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AHI Dropped below 3 at first, now hovers around 5-9
#1
I have a Dreamstation and Dreamwear.

At first it brought down my AHI to 1.5-3...then two weeks ago (I've had it for a month) something changed and now I average 5-9. I've changed the size of the cushion, tightened it...that hasn't been helping.

The machine has been on auto 4-20 the whole time and hovers around 11 for pressure. Did it auto calibrate wrong? My sleep center is of no help. I had to buy my own machine and set it up myself.

Any thoughts? Can I start the calibration process again on the machine?

Untreated I was at around 17 AHI.

Thank you for your help.
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#2
Welcome

Are you experiencing higher leaks than two weeks ago?


Using FlashAir W-03 SD card in machine. Access through wifi with FlashPAP or Sleep Master utilities.

I wanted to learn Binary so I enrolled in Binary 101. I seemed to have missed the first four courses. Big Grinnie

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#3
Welcome to Apnea Board sviddle,
If you haven't already ordered the Clinicians manual, please do so by clicking on the link at top of page "CPAP Setup Manuals."

If you are saying that your pressure of 11 is the 90% pressure, then your starting pressure is too low.

Did you have a sleep study done? What was your titrated pressure. Just trying to get a feel for where your pressure setting should be.

In the meantime, if it were me in this situation, I would raise my starting pressure to 7 or 8 and watch for a while to see if AHI comes down.

The other thing is that it's important to get mask leaks under control. Don't over tighten straps.

Unfortunately, as of now, there is no current software that is compatible with the DreamStation. Hopefully that will change soon.

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#4
Hi sviddle,
WELCOME! to the forum.!
Hang in there for more suggestions and much success to you with your CPAP therapy.
trish6hundred
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#5
Before you change anything -- I replied to you on Jason's forum that we need to know what kind of events are contributing to the higher AHI -- obstructive apnea, central ("clear airway") apnea, hypopnea, unknown apnea. Raising your pressure may or may not be the appropriate fix depending on what types of events predominate.

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#6
kaiasgram,
He probably doesn't have access to that information as far as a breakdown of AHI.

And yes, I agree we shouldn't change pressures without something to go on, but a starting pressure of 4 is too low.

There is no software currently available to use with the DreamStation, although I don't use a DreamStation, I doubt this information is displayed on the machine itself except for basic info like AHI and 90% pressure.

sviddle,
The only option I can suggest is to use the Phillips Respironics Dream Mapper that should have come with your machine. I'm not sure that will give your a breakdown either.
You stated earlier that you bought the machine yourself and that the sleep clinic wasn't helping......
But I would ask the sleep clinic for a copy of your sleep report and perscription.


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#7
Hi and Welcome to ApneaBoard sviddle!! You'll get lots of great info and help around here with so many helpful and knowledgeable members!

Good luck getting your therapy sorted out.
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#8
If you are using the DreamMapper software to get your AHI#'s there was some kind of change to the app a few weeks ago, at least for me and my DreamStation. My DreamMapper numbers were always at least half of what my machine LCD screen would tell me. Then a few weeks ago they started matching the machine LCD. I discovered that the app was not reading my Hypopneas and it was throwing off my app AHI number. I thought it was weird that I never had any Hypopneas and now I know why.
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#9
(12-05-2015, 08:27 AM)OpalRose Wrote: kaiasgram,
He probably doesn't have access to that information as far as a breakdown of AHI.

I would think the event breakdown is available in the clinical menu but I also don't have that machine and can't confirm.

I don't think we know yet which DreamStation machine sviddle has -- APAP or CPAP Pro with that 30-day auto-trial thing. As a matter of fact, if it is the Pro model, could it be that the machine has shifted from APAP trial mode to straight CPAP and the fixed pressure is not working as well?

Hopefully sviddle will come back and clarify which model and the AHI breakdown -- regardless of which model, I would imagine that data is in the clinical menu. I believe the previous generation of Pro models were full data machines.
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#10
Thank you all for your comments and suggestions.

I have the APAP DreamStation.

It shows no leaks and the DreamWear is good about not leaking. I keep on switching between the medium and large nose piece to see if that changes anything, but it really doesn't.

The SleepMapper software shows:
Two Nights ago:
Total Central Apneas 13
Total Obstructive Apneas 21
Total Hypopneas 40

Then a week ago it showed:

Total Central Apneas 4
Total Obstructive Apneas 6
Total Hypopneas 11

It's set to the out-of-the-box setting of 4-20. I put AFlex on to 1 at the beginning because the pressure seemed too high.

I had a sleep study done. When they gave me the test machine for a week after my results, it was set to 4-20.

My sleep study showed:

Overall AHI: 18.6
Supine AHI: 38
Non-Supine AHI: 5.1
ODI: 15.1
Epworth Sleepiness Scale 0.

Not sure what else I should be looking at, since I didn't really get a report from them (Kaiser Permanente), just a letter with some stats so that I could order the machine on my own.
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