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[CPAP] Worse AHI with new machine, need advice!
#1
Worse AHI with new machine, need advice!
Hi everyone!

Earlier this year, I switched providers and got a new machine. My settings changed from flexible 5-15 to constant 8, and since I changed machines my AHI is all over the place.

I also noticed that with the new machine, my mouth gets really dry, even though the humidifier works as expected and I have heated tubing now as well. Should I try a different mask? I used a full-face Amara in the past and now I have the full-face Amara View.

I'd like some advice on what I should try. Should I go back to the old 5 to 15 setting?

[attachment=9096]

Thanks,
Thomas
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#2
RE: Worse AHI with new machine, need advice!
First question is why were you changed to a constant 8?

Can you provide a detail chart so we can see what's going on? See my signature for how to organize it because not all charts are equally important.

That said per the summary you were doing much better with pressure range and if this were me where I knew the reason for the constant 8 I very likely would go back and reevaluate from there. But without knowing why that is a guess.
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#3
RE: Worse AHI with new machine, need advice!
I had a new sleep study done and that’s what they changed me to. I don’t know why exactly. ¯\_(ツ)_/¯ 

I’ll post some more details as soon as I’m back home.
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#4
RE: Worse AHI with new machine, need advice!
Please post a copy of the new sleep study. The full study minus the personal stuff and not just the summary.
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#5
RE: Worse AHI with new machine, need advice!
It would help to know what machine you had before and the exact model of Dreamstation you have now. The chart does not lie and you were clearly better before the change. I would contact the doctor's office and complain the short sleep study obviously failed, and you want back on Auto CPAP. You have the evidence to back it up.

Please post a daily detail chart, and we can make suggestions based on that. Based on the pressure in your summary chart, you ended up with about the average pressure you used to have on auto CPAP. Just eyeballing that chart, it looks like you need fixed pressure of 9.5, which is about your previous 90% pressure. If you have an Auto in fixed CPAP pressure mode, I would suggest minimum and maximum pressure of 8-12 in auto mode.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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#6
RE: Worse AHI with new machine, need advice!
Still working on getting the data together! Thanks for trying to help me out, I will post this soon. Smile
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#7
RE: Worse AHI with new machine, need advice!
I've added the charts from my worst day back in July and from a few days ago when my AHI was all fine.

The issues started when I switched from a System One (60 Series) RemStart Auto Variable APAP to the current constant pressure DreamStation. (I'm also attaching an older chart from February when I was on the old machine.)

I don't have a copy of the new sleep study (I had a new at-home study that was "inconclusive", and a full overnight study study done back in March iirc). Still trying to get them to fax that over to me.

Main issues are:
* Way higher AHI, especially in Summer months (?)
* Very dry mouth with new mask and machine, which I hadn't had before. Often scratchy throat feeling in the mornings.
* Subjectively I feel like I wake up more often and don't sleep as well

On the old machine, my AHI never ever got higher than 5 or so.

A good day on the new machine:
[attachment=9114]

A bad day on the new machine:
[attachment=9115]

Typical day on the old machine:
[attachment=9116]

Thanks for taking a look!
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#8
RE: Worse AHI with new machine, need advice!
Here's a more detailed before and after:

* AHI goes all over the place when I started new machine
* I seem to have a shorter average session time (I wish SleepyHead would do trendlines)
* Not in the picture, but I have no more major mask leaks with the new machine (had issues on the old one)
* Hey, I'm pretty good with compliance! Smile

[attachment=9117]
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#9
RE: Worse AHI with new machine, need advice!
Just to copy the full old/new machine names here:

OLD:
Philips Respironics System One (60 Series) RemStar Auto with A-Flex (560P), Amara full face mask

NEW:
Philips Respironics DreamStation Auto CPAP (500X110), Amara View minimal contact full face mask
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#10
RE: Worse AHI with new machine, need advice!
I think it's pretty clear, you did better with auto CPAP  at 5-15, than fixed pressure at 8.0.  Setting the machine to auto mode, with minimum pressure at 8.0, and maximum at 12 should cover your needs well.  The example of worst case, appears to have obstructive clutters that look positional.  Your current setting of 8.0 cm fixed pressure is below your previous 90% pressure, and that would be the correct level for fixed pressure.  Looking at the pressure history below, 9.0 cm looks like a better choice for fixed pressure.  If you're going to use fixed pressure, you can self titrate, by adding pressure in 0.5 cm increments until obstruction resolves, but it looks to me like your pressure needs change, so I'm puzzled why you would not use auto mode.

[Image: attachment.php?aid=9117]
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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