average of the number of Apneas and Hypopneas per hour.
Apneas come in two flavors -- Obstructive and Clear Airway (Sometimes called a Central Apnea.) These two are abbreviated OA and CA. An *event* is a CA, OA or Hypopnea.

During the time when leak exceeds 24 LPM, therapy may be compromised as the blower may not be able to maintain pressure.
You are using the AirFit F10; which in my opinion isn't the best mask as it may be hard to keep a seal near the bridge of the nose due to the mask's silly strap design.

It's certainly possible to snore under PAP pressure. I see it on my data occasionally. An Auto machine will adjust pressure upward when snore is detected.

Provided you do not have a high count of CAs, then an Auto machine such as their Autoset would likely be better than straight CPAP. The Autoset can be set to a range of pressure that brackets the 10 cm-water. Then it has room to work with in minimizing obstructive events.

We'll see after they retest you. Ask for copies of you sleep reports. Also ask for a copy of you prescription.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
(This post was last modified: 08-03-2016 08:51 AM by justMongo.)
08-03-2016 08:48 AM
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DeepBreathing Offline
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Post: #3
RE: AHI A Month In (and other newbie questions)
G'day dclaryjr, welcome to Apnea Board.

(08-03-2016 07:58 AM)dclaryjr Wrote:  I’ve been lurking here about a month now—time to jump in with a couple questions. First, my ResMed MyAir reports have consistently shown my Events Per Hour to be between 7 and 10. I’ve tried searching (and even called ResMed) to get a definition of an “event” without much luck. The tech at my DME company doesn’t seem concerned. However, I have an office mate who is also on a ResMed machine, and his events are a flatline < 1.

The MyAir service doesn't provide adequate data to really understand what's happening with your therapy or how to fine tune it. What's really needed is specialist software like SleepyHead, which is a free download from http://sleepyhead.jedimark.net/

Mongo has explained what the events are - to be considered clinically treated your AHI should be under five. 7 - 10 doesn't really cut it - to my way of thinking it smacks of laziness on the part of your DME. (Don't forget - they get paid for supplying stuff, not making people better).

Quote:The other question concerns acceptable leak rate. The graph on the MyAir report shows 24L/min as being the threshold. Mine stats are usually below 10, but sometimes go over a little. Is that something to be concerned about?

If the leak goes over 24 the machine won't be able to optimise your therapy, nor will it be able to properly diagnose what events you're having. A constant small leak is not likely to be a bother, neither is an occasional large leak. However prolonged large leaks will compromise your therapy. The other issue with leaks is that they can disturb your sleep, blowing into your eyes or causing "face farts". So even if the numbers look OK your sleep can still be disturbed by leaks.

Quote:I guess the bottom line is how do I feel, and I can say I’m experiencing less daytime sleepiness but it’s still there. The urge to nap is still present but not as strong.

I think this indicates the therapy is starting to do you good, but still is still a lot of room for improvement and fine tuning.

Quote:Finally, I’m going to get retested because my wife said she heard me snoring a couple times even though I had the mask on. I’m not positive that was the case, but the sleep center wants to have their most experienced tech test me (I got a rookie last time). So we’ll see…..

Really?? If I tried a line like that on a client I'd be out of business. I don't know your sleep centre, so I'm not prepared to say it's BS, but it sure smells like it. I hope you're not paying for this with your own coin - if so I'd demand a full refund from the first test.

It's not uncommon to snore with the mask on - it's just an indication that you don't have everything set optimally. You don't need a sleep test for that, you need somebody who knows how to set up a machine and monitor your progress.

The main thing an apneac needs is a healthy dose of scepticism and the ability to "work the system". As one of our members says: If a DME tells you it's dark at midnight, go outside and look for yourself.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-03-2016 09:24 AM
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dclaryjr Offline

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Machine: ResMed Airsense 10 (Autoset)
Mask Type: Full face mask
Mask Make & Model: ResMed AirFit F10
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CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments: I wanna sleep like this baby (my great-grandson)

Sex: Male
Location: Texas U.S.A.

Post: #4
RE: AHI A Month In (and other newbie questions)
(08-03-2016 08:48 AM)justMongo Wrote:  First, if I may ask, which specific Airsense 10 do you have?

I'm pretty sure it's CPAP but I'll have to check when I get home.


Quote:During the time when leak exceeds 24 LPM, therapy may be compromised as the blower may not be able to maintain pressure.
You are using the AirFit F10; which in my opinion isn't the best mask as it may be hard to keep a seal near the bridge of the nose due to the mask's silly strap design.

I started with an F&P Simplus but I asked to try the Airfit. I find it more comfortable, and the leak rate has stayed under 10 fairly consistently. The Simplus started making an annoying whining noise that would go away if I tapped on the vent, but then it would come back. The AirFit has been quiet.



Quote: We'll see after they retest you. Ask for copies of you sleep reports. Also ask for a copy of you prescription.

Will do...and I appreciate the response.

Dave
08-03-2016 09:53 AM
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dclaryjr Offline

Preferred Members

Posts: 41
Joined: Jul 2016

Machine: ResMed Airsense 10 (Autoset)
Mask Type: Full face mask
Mask Make & Model: ResMed AirFit F10
Humidifier: ResMed
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments: I wanna sleep like this baby (my great-grandson)

Sex: Male
Location: Texas U.S.A.

Post: #5
RE: AHI A Month In (and other newbie questions)
(08-03-2016 09:24 AM)DeepBreathing Wrote:  G'day dclaryjr, welcome to Apnea Board.

Thanks, mate!! Smile

Quote:The MyAir service doesn't provide adequate data to really understand what's happening with your therapy or how to fine tune it. What's really needed is specialist software like SleepyHead,

I've downloaded it...just have to get around to buying an SD Card reader.

Quote: Mongo has explained what the events are - to be considered clinically treated your AHI should be under five. 7 - 10 doesn't really cut it - to my way of thinking it smacks of laziness on the part of your DME. (Don't forget - they get paid for supplying stuff, not making people better).

Yea, my DME provider is definitely suspect. I even received one of those automated emails from ResMed saying that my AHI looked high. That's why I brought it up to my doctor (an internist--not a sleep specialist), and he thought it was a good idea to get retested.

Quote:If the leak goes over 24 the machine won't be able to optimise your therapy,

It's been above 10 twice in the last 14 days; otherwise, it's been zero or in the 5-7 range. I always get the green smiley face on the machine!


Quote:Really?? If I tried a line like that on a client I'd be out of business. I don't know your sleep centre, so I'm not prepared to say it's BS, but it sure smells like it. I hope you're not paying for this with your own coin - if so I'd demand a full refund from the first test.

I probably didn't state that correctly. It was my physician that asked for the retest. I feel like the woman that does the scheduling just wants her best tech on this one (although you'd think they should be confident that all their employees are totally competent). To answer your question, it's costing me a $12 co-pay.

Quote:It's not uncommon to snore with the mask on - it's just an indication that you don't have everything set optimally. You don't need a sleep test for that, you need somebody who knows how to set up a machine and monitor your progress.

I think we have a recurring theme here. DME support is important.

Quote: If a DME tells you it's dark at midnight, go outside and look for yourself.

Ha!! Thanks for the response. I'll follow-up later.

Dave

P.S. Side note--since OZ is at the center of the "apneac" universe, shouldn't the forum software recognize Aussie spelling? Too-funny
08-03-2016 10:34 AM
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SuperSleeper Offline

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Post: #6
RE: AHI A Month In (and other newbie questions)
(08-03-2016 10:34 AM)dclaryjr Wrote:  P.S. Side note--since OZ is at the center of the "apneac" universe, shouldn't the forum software recognize Aussie spelling? Too-funny

˙ǝɹǝɥdsᴉɯǝɥ uɹǝɥʇɹou ǝɥʇ uᴉ sʞloɟ sn puɐʇsɹǝpun ʎllɐǝɹ oʇ sǝᴉssn∀ ʇuɐʍ ǝʍ ɟᴉ ǝʇᴉɹʍ oʇ ǝʌɐɥ p,ǝʍ ʎɐʍ ǝɥʇ sᴉ sᴉɥʇ 'ɹǝpun uʍop sᴉ ɐᴉlɐɹʇsn∀ ǝɔuᴉS


Coffee

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

08-03-2016 10:53 AM
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dclaryjr Offline

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Machine: ResMed Airsense 10 (Autoset)
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Post: #7
RE: AHI A Month In (and other newbie questions)
Well played, SS!!

Too-funny
08-03-2016 10:59 AM
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dclaryjr Offline

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Posts: 41
Joined: Jul 2016

Machine: ResMed Airsense 10 (Autoset)
Mask Type: Full face mask
Mask Make & Model: ResMed AirFit F10
Humidifier: ResMed
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments: I wanna sleep like this baby (my great-grandson)

Sex: Male
Location: Texas U.S.A.

Post: #8
RE: AHI A Month In (and other newbie questions)
(08-03-2016 08:48 AM)justMongo Wrote:  First, if I may ask, which specific Airsense 10 do you have? Look lower right and it may say CPAP, Autoset, VPAP or ....
Since you list a fixed pressure on 10, it likely says CPAP.

I just noticed on my MyAir report that my machine is listed as "AirSense 10 Autoset." I'm guessing it had to get that from the model number/serial number I entered when I set it up, because I don't think I typed that in. So I take it this machine is capable of varying pressure. Correct? The settings screen (user) shows a pressure of 10. So can this model do either variable or a constant pressure?

Dave
08-03-2016 11:50 AM
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justMongo Offline

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Post: #9
RE: AHI A Month In (and other newbie questions)
Then it will say Autoset just below Airsense 10 on the lower right.
The Autoset can run as a fixed CPAP or a self adjusting Auto mode.
That type machine is the most popular on apneaboard.

You should get the SD card reader; and check your data with software. The question is:
What is you AHI composed of in terms of CA, OA, and hypos. If it's dominated by OA and hypos, then a switch to auto, giving it room to run a bit higher pressure may do the trick. If insurance is paying for the new study -- go for it. It might be that CAs are dominant; and a different machine is required to tame them.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
08-03-2016 01:41 PM
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dclaryjr Offline

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Machine: ResMed Airsense 10 (Autoset)
Mask Type: Full face mask
Mask Make & Model: ResMed AirFit F10
Humidifier: ResMed
CPAP Pressure: 10
CPAP Software: SleepyHead

Other Comments: I wanna sleep like this baby (my great-grandson)

Sex: Male
Location: Texas U.S.A.

Post: #10
RE: AHI A Month In (and other newbie questions)
I got my doctor to send me a copy of the sleep study and the prescription. I've attached the respiratory summary. Hypos and OAs definitely dominate.

   

The conclusion says I had a good response at 10 cm H20 with no respiratory events.
08-03-2016 02:03 PM
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