Can someone review this SleepyHead data?

[apneahead1234]

[attachment=3496]Hi:

I'm new here so I'm sorry if I'm violating some board rules in some way.  I have been using AutoCPAP for a month and my AHI has consistently stayed in the 10-20 range.  I tried adjusting the pressure, and that had no noticeable impact.  I went in for a titration study, and the doctor set my pressure to 5.0, saying that I had no apneas in that range during the study.
 
Anyway, my AHI is still very high.  Attached is the most recent night from SleepyHead.  I'm sorry if I should be including something else instead of this.

What do I do?  I'm starting to feel hopeless.  I can't stay awake at work and I'm at risk of losing my job.  I can't wait another month to see the doctor.  Can anyone help me?

[Gideon]

which Phillips Respironics do you have? Read the model number on the bottom (DSX400x11, DSX500x11, DSX600x11)
A pressure of 5 is too little for you. I would set your min to 6 and your max to 15 then post, expect further adjustments.

[Crimson Nape]

Hi apneahead1234 -

Please review the topics under my Useful Links section below for information as to what information is needed to help us with your SleepyHead data.  Displaying the Details tab data will provide better information than the Events tab.  You can turn off the VS2 event flag as well.

-Red

[justMongo]

Welcome to ApneaBoard. You have many hypopneas at 5 cm-water. Those could be prevented with a pressure increase.
In my amateur opinion, 5 is just silly. Might as well have a butterfly flap its wings. Saying you had no apneas at 5 is akin to saying we detected no apneas when you were not hooked up.

Now, if increased pressure raises the CA count, then the CPAP machine is likely not the correct machine as you may have mixed apnea -- a combination of obstructive and central apnea. That will require jumping through more hoops. More studies, and perhaps untimately to an ASV machine.

What happens at higher pressures? Why are you running fixed pressure if you have an autoPAP?

Let's nail down exactly which machine you have. Kind Regards, Mongo

[apneahead1234]

Here's some more detail.  My machine is a DSX500H11.

I want to be clear that I've put the pressure on 6-15 previously and that hasn't helped.  I don't know why my doctor would want the pressure to go back to 5, but they said that is what worked in the titration study, and they said it was most effective if it was set to a fixed number.  Why would they say that if it wasn't true?

I'm sorry I seem so delirious.  This is about the worst thing that has happened to me in a long time.

[Gideon]

You have a "Philips Respironics DreamStation Auto CPAP Machine" which is what you should say in your profile.
I thought you had tried a spread before, but it would help if you can provide a chart with a range similar to 6-15. That will tell us more about what you are experiencing. I expect you will see a recommendation of different settings once we see that, otherwise the suggestion would be to raise your pressure in steps.

[Crimson Nape]

As everyone else has pointed out, your pressure is too low.  I will suggest that you bump up the pressure to at least 8cm to see how that addresses your Hypopneas and OA's.  With an empty humidifier, look at the bottom of your machine.  You should see a number beginning with something like DSX . . .  then a number.  It will really help us to know your CPAP capabilities.

-Red

[Gideon]

Your setting of 5cm was likely determined at a sleep lab, in a strange bed, a strange pillow, with you wired up to a lot of instrumentation, with your ability to change position hindered by all the attachments, let alone a mask and hose on your face for the first time, and breathing with a machine blowing in your face, yea I'm sure that was a real normal night (sarcasm intended).  We see real settings that differ from lab settings all the time here.  I'm sure that under THOSE circumstances I'm sure it was a good choice.

[justMongo]

I want to be clear that I've put the pressure on 6-15 previously and that hasn't helped.  I don't know why my doctor would want the pressure to go back to 5, but they said that is what worked in the titration study, and they said it was most effective if it was set to a fixed number.  Why would they say that if it wasn't true?

Why? Who knows. Obviously it doesn't work at 5 -- the proof is in the data. Hang in there.

[Melman]

My Dr. prescribed a fixed pressure of 9. When he finally looked at data after several years he decided it wasn't adequate and increased the setting to 10. I then got a sleepyHead compatible machine and saw hat 10 wasn't working well. AHI numbers were often in the teens. I discovered this forum and was advised to  use auto settings with a range of 9-14. Since then my AHI numbers are usually been 0.0 to 0.7 and never higher than 3. Choosing to ignore my Doctor has been beneficial. I have since informed him of the change in my last compliance visit and got no grief for having made the changes.