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AHI fluctuating from very low to high
#1
Question 
AHI fluctuating from very low to high
I’m looking for any advice to an issue I’ve been experiencing. Sometimes I would wake up with my mouth dry so I know I was gasping all night like before without cpap. I’ve been on cpap for 3 weeks now. For some reason some nights my AHI would be between 1-4 and other nights it would be 30 or 60 or in the case of last night over 90.


I wear a full face mask and I experience no leaks. The only difference I can tell you is that on the nights where my AHI is low and I have a good night sleep is when I’m at home in my apartment. The nights where it has been high I was away from home, at my parents house and in the case of last night; I’m on a vacation trip, staying at an Airbnb and I’m sleeping on a couch. The couch is super soft and a bit uncomfortable with no back support.

I have no idea if my sleeping location has an effect but I find it weird that I’m having this much apnea events while on cpap with no leaks and that it only happens away from home

Any help would be appreciated.

I use sleepyhead as well but the data is very complicated and I don't know how to read it very well
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#2
RE: AHI fluctuating from very low to high
Hi dfabro,
Welcome to Apnea Board!

Your AHI fluctuations are a bit extreme.  Did you have a sleep study done?  What were the results?

Since you are already using SleepyHead, posting a screenshot of your data would be helpful.

Just use the directions below in my signature line.  The first link will explain how to organize the daily page for review.  The second link explains how to use the attachment feature to post your screenshot here.

Once we see some data, we are better able to advise.  

Here is a guide to SleepyHead:
http://www.apneaboard.com/wiki/index.php...SleepyHead
OpalRose
Apnea Board Administrator
www.ApneaBoard.com
Dreaming


https://www.sleepfiles.com/OSCAR
OSCAR Chart Organization
Using Attachments to Post ScreenShots.




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.
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#3
RE: AHI fluctuating from very low to high
here is the screenshot let me know if you need anything else.
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#4
RE: AHI fluctuating from very low to high
while you're waiting for replies from more-experienced members, I'll offer a couple thoughts. by your description I'd say it's not the locations so much as the beds, especially the soft uncomfortable couch, that's exacerbating snoring and flow limitations and causing positional apnea. maybe you need a firm mattress. you might have been bent neck chin tucked. soft sagging surface, maybe the wrong pillows and maybe a natural tendency toward positions that restrict the airway. many people have had great success with a soft cervical collar to align the airway, reduce snoring and clusters of apnea. second, pressure rises to max and stays there. it would be useful to compare this high ahi chart to one with your lower ahi's. if the machine goes to max on those nights too, it looks to me like you'd be better off with min 9 - 10 with max at 20 until you see how high the machine wants to go.
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#5
RE: AHI fluctuating from very low to high
Ok, wasn’t expecting that. You have severe obstructive Sleep Apnea. What were the results of your sleep study? Was there any Central Apnea showing up?

Since you are at your maximum pressure of 11cm, I suggest you change your settings to a minimum pressure of 10 and a maximum of 20. You can also use EPR for comfort. Start with a setting of 2.

Do you sleep on your back? If so, you might be tucking your chin into your chest which can cut off your airway. You may benefit if you used a soft cervical collar to keep you from tucking your chin and to keep your neck aligned.

You mentioned you sleep at different locations, so this could be an issue too.

Mouth breathing, even with using a full face mask can cause dry mouth. The cervical collar can help that too.

If you want, you can also show us a graph when you are sleeping at home vs. someplace else.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com
Dreaming


https://www.sleepfiles.com/OSCAR
OSCAR Chart Organization
Using Attachments to Post ScreenShots.




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.
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#6
RE: AHI fluctuating from very low to high
I think you need a soft cervical collar to correct the positional apnea while you're sleeping on that couch. You can open up the machine pressure a bit to see if it helps. I would start at no less than 9.0 cm minimum pressure and 20.0 maximum pressure. I'm almost certain that you are experiencing airway closure from your sleeping position, and that your head is tilted in a way that your chin tucks to your chest. ANY Walgreens store sells soft cervical collars, and judging from the looks of this, I'd pick one up this afternoon. You want a comfortable fit that will prevent your chin from tucking. Also reduce the number of pillows or get your head off the armrest.
Sleeprider
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.
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#7
RE: AHI fluctuating from very low to high
I sleep differently depending on where I am.  I sleep small-o-okay next to my wife, which she prefers, on a thick memory-foam-like Dormeo mattress.  I sleep better, but not reliably so, in the spare bedroom with a conventional mattress.  I sleep differently when in a motel, or when visiting and in someone's house.  There's more than one factor at play potentially, so it could be seen as a 'confluence' of factors ganging up and making our sleep less predictable and of poorer quality...generally.

The wife: she's a very noisy sleeper.  When she goes deep, and if I make the mistake of entering our bed when she is deep, it's a long haul for me to relax and to fall asleep.  Her breathing and groaning are Stentorian at times, so much so that I have given up and left to go to the spare bed.  She is a chin-dipper, and will highly preferentially sleep on her back...supine.  Part of my inability to rest when within earshot, including down the hall, is that she gets progressively restricted and begins to gurgle and finally gasp loudly when she's trying to fall into REM sleep.  No REM for her, little for me.  Why do I relate this?  Because, her way of sleeping, supine and unsupported, means that neither of us is going to have a good night's sleep.  I finally talked her into trying a cervical collar.  She hates it.  Detests it.  But she respects me enough to have persisted for about three months now, and I am pleased to say that her sleep, and mine, have at least halved the degree of misery that was the case previously.

Listen to Sleeprider.
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#8
RE: AHI fluctuating from very low to high
"Listen to Sleeprider."

I understand brevity mesenteria, even though I'm no good at it, so no offense intended. I find your postings informative and useful so I surely don't mean to pick on you. in fact, in my mind the following is addressed to all of us. please read this as an attempt to be positive and supportive, the spirit in which it is intended.

so I'll risk being a not-so-humble jerk: we all know Sleeprider is "the man" around here and deservedly so, but let's give credit when and where credit is due: "listen to Sleeprider, OpalRose and sheepless", each having given virtually the same response in reverse order.

I would have said this even if I hadn't posted to this thread, although I wouldn't have if I'd been the only other one. I completely understand it's not always possible to remember all who might be credited, or practical to even try, but even "and others" is good to the extent that it acknowledges that even though Sleeprider is head of the class, there's more than one helpful member here.

SarcasticDave had a quip that I don't remember exactly: something to the effect that even the something squirrel gets the nut sometimes. you get the drift.

kick me now for being a jerk and get it over with.
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#9
RE: AHI fluctuating from very low to high
sheepless,
All good points. I think all it amounts to is that many folk don’t bother reading all the posts and only read the last post.

When I look back on the posts in this thread, the thing I noticed first is that everyone gave almost identical advice. So a positive note is that we are on the same page. That’s what makes Apnea Board so special is the different members with various amounts of knowledge to share.

I know this saying has been around awhile, but here goes....”There is no I in Team.” Smile
OpalRose
Apnea Board Administrator
www.ApneaBoard.com
Dreaming


https://www.sleepfiles.com/OSCAR
OSCAR Chart Organization
Using Attachments to Post ScreenShots.




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.
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#10
RE: AHI fluctuating from very low to high
I totally agree OpalRose. honestly, I'm not at all concerned for my own sake; more for the principle. 'I' is opposite my point that it's best to be supportive of all, hence share credit when and where it's due if possible. and credit etc is the common phrase but probably not the right word. acknowledgement is more what I have in mind. I'm not concerned about any one instance; this was just a really clear and obvious one to make the point to be inclusive when appropriate.
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