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AHI high but feel awesome - confused
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knubob Offline

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Posts: 4
Joined: Feb 2016

Machine: Respironics System One (60 Series) RemStar Auto with A-Flex
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro
Humidifier: Respironics System One (60 Series) RemStar Auto with A-Flex
CPAP Pressure: 8.5 - 14.5
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Montana

Post: #1
Question AHI high but feel awesome - confused
I am a Newbie and am confused:


If I wear my full face mask (Mirage Quattro) and the pressure is in the 6 to 18 range, I wake up in the morning feeling awesome, but my AHI is high (between 12 to 20).

But if I try to reduce my AHI by wearing a nasal mask (Dreamwear) with the same pressures, my AHI is low but I feel like a zombie the next day.

I’ve uploaded Dreamwear screenshot.

How can I wake up feeling awesome and get my AHI to below five?? Huh



[attachment=2144]




RK
02-12-2016 06:06 PM
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wolson Offline

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Posts: 92
Joined: Dec 2015

Machine: PRS1 C-Flex
Mask Type: Other
Mask Make & Model: Dreamwear
Humidifier: Remstar
CPAP Pressure: 10 cm H20 C-flex x3
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Red Canyon, Lander, Wyoming

Post: #2
RE: AHI high but feel awesome - confused
(02-12-2016 06:06 PM)knubob Wrote:  I am a Newbie and am confused:


If I wear my full face mask (Mirage Quattro) and the pressure is in the 6 to 18 range, I wake up in the morning feeling awesome, but my AHI is high (between 12 to 20).

But if I try to reduce my AHI by wearing a nasal mask (Dreamwear) with the same pressures, my AHI is low but I feel like a zombie the next day.

I’ve uploaded Dreamwear screenshot.

How can I wake up feeling awesome and get my AHI to below five?? Huh

RK

Welcome to Apnea Board!

It looks like you are getting leakage. I would suggest tightening and balancing the tightness of the mask on both sides of your mask a bit as it should not leak at those pressures.

A given mask does not fit everybody correctly. You may be better off with FFM. Without seeing the FFM traces, another problem might be that that a lot pre-sleeping and post-sleeping junk might be affecting your AHI which you do not have with the Dreamwear.

AHI does not guarantee quality of sleep, unfortunately. I see that you woke up a couple of times and you have a high percentages of CA's particularly around 0130. I don't know how long you have been using APAP. You might be better with C- Flex mode set at 9 cm H20 than with APAP. I would discuss this with your prescribing doctor.

Walt

Walter W. Olson, Ph.D., P.E.
Professor Emeritus
02-12-2016 06:26 PM
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Possum Offline

Advisory Members

Posts: 254
Joined: Oct 2015

Machine: Resmed Airsense Autoset A10
Mask Type: Nasal pillows
Mask Make & Model: Airfit P10
Humidifier: (included in CPAP model)
CPAP Pressure: 8-12
CPAP Software: ResScan SleepyHead

Other Comments: Innovo CMS-50F+ pulse oximeter

Sex: Male
Location: San Diego, California, USA

Post: #3
RE: AHI high but feel awesome - confused
I suspect that your AHI is low yet you feel like a zombie with nasal masks because you have issues with mouth leak. A surprisingly simple solution is a chin strap, which can help train you to keep your mouth closed. If a chin strap does not help, then you might need to persist with a full-face mask. You might also want to reassess your therapy type - maybe A-flex isn't right for you?
02-12-2016 06:58 PM
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surferdude2 Offline

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Posts: 1,077
Joined: Jul 2014

Machine: ResMed S9 AutoSet
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro & Optilife
Humidifier: ResMed H5i @ #3 if nose breathing & #5 if mouth breathing
CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #4
RE: AHI high but feel awesome - confused
Generally your leaks are well controlled but there is that one hour period (approx. 12:45 to 1:45) that you probably were awakened by the massive leak. That's when the bulk of your CA's were flagged. Without that one hour slice, your therapy looks excellent.

Perhaps a hybrid mask may be the answer if you can't control the mouth leak. Get a chin strap and keep trying. If you feel good, that's most of the battle won already. The numbers don't often tell the whole tale. Throw out the one big cluster of CA's and you'll see what I mean.

For many people, several CA's spaced throughout the night can mean the level of sleep is very shallow and good rest is not being had. They are often flagged while awake. You have an indication of that in your posted graph.

Dude
(This post was last modified: 02-12-2016 07:27 PM by surferdude2.)
02-12-2016 07:19 PM
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trish6hundred Offline

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Posts: 6,452
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #5
RE: AHI high but feel awesome - confused
Hi knubob,
WELCOME! to the forum.!
Hang in there for more responses to your post and much success to you with your CPAP therapy.

trish6hundred
02-12-2016 08:04 PM
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knubob Offline

Members

Posts: 4
Joined: Feb 2016

Machine: Respironics System One (60 Series) RemStar Auto with A-Flex
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro
Humidifier: Respironics System One (60 Series) RemStar Auto with A-Flex
CPAP Pressure: 8.5 - 14.5
CPAP Software: SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Montana

Post: #6
RE: AHI high but feel awesome - confused
(02-12-2016 06:58 PM)Possum Wrote:  I suspect that your AHI is low yet you feel like a zombie with nasal masks because you have issues with mouth leak. A surprisingly simple solution is a chin strap, which can help train you to keep your mouth closed. If a chin strap does not help, then you might need to persist with a full-face mask. You might also want to reassess your therapy type - maybe A-flex isn't right for you?

Thanks for your help..

I forgot to add that I do/did where a chinstrap with the Dreamwear... Maybe it came loose... I have to admit, I don't do well with chinstraps...

If I have to choose, I'll take the feel-awsome-but-hi-AHI Mirage Quattro. How dangerous is a 12.39 AHI?

RK

PS:I would like to attach another screenshot of the Quattro FFM, the awesome feeling one, but as a new beginner, they won't let me... max out on attachments?Any advise?
02-12-2016 08:13 PM
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Mr. Van Winkle Online

Advisory Members

Posts: 258
Joined: Nov 2014

Machine: Resmed Airsense 10 Autoset
Mask Type: Nasal mask
Mask Make & Model: F&P Eson
Humidifier: Airsense
CPAP Pressure: 9 -15
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location: Minnesota

Post: #7
RE: AHI high but feel awesome - confused
(02-12-2016 08:13 PM)knubob Wrote:  
(02-12-2016 06:58 PM)Possum Wrote:  I suspect that your AHI is low yet you feel like a zombie with nasal masks because you have issues with mouth leak. A surprisingly simple solution is a chin strap, which can help train you to keep your mouth closed. If a chin strap does not help, then you might need to persist with a full-face mask. You might also want to reassess your therapy type - maybe A-flex isn't right for you?

Thanks for your help..

I forgot to add that I do/did where a chinstrap with the Dreamwear... Maybe it came loose... I have to admit, I don't do well with chinstraps...

If I have to choose, I'll take the feel-awsome-but-hi-AHI Mirage Quattro. How dangerous is a 12.39 AHI?

RK

PS:I would like to attach another screenshot of the Quattro FFM, the awesome feeling one, but as a new beginner, they won't let me... max out on attachments?Any advise?

One other thing you could try , I notice your pressure is 6 -18 range , when you adjust your mask for tightness while your still awake try doing your adjustment with your pressure in the higher range like 16 maybe.
I know when I started CPAP, I was always needing to readjust my mask after I'd been sleeping awhile (Awaken from leaks), so I had discovered as my pressure would increase is was like my mask was being blown off my face.
If you can get the leaks down you will feel better, and practice keeping your tongue to the roof of your mouth.
Good Luck!
02-12-2016 08:36 PM
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AshSF Online

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Posts: 356
Joined: Oct 2014

Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
Humidifier: PRS1 60 series with Heated Tube
CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

Sex: Male
Location:

Post: #8
RE: AHI high but feel awesome - confused
Your leak rate in the graph is fine. Even when it shot up a bit, it didn't go into large leak territory.

I suspect that your machine uses more of the 6-18 cm range when you use the FFM vs. the Dream wear.

You have 2 options that you can try now:
1) narrow the pressure range and just go with the dreamwear. You can probably go to a fixed pressure of 9cm and evaluate your therapy and how you feel in the morning.
2) the other way be to go with the FFM but raise your min pressure from 6 to maybe a 9. I am just speculating here since we haven't seen a chart from your FFM nights.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
02-12-2016 11:03 PM
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