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[CPAP] AHI
#1

I have an DeVilbiss IntelliPAP AutoAdjust with SmartFlex CPAP machine. The pressure is set at 6. The smart code says I have a Apnea/Hypopnea Index of 13 - 16 over a 90 day period. I don't know if that's good or bad and the doctor doesn't seem to want to tell me. I'm thinking it should be around zero. I am thinking about increasing the pressure to 7 and see what happens. Anybody have any thoughts on this?[/quote]
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#2
I advise you to download a copy of sleepyhead software, the latest version (at least) is supposed to work with the intellipap, then you can read the data and see what's happening, not just trying to average your night out to a single number.
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#3
(06-20-2014, 07:12 PM)Mammoth Hunter Wrote:
I have an DeVilbiss IntelliPAP AutoAdjust with SmartFlex CPAP machine. The pressure is set at 6. The smart code says I have a Apnea/Hypopnea Index of 13 - 16 over a 90 day period. I don't know if that's good or bad and the doctor doesn't seem to want to tell me. I'm thinking it should be around zero. I am thinking about increasing the pressure to 7 and see what happens. Anybody have any thoughts on this?

[/quote]

13-16 is a little high, but not alarmingly so. If it was my body, I would raise the pressure to 7 and watch it for a few days. If that helps, then maybe 8 for a few days.. That sort of thing.
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#4
(06-20-2014, 07:12 PM)Mammoth Hunter Wrote: I am thinking about increasing the pressure to 7 and see what happens. Anybody have any thoughts on this?
I would set the machine on AutoAdjust mode, e.g 6 - 10 and let machine figure it out. The machine report 90th percentile pressure, indicates that therapy pressure was at or below this pressure for 90% of the night

Download the software so you get better idea of whats going
IntelliPAP AutoAdjust consider leak rates above 95 LPM deem excessive

SleepyHead download link http://www.apneaboard.com/forums/Thread-...Discussion


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#5
(06-20-2014, 07:12 PM)Mammoth Hunter Wrote: The smart code says I have a Apnea/Hypopnea Index of 13 - 16 over a 90 day period. I don't know if that's good or bad and the doctor doesn't seem to want to tell me. I'm thinking it should be around zero. I am thinking about increasing the pressure to 7 and see what happens. Anybody have any thoughts on this?

First of all, an AHI of 13-16 is on the border between mild and moderate apnea, so you need a doctor who can explain why he's interpreting that score the way he is. The doctor you have now is not doing that.

Your AHI should be under 5. An AHI of 5-15 is diagnosed as mild sleep apnea and should be treated because it interferes with your ability to get the deep restorative sleep you need to lead a normal life. It will also increase your chance of a heart attack or stroke.

As to whether the pressure should be increased or not, we need to know the values of the three numbers that are adding up to the AHI of 13-16. Two of those numbers are the obstructive apnea index and the hypopnea index. If they are the dominant terms then increasing the pressure is likely to reduce your AHI. Your pressure of 6 is quite low, so raising it seems to be a reasonable thing to try.

On the other hand, the third number is the clear airway apnea index (also called the central apnea index). If that number is dominant then raising your pressure probably won't help, and it might even make it worse. It may be that you need a more complex CPAP machine designed to treat central apnea.

If it were me I'd get a different doctor. And I'd experiment with raising the pressure. Just keep a close look at your AHI and see that it doesn't go any higher.

There are other things to look at, too, like the lengths of these 13-16 events that you're having each hour. Keeping your leak rate low is important, and so is compliance (using the machine every time you sleep). In fact, they are more important.

What was your initial diagnosis that led to you being prescribed a CPAP machine? Was it mild, moderate, or severe sleep apnea? Was it obstructive sleep apnea, central sleep apnea, or a mixture of the two?
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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
(06-20-2014, 10:15 PM)Sleepster Wrote:
(06-20-2014, 07:12 PM)Mammoth Hunter Wrote: The smart code says I have a Apnea/Hypopnea Index of 13 - 16 over a 90 day period. I don't know if that's good or bad and the doctor doesn't seem to want to tell me. I'm thinking it should be around zero. I am thinking about increasing the pressure to 7 and see what happens. Anybody have any thoughts on this?

First of all, an AHI of 13-16 is on the border between mild and moderate apnea, so you need a doctor who can explain why he's interpreting that score the way he is. The doctor you have now is not doing that.

Your AHI should be under 5. An AHI of 5-15 is diagnosed as mild sleep apnea and should be treated because it interferes with your ability to get the deep restorative sleep you need to lead a normal life. It will also increase your chance of a heart attack or stroke.

As to whether the pressure should be increased or not, we need to know the values of the three numbers that are adding up to the AHI of 13-16. Two of those numbers are the obstructive apnea index and the hypopnea index. If they are the dominant terms then increasing the pressure is likely to reduce your AHI. Your pressure of 6 is quite low, so raising it seems to be a reasonable thing to try.

On the other hand, the third number is the clear airway apnea index (also called the central apnea index). If that number is dominant then raising your pressure probably won't help, and it might even make it worse. It may be that you need a more complex CPAP machine designed to treat central apnea.

If it were me I'd get a different doctor. And I'd experiment with raising the pressure. Just keep a close look at your AHI and see that it doesn't go any higher.

There are other things to look at, too, like the lengths of these 13-16 events that you're having each hour. Keeping your leak rate low is important, and so is compliance (using the machine every time you sleep). In fact, they are more important.

What was your initial diagnosis that led to you being prescribed a CPAP machine? Was it mild, moderate, or severe sleep apnea? Was it obstructive sleep apnea, central sleep apnea, or a mixture of the two?
Thank you for your reply. My initial diagnosis was mild OSA. When I did the test using the CPAP at the sleep lab the results were dramatic however not so much so at home. The machine I am using only gives the A/H Index so I cant see the information that makes it up. I am using a nose mask and always wake up two or three times with severe dry mouth so apparently my mouth is opening. I have a beard so I believe the full face mask probably wont work. I'm going to make a chin strap.
New development:
I discovered that My CPAP is automatic and if I am interpreting the results correctly the machine doesn't seem the think I need more pressure. My real problem is not the doctor but the person who gets the data and communicates it to the doctor. The doctor just isn't getting the data so the doctor has now agreed to let me email the data to him directly. He also is not opposed to me adjusting the machine myself as long as I set it the way he tells me. This might be the breakthrough I needed.
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#7
Hi Mammoth Hunter,
WELCOME! to the forum.!
It's good to hear that your doc is open to you adjusting your machine.
Hang in there for more responses to your post and best of luck to you with your CPAP therapy.
trish6hundred
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#8
(06-21-2014, 06:52 AM)Mammoth Hunter Wrote: My initial diagnosis was mild OSA. When I did the test using the CPAP at the sleep lab the results were dramatic however not so much so at home.

But were you diagnosed with obstructive sleep apnea? This is the most common type of sleep apnea and the easiest to treat. Central apnea is harder to treat, so that is why I'm asking.

Quote:I am using a nose mask and always wake up two or three times with severe dry mouth so apparently my mouth is opening. I have a beard so I believe the full face mask probably wont work. I'm going to make a chin strap.

Adjust it tightly enough so that chewing is uncomfortable, but you can still open you mouth comfortably.

If you are mouth-leaking this would explain your lack of success. When the pressurized air escapes from your mouth your airway can collapse, just as it would if you had no CPAP machine at all! A chin strap is a very common remedy for this very common problem.

I'm not familiar with your brand of CPAP machine, but if there is some way to monitor your leak rate you need to do it. It's the only way to tell if the chin strap is working.

If that is your problem then the machine is not reporting your AHI correctly. There's no way a CPAP machine can measure AHI during a large leak.

So it seems there's a good chance that the chin strap will do two things: lower the AHI reported by the machine, and make you feel much better.

By the way, Amazon has some good deals on chin straps.

Good luck and keep us posted.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#9
(06-21-2014, 06:52 AM)Mammoth Hunter Wrote: I discovered that My CPAP is automatic and if I am interpreting the results correctly the machine doesn't seem the think I need more pressure.
Not exactly, the AutoAdjust have two modes:
1- CPAP mode ... the machine deliver constant pressure all night long (except Ramp period)
2- AutoAdjust mode ... the machine auto-adjust pressure as needed during the night

Your machine set on CPAP mode (not AutoAdjust mode) set at pressure 6, the machine deliver 6 all night long except Ramp time


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#10
(06-21-2014, 05:34 PM)zonk Wrote:
(06-21-2014, 06:52 AM)Mammoth Hunter Wrote: I discovered that My CPAP is automatic and if I am interpreting the results correctly the machine doesn't seem the think I need more pressure.
Not exactly, the AutoAdjust have two modes:
1- CPAP mode ... the machine deliver constant pressure all night long (except Ramp period)
2- AutoAdjust mode ... the machine auto-adjust pressure as needed during the night

Your machine set on CPAP mode (not AutoAdjust mode) set at pressure 6, the machine deliver 6 all night long except Ramp time
I have gone through all the settings and I now believe I understand the machine. ai changed it from the CPAP mode to the Auto Adjust mode and bumped the high limit to 7.
Will see what happens now.
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