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AHI all over the place, pretty frustrated...
#1
AHI all over the place, pretty frustrated...
AHI all over the place, pretty frustrated
Here’s a little bit of the back story. In Fall of 2013 I had a sleep study done because I’m a deep breather and heavy snorer. At that time I was 48. During the study I had 55 obstructive hypopneas, 8 central apneas, 8 obstructive apneas, with an AHI of 23. I was prescribed a pressure of 8.0 and told I have very minor sleep apnea. So for the last four years I would pretty consistently wear my mask to bed. The snoring pretty much stopped, which helped my wife sleep better. I was using a Respironics Remstar pro 450P and SwiftFX nasal pillows. Today I’m 5’9”, 52 years old, weigh 175lbs which puts my BMI above normal. I’m very active with intense workouts three times a work and I ride my bike to work most days ten miles each way. My resting heart rated is around 43.
A couple weeks ago a friend of mine was diagnosed with sleep apnea and was showing me his new machine and the app that shows him his data. My Respironics machine was starting to have issues with the humidifier leaking so I just decided to upgrade to the Respironics DreamStation Pro which I have been using for two weeks. In addition, I thought I would try out a different nasal pillow mask and have tried the Golife and DreamWear. Since I started using the new machine I found this board and have been reading and researching daily. I’ve tried all sorts of suggestions from other users, and several setting combinations. After two weeks I don’t feel like I am making much progress. In fact, I think I’m just going around in circles. I have also downloaded the SleepyHead software and loaded all the data I have on SD cards. I’m not sure what I am reading when I look at all this data. Here are some of my notes:
 
Date, Mask Type, AHI, Clear Away, Obstructive, Total Hypop, Pressure, Auto Ramp On, Ramp Setting, 90% Pressure, Flex, 

3/24, Golife,        3.5,       2,              1,                  18,           8.0,             N0,  ,  ,                                                 1,
3/25, SwiftFX,      9.5,      24,             3,                  57,           8.0,             No,  ,  ,                                                  1,
3/26, Golife,         5.8,     11,             1,                  38,            8.0,             No,  ,  ,                                                 1,
3/27, Golife,         11.8,    23,            10,                 42,          8.0,               no,  ,  ,                                                  2,
3/28, Golife,         14.8,    47,            30,                 45,  ,                          Yes,          8-12,                   11.6,            2,
3/29, Golife,         5.8,     13,             8,                  34,  ,                           Yes,          9-14,                   10.2,            2,
3/30, Golife,         11.2,   51,             13,                26,  ,                            Yes,          9.5-13,                13,               2,
3/31, Golife,         6.6,    16,              15,                26,  ,                            Yes,          9.5-15,                11.2,             2,
4/1, Golife,          7.3,     21,              6,                  22,  ,                             Yes,         9.5-14,               11.2,              2,
4/2, Golife,          8.8,     14,              7,                  16,  ,                            Yes,           9.5-13.5,            12.3,             3
4/3, Dreamwear, 6.4,      22,              5,                  19,  ,                            Yes,          10.5-13.0,          11.5,              3,
4/4, Dreamwear, 8.6,      28,            16,                  38,  ,                             Yes,         10.5-12.5,           12.5,              3, 
 
I've noticed with the higher pressure I get bloated and gassy. I read to increase the Flex, but that didn't seem to help.
I’m using a Windows surface so the SleepyHead data is pretty crunched on my screen and I’ve seen on this board where moderators are able to look at SleepyHead data without members posting screenshots. And because this is my first post, I don’t think I can post images yet. And, I wouldn't know what data to include. Like I said my screen is pretty crunched.
All that to ask for your wisdom. I don’t know what to do and I’d rather not go back for a sleep study unless absolutely necessary. My AHI is so sporadic, and I am not even sure that is the best measure of success. I think I’ve narrowed the best mask for me to be the GoLife. It really stays in place. Leaves nasty imprints on my face but at least I’m not battling it in the night. I’ve tried sleeping without a pillow, didn’t seem to help. I have a cervical collar on its way to me. Where do I go from here? I’d like specific suggestions for my settings. Do I go back to fixed pressure at 8.0? Do I put Flex back to 1?  I’d really appreciate you sharing wisdom.
Thank you in advance!
cbombzzz
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#2
RE: AHI all over the place, pretty frustrated...
You have a lot of Clear Airway events.  These usually correlate with Central Apnea.  It will help us help you if you would post your Sleepyhead charts so we can see what is happening.


Thanks

Fred
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#3
RE: AHI all over the place, pretty frustrated...
It's possible you need to be on a different type machine. It would help if you could post some sleepyhead charts here.
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#4
RE: AHI all over the place, pretty frustrated...
cbombzzz,

Use the links below in my signature line. This will show you how to organize your SleepyHead charts and post here.

Pay attention to the organization of graphs. Include the following graphs: Events, Flow Rate, Pressure,
Leak Rate and Snores. Also include the left sidebar minus the calendar.

Use the attachment feature to post here. You no longer need 4 posts.
OpalRose
Apnea Board Administrator
http://www.ApneaBoard.com

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#5
RE: AHI all over the place, pretty frustrated...
based off the info, I second walla walla's thought. I think you'll need another titration study. I don't think cpap is the proper therapy for you. The purpose of the titration study is to get you on bipap.

also, the golife mask is discontinued... Smile
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#6
RE: AHI all over the place, pretty frustrated...
Some comments. As others have said some of your days have a high number of CA events. A standard auto CPAP will not reduce them much if at all. However there are some days where OA events are high, and the total AHI is high as a result. There is some potential to reduce those with your machine. It seems you are running pressures fairly high and close to your max pressure setting. It may be too low. However it would be very helpful to see the Daily detailed SleepyHead charts. As others have suggested use the link in my signature to optimize your screen layout. Be sure to maximize the SleepyHead window to full screen before you do the screen capture. 

The general guideline is to get AHI under 5, and you may be able to do that, or get close. The alternatives like the ResMed AirCurve ASV Auto would work much better than an Auto CPAP, but they are very expensive.
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#7
RE: AHI all over the place, pretty frustrated...
(04-05-2018, 08:54 AM)cbombzzz Wrote: AHI all over the place, pretty frustrated
...
Date, Mask Type, AHI, Clear Away, Obstructive, Total Hypop, Pressure, Auto Ramp On, Ramp Setting, 90% Pressure, Flex, 

3/24, Golife,        3.5,       2,              1,                  18,           8.0,             N0,  ,  ,                                                 1,
3/25, SwiftFX,      9.5,      24,             3,                  57,           8.0,             No,  ,  ,                                                  1,
3/26, Golife,         5.8,     11,             1,                  38,            8.0,             No,  ,  ,                                                 1,
3/27, Golife,         11.8,    23,            10,                 42,          8.0,               no,  ,  ,                                                  2,
3/28, Golife,         14.8,    47,            30,                 45,  ,                          Yes,          8-12,                   11.6,            2,
3/29, Golife,         5.8,     13,             8,                  34,  ,                           Yes,          9-14,                   10.2,            2,
3/30, Golife,         11.2,   51,             13,                26,  ,                            Yes,          9.5-13,                13,               2,
3/31, Golife,         6.6,    16,              15,                26,  ,                            Yes,          9.5-15,                11.2,             2,
4/1, Golife,          7.3,     21,              6,                  22,  ,                             Yes,         9.5-14,               11.2,              2,
4/2, Golife,          8.8,     14,              7,                  16,  ,                            Yes,           9.5-13.5,            12.3,             3
4/3, Dreamwear, 6.4,      22,              5,                  19,  ,                            Yes,          10.5-13.0,          11.5,              3,
4/4, Dreamwear, 8.6,      28,            16,                  38,  ,                             Yes,         10.5-12.5,           12.5,              3, 
 
...

I'm no expert, so won't be adding anything to the expert advice you've been given. I do want to make you aware that too many changes at once will obfuscate your results. It's important (almost critical) to get your settings right, then work on factors such as snore; leaks; masks; etc.

Welcome to the forum, we're glad you're here.
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#8
RE: AHI all over the place, pretty frustrated...
Ok, I will work on this. 
How many days of information is valuable? Do you need data from when I just ran the pressure at 8.0 or would you like to see when I changed the pressure to vary? I have so much info and it is all over the place I don't know what would help you.

Thank you,

cbombzzz
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#9
RE: AHI all over the place, pretty frustrated...
Most recent one (or two, if there have been no settings changes)
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#10
RE: AHI all over the place, pretty frustrated...
What's the difference between CPAP and BIPAP and any others?
Frick, I just bought this machine. Does that mean I'm SOL with the $ paid? I didn't go through any doctor, I just bought mine where I buy my supplies. 
Also, if BIPAP is what I need to get the best night's sleep, I'd do it.
Is a titration study done in a lab again? Or is that something I can have done at home? 
I guess it's time to schedule an appointment with my Doc. Damn!

I appreciate the help/feedback.

cbombzzz
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