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[Diagnosis] Sleeping positions and AHI?
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Dolla Bill Offline

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Posts: 72
Joined: Feb 2012

Machine: ResMed AirSense Autoset S10
Mask Type: Nasal pillows
Mask Make & Model: Swift Air fit P10 nasal pillow
Humidifier: Airsense 10 Humidifier
CPAP Pressure: avg. 10.1
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location: Atlanta

Post: #1
Sleeping positions and AHI?
I am using a Swift FX nasal mask and a Resmed Autoset S9 with humidifier and climate control tube.

Have been using this setup for several years. I thought that sleeping on my back would be more comfortable than my usual sleeping on my left side and might be better in not dislodging my mask.

So I began doing this. In checking my AHI, I find that in sleeping on my side, I am averaging AHI in no more that 1. Sometimes as low as .3 when side sleeping.

But on my back, I am averaging 7 to 9 AHI, but I sleep much better in that sleeping position. No dry mouth, so I don't think I am mouth breathing. I have the Rescan software, but don't really know how to use it well. I can post data from it if it will help.

In either sleeping position, I am NOT getting the red frowning face (on the S9) that indicates poor mask fit.

Also when I am laying on my side, I can feel that pressure generated by the CPAP is quite a bit less than laying on my back.

Any ideas?

Is 7-9 AHI acceptable? I had heard that over 5 was not so good,
06-23-2014 06:36 AM
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archangle Online
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Posts: 3,163
Joined: Feb 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: ResMed S9 H5i
CPAP Pressure: 16-20
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments: Happy PAPper

Sex: Undisclosed
Location: USA

Post: #2
RE: Sleeping positions and AHI?
(06-23-2014 06:36 AM)Caddyshack Wrote:  Is 7-9 AHI acceptable? I had heard that over 5 was not so good,

There's no "cliff" you step off of at AHI=5. You just need to draw a line somewhere for insurance and diagnostic purposes.

Also AHI counts all apneas the same, whether it's 11 seconds long or 120 seconds long. Learn to look at your airflow waveforms and figure out how long your apneas are.

Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
06-23-2014 07:05 AM
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zonk Offline

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Posts: 7,908
Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #3
RE: Sleeping positions and AHI?
Hello Caddyshack and welcome to the forum
Your machine set at 'CPAP Pressure: 4-16'
Whats pressure and leaks ... median, 95th percentile, maximum

I feel better with minimum pressure closer to 95th percentile pressure

Whats the makeup of AHI (obstructive, hypopnea, central apnea)
The machine score apnea events whether you,re asleep or awake
Those awake events while sleeping on your back are meaningless and ought be discarded for true AHI
06-23-2014 07:11 AM
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Dolla Bill Offline

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Posts: 72
Joined: Feb 2012

Machine: ResMed AirSense Autoset S10
Mask Type: Nasal pillows
Mask Make & Model: Swift Air fit P10 nasal pillow
Humidifier: Airsense 10 Humidifier
CPAP Pressure: avg. 10.1
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location: Atlanta

Post: #4
RE: Sleeping positions and AHI?
Am DL the Sleephead software. Thanks for the reply Archangel.

Looking for a solution where I can sleep on my back. Have developed slight arthritis in left shoulder that makes this position more difficult.

Zonk, don't quite understand what you are saying. Is there a log I can post from the ResMed or Sleepyhead that could help you/me better understand the situation and get some better answers?
(This post was last modified: 06-23-2014 07:15 AM by Dolla Bill.)
06-23-2014 07:13 AM
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DeepBreathing Offline
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Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #5
RE: Sleeping positions and AHI?
(06-23-2014 06:36 AM)Caddyshack Wrote:  I am using a Swift FX nasal mask and a Resmed Autoset S9 with humidifier and climate control tube.

Have been using this setup for several years. I thought that sleeping on my back would be more comfortable than my usual sleeping on my left side and might be better in not dislodging my mask.

So I began doing this. In checking my AHI, I find that in sleeping on my side, I am averaging AHI in no more that 1. Sometimes as low as .3 when side sleeping.

But on my back, I am averaging 7 to 9 AHI, but I sleep much better in that sleeping position. No dry mouth, so I don't think I am mouth breathing. I have the Rescan software, but don't really know how to use it well. I can post data from it if it will help.

In either sleeping position, I am NOT getting the red frowning face (on the S9) that indicates poor mask fit.

Also when I am laying on my side, I can feel that pressure generated by the CPAP is quite a bit less than laying on my back.

Any ideas?

Is 7-9 AHI acceptable? I had heard that over 5 was not so good,

G'day Caddyshack, welcome to the forum., Welcome

5 is usually regarded as the borderline, but as Archangel said there's no "cliff" - it's all a matter of degrees. However, low AHI is better and under 5 is a good target.

I suspect what's happening is this: The obstructive apnea is caused by the tongue and soft palate falling back and closing off your airway. This is much more likely to occur when sleeping on your back. When you sleep on your side, these soft tissues are likely to move away from the back of your mouth, and not block the airway. That's why you get a much lower AHI when sleeping on your side. If you prefer sleeping on your back, it may be necessary to increase your pressure to overcome the mechanical obstruction which occurs in that position.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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(This post was last modified: 06-23-2014 08:57 AM by DeepBreathing.)
06-23-2014 07:15 AM
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readyforsleep Offline

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Posts: 233
Joined: Mar 2014

Machine: Resmed S9 AutoSet for her
Mask Type: Nasal pillows
Mask Make & Model: Swift FX for her
Humidifier: attached
CPAP Pressure: 14.6-17.4
CPAP Software: SleepyHead

Other Comments:

Sex: Female
Location: Lawrenceburg, Indiana

Post: #6
RE: Sleeping positions and AHI?
Welcome to the forum! You are right sleeping on our backs does cause more apneas. Since you want to sleep on you back (and I don't blame you there) take
a look at your pressure graph in rescan. You may be able to increase your high
pressure to capture those events. I would suggest you post your pressure and
ahi graph. There are alot of people here that can advise you.

When and if you do make any changes, treat it like a scientific experiment. Make
one change at a time, make small incremental changes, and make changes slowly. I learned this the hard way! I wanted to fix it fast!,,,

2010 sleep study 63 AHI, 2014 3.0
06-23-2014 07:15 AM
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trish6hundred Offline

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Posts: 6,452
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #7
RE: Sleeping positions and AHI?
Hi Caddyshack,
WELCOME! to the forum.!
Hang in there for more responses to your post and best of luck to you.

trish6hundred
06-23-2014 08:19 AM
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Dolla Bill Offline

Preferred Members-2

Posts: 72
Joined: Feb 2012

Machine: ResMed AirSense Autoset S10
Mask Type: Nasal pillows
Mask Make & Model: Swift Air fit P10 nasal pillow
Humidifier: Airsense 10 Humidifier
CPAP Pressure: avg. 10.1
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location: Atlanta

Post: #8
RE: Sleeping positions and AHI?
I have imported data into SLeepyhead. I see a place to export, but seems to be doing so in a CSV file format. Will this work for you, or is there a better format? Also should I export for last six months or what?

Bill

PS, I noticed that my max pressure is at about 12 and before I had it set at 17. Don't know why I changed it, but seems like it should be back at 17. Los pressure is about 5.
06-23-2014 09:10 AM
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jaycee Offline

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Posts: 115
Joined: May 2014

Machine: S-9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quattro Air Large
Humidifier: 5i
CPAP Pressure: 9-13
CPAP Software: ResScan

Other Comments: RT at a DME

Sex: Male
Location:

Post: #9
RE: Sleeping positions and AHI?
If you are going to adjust your own auto cpap pressures, I would recommend increasing the starting pressure to what you can comfortably tolerate.

4 is too low IMO. You may be having apneas/hypopneas when you are first getting to sleep and the auto starts to kick up the pressure to deal with them. But if you start at a higher starting pressure you may be able to cut down on the amount of them when you are first getting into deep sleep.

So, when I am asked to recommend auto pressures on a patient:

Low = what they can comfortably tolerate
High = a little bit above their 95% pressure

So while a patient might start with a range of let's say 4 to 16 (I would never recommend personally starting a patient as low as 4 unless they absolutely couldn't tolerate more), as you get more and more used to the pressure I would keep increasing the low pressure as tolerated. I usually put the high pressure 1 or so above the 95% pressure.

Let's say your 95% pressure is 12. If you tolerate 12 with no difficulties, I would set your starting pressure at 12. As time passes, you may need to tweak your settings occasionally (especially with weight gain or loss).
06-23-2014 09:14 AM
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Dolla Bill Offline

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Posts: 72
Joined: Feb 2012

Machine: ResMed AirSense Autoset S10
Mask Type: Nasal pillows
Mask Make & Model: Swift Air fit P10 nasal pillow
Humidifier: Airsense 10 Humidifier
CPAP Pressure: avg. 10.1
CPAP Software: ResScan SleepyHead Other Software

Other Comments:

Sex: Male
Location: Atlanta

Post: #10
RE: Sleeping positions and AHI?
(06-23-2014 09:14 AM)jaycee Wrote:  If you are going to adjust your own auto cpap pressures, I would recommend increasing the starting pressure to what you can comfortably tolerate.

4 is too low IMO. You may be having apneas/hypopneas when you are first getting to sleep and the auto starts to kick up the pressure to deal with them. But if you start at a higher starting pressure you may be able to cut down on the amount of them when you are first getting into deep sleep.

So, when I am asked to recommend auto pressures on a patient:

Low = what they can comfortably tolerate
High = a little bit above their 95% pressure

So while a patient might start with a range of let's say 4 to 16 (I would never recommend personally starting a patient as low as 4 unless they absolutely couldn't tolerate more), as you get more and more used to the pressure I would keep increasing the low pressure as tolerated. I usually put the high pressure 1 or so above the 95% pressure.

Let's say your 95% pressure is 12. If you tolerate 12 with no difficulties, I would set your starting pressure at 12. As time passes, you may need to tweak your settings occasionally (especially with weight gain or loss).


I'll try this and get back to you. A little fuzzy on the high end pressure. If for example, I am at 12 starting pressure (Low) am I looking at 13 as the High pressure? I think that I am missing something here. Dont-know

There are a few other settings I may have changed, or need to be changed. I recognize the intelligence of changing one thing at a time and plan to start with pressure.

But, is there a way to bring the S9 back to factory defaults?
(This post was last modified: 06-23-2014 11:41 AM by Dolla Bill.)
06-23-2014 11:37 AM
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