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Confused about AHI results
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AndyB Offline

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Machine: ResMed AirSense 10 Autoset with RERA
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CPAP Pressure: 10.4-13.0
CPAP Software: SleepyHead

Other Comments: Diagnosed May 2015; EPR @ 1cmH2O; Ramp off; ResMed Climateline heated hose

Sex: Male
Location: SE Wisconsin

Post: #1
Confused about AHI results
I've just finished 2 months on CPAP therapy, and things have settled down pretty well. Thanks very much to the many helpful suggestions and encouraging messages I've received here.

I've used my CPAP every night since starting therapy in early June, and i keep my mask on faithfully for 6-7 hours per night. I sleep on my side all night, usually. After a couple of rocky weeks at the beginning, my AHIs are now consistently under 5.0, usually between 3.0-4.5.

One thing puzzles me, however. Very often my 1st session, which is typically 4-5 hours, has dramatically better results than my shorter 2nd session and -- when I have more than 2 sessions -- my even shorter 3rd session.

Most of my AHI events comprise CAs, with very few hypopneas, and even fewer, if any, OSAs and RERAs. What happens is that I frequently experience a disproportionate number of closely-bunched CAs in the early morning after I've gotten up to use the bathroom and then go back to bed. For example, attached is a Sleepyhead screenshot of last night, showing the difference in results between my 1st session (5 hr 20 min) and my 2nd session (27 min). The AHI for my 1st session was 1.90, but with the 27 min 2nd session factored in, the AHI jumps to 3.90, twice what it was previously. The cause was 1 hypopnea and a cluster of 10 CAs in the short 2nd session.

This pattern is very common for me -- good therapy results for most of the night, then a short period in early morning with lots of CAs, resulting in a passable, but decidedly mediocre, overall AHI result.

Any thoughts on what's going on here, and what, if anything, I can do about it?

[attachment=1663]
(This post was last modified: 08-10-2015 03:29 PM by AndyB.)
08-10-2015 03:26 PM
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AndyB Offline

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Posts: 72
Joined: May 2015

Machine: ResMed AirSense 10 Autoset with RERA
Mask Type: Full face mask
Mask Make & Model: F&P Simplus, ResMed AirFit F10; PR Amara View
Humidifier: ResMed integrated heated
CPAP Pressure: 10.4-13.0
CPAP Software: SleepyHead

Other Comments: Diagnosed May 2015; EPR @ 1cmH2O; Ramp off; ResMed Climateline heated hose

Sex: Male
Location: SE Wisconsin

Post: #2
RE: Confused about AHI results
Here's a better link for the image: http://screencast.com/t/t7K0QU9tu3iH
08-10-2015 03:31 PM
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zonk Offline

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Machine: A10 AutoSet
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Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #3
RE: Confused about AHI results
(08-10-2015 03:26 PM)AndyB Wrote:  What happens is that I frequently experience a disproportionate number of closely-bunched CAs in the early morning after I've gotten up to use the bathroom and then go back to bed.
Events scored while you're awake, are meaningless and can be discarded
08-10-2015 04:24 PM
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AndyB Offline

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Joined: May 2015

Machine: ResMed AirSense 10 Autoset with RERA
Mask Type: Full face mask
Mask Make & Model: F&P Simplus, ResMed AirFit F10; PR Amara View
Humidifier: ResMed integrated heated
CPAP Pressure: 10.4-13.0
CPAP Software: SleepyHead

Other Comments: Diagnosed May 2015; EPR @ 1cmH2O; Ramp off; ResMed Climateline heated hose

Sex: Male
Location: SE Wisconsin

Post: #4
RE: Confused about AHI results
I'm asleep during these shorter early morning sessions, but undoubtedly I'm not sleeping deeply.
08-10-2015 04:35 PM
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Jim Bronson Offline

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Location: California

Post: #5
RE: Confused about AHI results
Same here. That's when almost all of my centrals take place.
08-10-2015 08:51 PM
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PaytonA Offline
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Machine: ResMed S9 VPAP Auto
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CPAP Software: ResScan SleepyHead

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Location: Orange County,California

Post: #6
RE: Confused about AHI results
I get the same type of thing only with a few OAs thrown in for good measure, if I am barely asleep or if I am drifting between being asleep and awake. I think it is just sleep-wake junk and should be disregarded.

Best Regards,

PaytonA
08-10-2015 09:02 PM
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AndyB Offline

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Posts: 72
Joined: May 2015

Machine: ResMed AirSense 10 Autoset with RERA
Mask Type: Full face mask
Mask Make & Model: F&P Simplus, ResMed AirFit F10; PR Amara View
Humidifier: ResMed integrated heated
CPAP Pressure: 10.4-13.0
CPAP Software: SleepyHead

Other Comments: Diagnosed May 2015; EPR @ 1cmH2O; Ramp off; ResMed Climateline heated hose

Sex: Male
Location: SE Wisconsin

Post: #7
RE: Confused about AHI results
Thanks for the replies -- I thought there might be more to it than just transition-time CAs, but I'm glad to get other opinions.
08-11-2015 10:01 AM
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surferdude2 Offline

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CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
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Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #8
RE: Confused about AHI results
The machine aren't accurate in reporting events while you're awake. I often run test sessions during the day while watching TV or reading and often get several OA's scored and my AHI is often reported as being above 10. All that when I know for an absolute fact that I never pause breathing for any 10 second intervals. It makes me wonder if the reports are all that accurate when sleeping. That may help justify why you are required to get a lab sleep test to get insurance to cover the cpap machine.

Dude
08-11-2015 10:13 AM
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surferdude2 Offline

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CPAP Pressure: 12 ~ 20 & 11 ~12 if nasal mask
CPAP Software: ResScan SleepyHead

Other Comments: Late stage 2 emphysema

Sex: Male
Location: Mousetown, Southern Illinois

Post: #9
RE: Confused about AHI results
[Image: 98vdy8.jpg]
(This post was last modified: 08-11-2015 08:57 PM by surferdude2.)
08-11-2015 10:48 AM
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MobileBasset Offline

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Machine: ResMed AIRCURVE 10 V Auto
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Sex: Female
Location: Florida

Post: #10
RE: Confused about AHI results
(08-11-2015 10:48 AM)surferdude2 Wrote:  https://www.dropbox.com/s/fktalfepdxfja7x/falsehoods.jpg?dl=0

Did you zoom in on the flow rate for those events to see what type of flow disturbance was being detected? If not please do so.
I find it very interesting that you are not aware of any disturbances yet the machine senses something.

I now know that I skip breathing when I am awake but I did not become aware of it until I took up SCUBA diving (many years ago). Loud breathing is the only thing you hear and it takes a little bit more effort than regular breathing so it was easier to notice.

if you can't decide then you don't have enough data.
08-11-2015 11:59 AM
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