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AHI all over the map... Any thoughts?
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JPDTrek Offline

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Posts: 11
Joined: Jul 2016

Machine: Phillips Dreamstation Apap
Mask Type: Nasal mask
Mask Make & Model: Phillips Dreamwear
Humidifier: Integrated
CPAP Pressure: 6cm-16cm
CPAP Software: SleepyHead

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Sex: Male
Location: LA

Post: #1
AHI all over the map... Any thoughts?
Hey guys -

So, just completed day four, so totally expecting anomalies as I get used to my therapy.... and I also know I'm not comfortable at all in my mask. (Hopefully I'll have the F&P Simplus Day after tomorrow... You'll see some leakage below, too). ALSO... I'm traveling right now, so I'm sure being in an unfamiliar place has something to do with it.

But --- was wondering if anyone had any thoughts or advice regarding my AHI patterns...?

Night 1: 4.53 (6-16cm)
Night 2: 8.40 (6-16cm)
Night 3: 6.19 (I adjusted sightly to 8.5c-16cm)
Night 3: 12.42 (I adjusted slightly to 9-15cm)

I made the pressure increases because it seemed as if there was a clear correlation between my pressure dropping, then immediate OA's and Hypopnea's... So I thought if I kept the pressure from going too low I'd be making an improvement. Not so. Any suggestions? Sleepyhead photos are below.

[Image: screenshot_20160802_123235.png]

[Image: screenshot_20160802_123240.png]

[Image: screenshot_20160802_123244.png]

[Image: screenshot_20160802_123247.png]


Also - I've developed this dry cough and irritation down near my bronchial tubes... Didn't have that before, and I don't feel dried out in my nose. Some places say it's just the adjustment that my lungs would be making to the pressure... But anyone else have any similar symptoms?

(Edit: Typo's).
(This post was last modified: 08-02-2016 01:37 PM by JPDTrek.)
08-02-2016 01:35 PM
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justMongo Offline

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Posts: 3,853
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

Other Comments: μολὼν λαβέ

Sex: Male
Location: Калифорния

Post: #2
RE: AHI all over the map... Any thoughts?
Stay at the initial pressure settings and give it some time. You have to become accustomed to the positive pressure before you can re-evaluate.
It's possible that you have some pressure induced central apnea that may abate with time. But, 4 days is too soon to be concerned.

It may be that it will turn out that you are not on the correct type of machine for your apnea.
If the centrals remain a significant contributor to your apnea, you may need to be put on a machine known as an ASV.

You appear to breathe rather shallow. Perhaps you are a small person; or you have other conditions.
Again, in the end, you may need the assist of an ASV.

For now, just stay the course. If you're working with a doctor, have him review in the near future.

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.
08-02-2016 04:13 PM
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green wings Offline

Advisory Members

Posts: 552
Joined: Feb 2016

Machine: Respironics System One RemStar Pro (460)
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: integrated humidifier
CPAP Pressure: 13.0 cm
CPAP Software: SleepyHead

Other Comments: using CPAP since Jan. 2016

Sex: Undisclosed
Location: US

Post: #3
RE: AHI all over the map... Any thoughts?
I would have made the same increase in the lower pressure. The PR algorithm definitely does exactly what you've noted. It will go straight back to the minimum pressure, and then more OAs happen.

But...you definitely had increased CAs last night, plus PB showing up. I have no idea how to evaluate PB or to make recommendations about it.

Probably you can either leave your settings where they were last night or go back to your initial settings. There seems to be some "body getting used to breathing with CPAP" going on. In other words, the stuff that's happening for you right now, event-wise, may well be transient. It may be too early for you to try to pinpoint your optimal pressure settings. I don't know how to explain that in a way that makes any sense.

The cough sounds worrisome. My first impulse is to say "try more humidity". Do you have asthma, though? We had a new person to this forum just last month who had a history of mild asthma, but who developed problems with asthma when she began using CPAP, and ended up having to stop it for now. See forum member Kris the Crone's threads if you want to read about it.



(08-02-2016 01:35 PM)JPDTrek Wrote:  I made the pressure increases because it seemed as if there was a clear correlation between my pressure dropping, then immediate OA's and Hypopnea's... So I thought if I kept the pressure from going too low I'd be making an improvement. Not so. Any suggestions?


Also - I've developed this dry cough and irritation down near my bronchial tubes... Didn't have that before, and I don't feel dried out in my nose. Some places say it's just the adjustment that my lungs would be making to the pressure... But anyone else have any similar symptoms?
08-02-2016 04:54 PM
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DariaVader Offline
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Posts: 1,827
Joined: Nov 2014

Machine: Resmed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10 for Her
Humidifier: H5i humidifier with ClimateLine heated hose
CPAP Pressure: 8-15
CPAP Software: SleepyHead

Other Comments: diabetes II, Thyroidectomized, Primary Immune Deficiency, and the list goes on :P

Sex: Female
Location: Oregon

Post: #4
RE: AHI all over the map... Any thoughts?
with an AHI of 107, stopping pap is not a very good option....

Cough = get humidity to goldilocks. too much or too little causes issues.

wrt the changing AHI every night, you need to give it a couple of weeks. you have a lot of adjusting to do.

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
08-02-2016 06:28 PM
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eseedhouse Offline

Advisory Members

Posts: 882
Joined: Dec 2014

Machine: ResMed Airsense 10 Autoset
Mask Type: Full face mask
Mask Make & Model: SimPlus
Humidifier: ResMed
CPAP Pressure: 7-10
CPAP Software: SleepyHead

Other Comments: Also on supplemental O2 at 3L/min. while sleeping.

Sex: Male
Location: Victoria, British Columbia

Post: #5
RE: AHI all over the map... Any thoughts?
As Paul Simon wrote "Slow down, you move too fast". Give yourself at least a week or so at each new setting. Your body and mind vary from night to night and you need a decent sized sample to even out the "noise" caused by these variations.

Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
(This post was last modified: 08-02-2016 09:43 PM by eseedhouse.)
08-02-2016 09:43 PM
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toinewi Offline

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Posts: 21
Joined: Jul 2016

Machine: Philips Dreamstation Auto BiPAP
Mask Type: Nasal mask
Mask Make & Model: F&P ESON
Humidifier: Philips
CPAP Pressure: 16-25
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Wisconsin

Post: #6
RE: AHI all over the map... Any thoughts?
I started about 2 months ago, was diagnosed at 109.6 AHI.

I'm still working back and forth with my doctor and sleep techs to get the settings dialed in. That said, your numbers are lower than mine were for the first week. Give it time. Also, isolate how you sleep if at all possible. I know sleeping on my back causes my AHI to skyrocket.
08-02-2016 10:15 PM
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Mike1953 Offline

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Posts: 134
Joined: Aug 2014

Machine: Resmed S9 Escape Auto
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10
Humidifier: Resmed Hi5
CPAP Pressure: 12
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Kansas USA

Post: #7
RE: AHI all over the map... Any thoughts?
Give it and yourself some time to adjust to your new life with a hose at night.

For free Medicare assistance for your state check out this page. http://www.seniorsresourceguide.com/directories/National/SHIP/
or here http://www.medicareinteractive.org/
08-04-2016 06:25 PM
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