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[CPAP] AHI increases significantly in last 1-2 hrs of sleep
#1
AHI increases significantly in last 1-2 hrs of sleep
Hi Guys,

Still struggling with finding the right settings Sad

I have been dealing with a situation recently - my apnea stays in control for most of the night but then increases to a significantly high level 1-2 hours before waking up. This makes me feel horribly tired in the morning.

I have attached a couple examples here and would love to hear your views and recommendations.

Thank you.

Pranav


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#2
RE: AHI increases significantly in last 1-2 hrs of sleep
ppk8, you seem to have some complex apnea here, and your therapy runs pretty well until pressures rise. You are using a pressure range of 11-20, and as soon as the pressure increases, your event also increase. I think I'd like you to try a pressure range of 8-11, or perhaps fixed pressure at 11.0 and see if this can clear up the problem a bit.
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#3
RE: AHI increases significantly in last 1-2 hrs of sleep
I'm also wondering about if you tried a cervical collar to keep the neck straight, I found (and many others) that it helps in reducing the number of obstructive events.  If it does help, then you may be able to lower your pressure which may help to lower the number of central apnea events....all the air blowing from CPAP blows lowers your carbon dioxide level and the body compensates by reducing the respiratory rate.  It takes awhile for the body to get acclimated to the CPAP carbon dioxide blow off effect.
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#4
RE: AHI increases significantly in last 1-2 hrs of sleep
hi sleep rider,

Thank you for your quick reply and indeed it makes sense! Which of the two would recommend i try first? a fixed pressure of 11 or within the range of 8-11?

thanks
pranav
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#5
RE: AHI increases significantly in last 1-2 hrs of sleep
It's impossible to predict which option will work best. In keeping with the best traditions of trial and error, give the variable pressure of 8-11 a try first, then if you see continued CA, H and OA during pressure changes, a fixed pressure is the next trial.
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#6
RE: AHI increases significantly in last 1-2 hrs of sleep
Hi All - i tried the fixed cpap at range of 11 and still had few events, with clusters of OAs, please see attached.

Do you recommend I rather try the 8-11 APAP range then?

or is 11 simply too high for fixed pressure?


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#7
RE: AHI increases significantly in last 1-2 hrs of sleep
I think lower pressure is needed. Higher pressure is apparently not your friend. OA is pretty low, and I think your pressure may end up at 8 or 9 cm as being where this settles out. What setting rate of CFlex + are you using?
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#8
RE: AHI increases significantly in last 1-2 hrs of sleep
I was going to suggest Fixed 9 with no Flex,  I see SR and I are heading in the same direction.

Lowering pressure to relieve the CA events.
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#9
RE: AHI increases significantly in last 1-2 hrs of sleep
Thanks guys - my C Flex is set at x1. I feel it helps in case of higher pressures such as yesterday at 11.

Would you suggest to try fixed pressure at 9 tonight? And keep flex on or off?
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#10
RE: AHI increases significantly in last 1-2 hrs of sleep
We frequently see that individuals with predominately CA events do better with a fixed pressure and minimal to no flex.

Try with flex, then you can try without flex in a couple nights.  


Fred
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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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