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AHI increase
#1
Sad 
AHI increase
Thought that I was doing pretty good with my Dream Wear. In the last week my AHI numbers have radically increased. I was staying below 4 and now they are between 7 and 12. That is about half of what I had before starting CPAP. The CAs are the most prevalent and occur throughout the night but occur most frequently toward the end of my sleep cycle. I have even had Cheyne Stokes respiration. There has been some mask leakage. I also seem to be having a large amount of air forcefully coming from the vent holes on the front of the mask which is a new development

1. Any ideas about what might be happening

2. Is there such a thing as "false" cheyne stokes events?

Thanks in advance for ideas.
Elbie
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#2
RE: AHI increase
It would help if you posted the data, including machine settings, with pressure and EPR.

While Sleepyhead by default labels periodic breathing as CSR, it is probably best to manually reset the chart labels in File/Preverences/Events to be Periodic Breathing (PB). CSR is very specfic and extremely unlikely in the absence of heart failure. Again, if you want to post a close-up of the flow chart with the periodic breathing, we can offer some ideas.
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#3
RE: AHI increase
(11-17-2016, 03:07 PM)elbie Wrote: Thought that I was doing pretty good with my Dream Wear. In the last week my AHI numbers have radically increased. I was staying below 4 and now they are between 7 and 12. That is about half of what I had before starting CPAP. The CAs are the most prevalent and occur throughout the night but occur most frequently toward the end of my sleep cycle. I have even had Cheyne Stokes respiration. There has been some mask leakage. I also seem to be having a large amount of air forcefully coming from the vent holes on the front of the mask which is a new development

1. Any ideas about what might be happening
Without seeing the data it is very hard to come up with ideas about what might be happening.

How long have you been PAPing?

And did your diagnostic and/or titration sleep studies say anything about CAs?

You say that the CAs are most prevalent at the end of the night. Are you waking up and then dozing for a long period of time? Are you dealing with a lot of middle of the night restlessness?

Have your leak graphs changed in any significant way?

Quote:2. Is there such a thing as "false" cheyne stokes events?
As sleeprider already said, most of the stuff that SH flags as "CSR" should more properly be called "Periodic Breathing". Most PB is NOT Cheyne Stokes Respiration, but CSR is a very particular kind of PB. It's not uncommon for a bit of PB to be scored now and then, and some people have a bit of it scored every night. When you zoom in on the flow rate data, you might even wonder why the machine scored a chunk of your breathing as PB because the "periodic" part of the breathing can be really subtle. And the more subtle it is, the less likely it actually represents something real.

In general if you have no heart conditions, small amounts of PB most likely mean nothing in terms of your health or your sleep. But if you have certain types of heart problems, including congestive heart failure, a large amount of PB that resembles known CSR can be a real health concern and should be reported to both your cardiologist and your sleep doctor.


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#4
RE: AHI increase
My experience is very similar to yours. I had primarily CA's (and hypopneas) that steadily increased over the years of CPAP treatment. My AHI ranged from 2-3 for 18 months, then slowly increased to 5. I switched to a Resmed Autoset and over the course of a year my AHI increased to a range of 7 to 12 (still less than 1/3 my untreated AHI but the CA's were bad, ranging in time from 20 to 26 seconds). What I read on this forum(and eventually accepted as fact!) was that the only thing that effectively treats CA's is an ASV machine (I had very few OA's). I'm thrilled to report that my AHI is now 0.0 (someone told me that's statistically impossible but the Resmed ASV machine and Sleepyhead data show it).

This ASV machine is a relief. I discovered after the fact that my older brother who also has sleep apnea uses an ASV machine after years of CPAP therapy. We both appear to have responded similarly to CPAP therapy (i.e., slowly developing CA's over the years).

I also showed occasional Cheynes Stokes breathing and was told (as stated above by Sleeprider) it was unlikely.

Good luck in your journey to restful sleep. This forum has better information than either of the two experienced doctors I've consulted (which is a compliment to this community and a sad indictment of the medical community in this specialty).

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