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Apnea newbie
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hmerovich Offline

New Members

Posts: 3
Joined: Sep 2013

Machine: Philips Respironics System One Remstar Auto A-Flex
Mask Type: Full face mask
Mask Make & Model: Respironics Full Confort Blue Gel
Humidifier: none
CPAP Pressure: 4-14
CPAP Software: SleepyHead Other Software

Other Comments:

Sex: Male
Location:

Post: #1
Apnea newbie
Hello

Let me introduce : My name is Horacio merovich and I am a new apnea patient. During my last sleep study they found that I have a AHI=52,8 and I had a tiltration study where they suggested me to use a pressure of 13.
but as I have a auto CPAP , I am trying to adapt myself to this machine because it seems to be a better therapy .

I have slept the last three days using APAP without any major issues but reviewing my Sleepyhead from last night I found that my AHI rises to 20 while the CPAP presssure lowers to 8 between 4:00 - 04:30 AM
I cant understand why the APAP didnt raise the pressure trying tp reduce my AHI.

Any ideas ?

Best regards and thanks in advance
10-16-2013 10:18 AM
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skyler Offline

Preferred Members

Posts: 75
Joined: May 2013

Machine: Respironics ASV
Mask Type: Nasal mask
Mask Make & Model: Respironics Wisp
Humidifier: System One Respironics
CPAP Pressure: 8-12-20
CPAP Software: Not using software SleepyHead

Other Comments: Diagnosed February 2008

Sex: Undisclosed
Location: Norfolk, Virginia

Post: #2
RE: Apnea newbie
Welcome to the forum. It takes the machine a bit of time to respond to apneas. I don't have the ability to open your file. I would day look at things over a longer period of time and give your self time to adjust to the machine. I applaud your interest.
One of the important points to evaluate is how you feel.
Keep us posted, please.
10-16-2013 10:44 AM
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trish6hundred Offline

Advisory Members

Posts: 6,430
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: #3
RE: Apnea newbie
Hi hmerovich,
WELCOME! to the forum.!
Hang in there for more answers to your questions and best of luck to you with your CPAP therapy.

trish6hundred
10-16-2013 11:07 AM
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Peter_C Offline

Advisory Members

Posts: 1,308
Joined: Sep 2013

Machine: System One DS960HS
Mask Type: Full face mask
Mask Make & Model: Mirage Quattro "MED"
Humidifier: Attached
CPAP Pressure: Auto mode-script is:15/3/3
CPAP Software: EncoreBasic Other Software

Other Comments: Severe obstructive sleep apnea 1999/Just got an ASV machine

Sex: Male
Location: Akron, Ohio USA

Post: #4
RE: Apnea newbie
Welcome, and as said above, it's great that you are taking the time to learn about your CPAP and sleep apnea. I've been on CPAP/BI-PAP for about a dozen years now, and it's only been the last few months that I've been trying to learn more.

Two points? I believe you can set a minimum pressure on your machine if you like, and I agree that the machine can't/won't instantly modify your pressure, it's more of a process based on averages.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-16-2013 12:46 PM
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bwexler Offline

Advisory Members

Posts: 563
Joined: Mar 2012

Machine: PRS 1 BiPAP autoSV Advanced, with Heated Tube humidifier
Mask Type: Nasal mask
Mask Make & Model: Sleepweaver √Član
Humidifier: Resperonics Heated Tube humidifier
CPAP Pressure: Max pressure 25.0 cm H20, Max
CPAP Software: SleepyHead EncorePro

Other Comments: CMS 50i with Software for SpO2

Sex: Male
Location: San Marcos, CA, USA

Post: #5
RE: Apnea newbie
It'd look at your report, but could not view the leaks as it was cut off at the bottom of the attachment. I did see the one spike to 80, which suggests your AHI increase was influenced a a large leak. That tends to make the data in that time fram unreliable.
10-16-2013 02:10 PM
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RonWessels Offline

Preferred Members-2

Posts: 465
Joined: Jun 2013

Machine: REMstar Auto AFlex DS560TS
Mask Type: Nasal mask
Mask Make & Model: ComfortGel Blue
Humidifier: REMstar Heated Tube DS6T
CPAP Pressure: 11 - 20
CPAP Software: SleepyHead

Other Comments: CMS50F Pulse Oximeter

Sex: Male
Location: Ontario, Canada

Post: #6
RE: Apnea newbie
Hi Horacio. Let me ask you a couple of questions about that night.

I notice on your graphs that there is are two discontinuities (breaks in the line) in your pressure graph, one at around 2:45 and the other around 4:15. Did you get up at these times, or otherwise wake up? Is it possible that you did wake up at 2:45, and then lay awake for perhaps half an hour before falling back asleep?

The reason I ask is that one possibility for the machine not responding to your apnea events is that it believes these are clear airway events. In other words, if you stop breathing because your airway is obstructed, increasing the pressure would help. However, if you simply stopped breathing without it being obstructed, increasing the pressure doesn't help at all (I'm ignoring AutoServo machines when I say that). That would mean that, as you lay there, perhaps tossing and turning trying to get back to sleep, you simply stopped breathing on occasion. This happens to me as well, but it doesn't really count towards your "true" AHI value, since you are intentionally stopping breathing. But the machine doesn't know that you are still awake and doing it intentionally, so even though it can't do anything about it, it still reports the events.

Actually, as I look again at your plots, I do have another explanation. The machine _did_ compensate for your events. Notice the pressure rising between 2:45 and 2:50, probably in response to the apnea events. It eventually raised the pressure sufficient to stop your apneas, but by then the "damage" was done. You had several apnea events. Now, the AHI is the average number of events per hour, so a running AHI value will keep the effects of a series of apnea events for a full hour before beginning to discount them. Hence, your AHI stays high for about an hour until the machine can discard those initial events.

This would imply to me that your minimum pressure setting is too low, and you start generating apnea events before your machine can properly compensate. Looking at your graphs, I would recommend increasing your minimum auto pressure setting to something closer to an appropriate treatment pressure.
(This post was last modified: 10-16-2013 02:57 PM by RonWessels.)
10-16-2013 02:49 PM
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hmerovich Offline

New Members

Posts: 3
Joined: Sep 2013

Machine: Philips Respironics System One Remstar Auto A-Flex
Mask Type: Full face mask
Mask Make & Model: Respironics Full Confort Blue Gel
Humidifier: none
CPAP Pressure: 4-14
CPAP Software: SleepyHead Other Software

Other Comments:

Sex: Male
Location:

Post: #7
RE: Apnea newbie
Thanks for your welcome and help.
I rebmuilt my graph. As you can see I had a large leak at 2:40 and I think that I woke up due to the leak. So the machine reduced their pressure to the min value (4 cm) .As soon as I got slept I had some AHI events and the machine needed some time to increase their pressure to avoid the events.
I will try increasing the min value.

Thanks again

Horacio


Attached File(s)
.pptx  apapgraph.pptx (Size: 140.49 KB / Downloads: 56)
10-16-2013 03:16 PM
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RonWessels Offline

Preferred Members-2

Posts: 465
Joined: Jun 2013

Machine: REMstar Auto AFlex DS560TS
Mask Type: Nasal mask
Mask Make & Model: ComfortGel Blue
Humidifier: REMstar Heated Tube DS6T
CPAP Pressure: 11 - 20
CPAP Software: SleepyHead

Other Comments: CMS50F Pulse Oximeter

Sex: Male
Location: Ontario, Canada

Post: #8
RE: Apnea newbie
Ah, that makes sense. The PRS1 machines also actively respond to large leaks by reducing the pressure in an effort to re-seal the mask against your face.

I'm glad to see that I'm not the only one plagued by incorrect axis labels in SleepyHead graphs.
10-16-2013 03:24 PM
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zonk Offline

Advisory Members

Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #9
RE: Apnea newbie
(10-16-2013 10:18 AM)hmerovich Wrote:  Hello

Let me introduce : My name is Horacio merovich and I am a new apnea patient. During my last sleep study they found that I have a AHI=52,8 and I had a tiltration study where they suggested me to use a pressure of 13.
but as I have a auto CPAP , I am trying to adapt myself to this machine because it seems to be a better therapy .

I have slept the last three days using APAP without any major issues but reviewing my Sleepyhead from last night I found that my AHI rises to 20 while the CPAP presssure lowers to 8 between 4:00 - 04:30 AM
I cant understand why the APAP didnt raise the pressure trying tp reduce my AHI.

Any ideas ?

Best regards and thanks in advance
Hi hmerovich
I did not open the file either, whats the 90% pressure and % large leak
From what you,re saying "CPAP pressure lowered to 8" then maybe raising the minimum set pressure but this does nothing for clear airways events as the machine don,t increase pressure in response to clear airways events
Its early days yet, data need to be viewed over time, for now concentrate on getting decent sleep and finding the right mask which is essential for effective therapy. The machine don,t increase pressure if large leak detected, increase pressure would cause more leaks and the fact that machine cannot tell whether if you were asleep or awake (apnea flagged while awake and during large leaks are meaningless)
10-16-2013 03:34 PM
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RonWessels Offline

Preferred Members-2

Posts: 465
Joined: Jun 2013

Machine: REMstar Auto AFlex DS560TS
Mask Type: Nasal mask
Mask Make & Model: ComfortGel Blue
Humidifier: REMstar Heated Tube DS6T
CPAP Pressure: 11 - 20
CPAP Software: SleepyHead

Other Comments: CMS50F Pulse Oximeter

Sex: Male
Location: Ontario, Canada

Post: #10
RE: Apnea newbie
For those that can't open .pptx files, I've attached the image here:

   
10-16-2013 03:51 PM
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