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Getting worse - The Great Nap of Mutiny
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LJones Offline

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Post: #1
Getting worse - The Great Nap of Mutiny
I have gone from an AHI of 5 to 10 to now almost 15... Not sure what is going on that is making a difference. Some have said my lower number needs to be raised. I do see that most of these are central apneas. Anxiety? I'm eating or drinking something wrong? So far my leaks are minimal. I did however wake up without the mask on last night. Evidently I subconsciously took a 2 hour break. Idk...

I am feeling better. I am tired, but a different tired if that makes sense. I am clearer and more patient (at least the last two days). Is that a placebo effect or am I really benefiting?

   
(This post was last modified: 09-07-2014 10:01 AM by LJones.)
09-07-2014 10:00 AM
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Galactus Online

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Post: #2
RE: Getting worse
Welcome to the board, I'm sorry I can't help you as I don't yet know enough to offer quality advice, but someone will be along shortly that will know.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-07-2014 10:56 AM
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retired_guy Offline

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Post: #3
RE: Getting worse
If it were me, I would increase the minimum some. Or, go to straight CPAP at 9. I still don't think I'd raise the max at this point because I don't want to encourage the CA's, if they are real CA's, to go higher. But I would increase the minimum, no other changes, and watch for a couple of days.
09-07-2014 11:07 AM
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justMongo Offline

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Post: #4
RE: Getting worse
What is the duration of your CA's? Short -- like 10 seconds?
CA's can be pressure induced. The snore suggests a little higher pressure -- but the CA's suggest otherwise.
I wish they would have provided an auto-bilevel machine.
You're sort of walking a knife's edge there.

I think this one is best left between you and your doctor.

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.
09-07-2014 12:10 PM
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LJones Offline

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Posts: 34
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Machine: Philips Respironics RemStar BiPap Auto with BiFlex (760P)
Mask Type: Nasal mask
Mask Make & Model: Philips Respironics Wisp
Humidifier: Onboard
CPAP Pressure: 9/4
CPAP Software: SleepyHead

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Post: #5
RE: Getting worse
I do have an auto machine, but I don't think the auto is turned on. I think it was supposed to and the tech missed it or it was left out of the order. I am going to call the Dr tomorrow. In the meantime I am going to clear my sinuses tonight and see what happens. I agree with retired guy though, it seems like the lower number is a long way from the higher. Kinda makes me feel panicky when I exhale. Who knows? I'll see what they say tomorrow.

I imagine that a 14 is better than what I have without the machine though.

Thanks for the responses, btw
(This post was last modified: 09-07-2014 04:09 PM by LJones.)
09-07-2014 04:08 PM
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LJones Offline

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Machine: Philips Respironics RemStar BiPap Auto with BiFlex (760P)
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Mask Make & Model: Philips Respironics Wisp
Humidifier: Onboard
CPAP Pressure: 9/4
CPAP Software: SleepyHead

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Post: #6
The Great Nap of Mutiny!!!!
Yesterday I took a nap at the result was an AHI of 21.7.... Mostly due to a crazy amount of CAs that continued, as I described in an earlier post, into the night.

Well, after the earlier discussion and calling my brother, I decided to hijack my machine and turn the auto function on... NAP TIME!!!! Dancing

Tomorrow's call to the Dr should be interesting if this holds up for the night. I suspect that the Auto was supposed to be on the whole time.

   
09-07-2014 07:05 PM
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retired_guy Offline

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Post: #7
RE: The Great Nap of Mutiny!!!!
Well the results look promising... Good luck tonight... Let us know how you come out!!!
09-07-2014 07:53 PM
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Galactus Online

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Machine: Phillips Respironics System One PRS1 DS760P Auto BiPAP
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Post: #8
RE: The Great Nap of Mutiny!!!!
Those numbers look pretty good, even I know that. Best of luck tonight.

If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
09-07-2014 07:57 PM
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vsheline Offline

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Post: #9
RE: The Great Nap of Mutiny!!!!
(09-07-2014 07:05 PM)LJones Wrote:  Yesterday I took a nap at the result was an AHI of 21.7.... Mostly due to a crazy amount of CAs that continued, as I described in an earlier post, into the night.

Well, after the earlier discussion and calling my brother, I decided to hijack my machine and turn the auto function on... NAP TIME!!!! Dancing

Tomorrow's call to the Dr should be interesting if this holds up for the night. I suspect that the Auto was supposed to be on the whole time.


Hi LJones, welcome to the forum!

Looks like when in AutoB mode the EPAP sometimes needed to be as high as 7. The machine automatically raised EPAP in order to avoid obstructive conditions like Snore and Flow Limitation, and the higher EPAP is no doubt responsible for the lower number of obstructive events.

Previously, were you using a fixed EPAP of 4 and a fixed IPAP of 9? If yes, then previously your Pressure Support (PS) had been a constant 5. PS is the amount of pressure boost during IPAP, so PS = (9 minus 4) = 5.

Looks like when in AutoB mode the Minimum Pressure Support setting (Min PS) was only 2, and as PS was automatically adjusted it stayed lower than 5. The lower PS may have helped lower the number of Central Apneas. The PS would have automatically adjusted itself in order to avoid obstructive conditions lie Flow Limitation.

When in AutoB mode, what was your Max EPAP setting?
Max IPAP = 25
Pax PS = 21
Min PS = 2
Max EPAP = ???
Min EPAP = 4

Be sure to ask your doctor whether he knows of any reason to lower the Max EPAP, MAX PS or Max IPAP. If you have a special lung condition, for example, a lower Max IPAP may be advisable.

Also, we already have seen from your high number of Clear Airway apneas when your PS was fixed at 5, that perhaps your number of CAs would be higher if your PS were to be always 5. For those who are susceptible to CA events, sometimes a higher amount of PS will increase the number of their CA events.

But, on the other hand, it is fairly common for patients who are just starting out on PAP therapy to have a moderate amount of centrals, and usually the number of centrals will decrease over time, so that within weeks or months the number becomes small, as their body becomes accustomed to sleeping with the PAP therapy.

Take care,
--- Vaughn

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 09-07-2014 08:49 PM by vsheline.)
09-07-2014 08:43 PM
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vsheline Offline

Advisory Members

Posts: 1,908
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Machine: S9 VPAP Adapt (USA Model# 36007, not better 36037 or 36067)
Mask Type: Full face mask
Mask Make & Model: F10 or SimPlus w/ 2Liners. MirageQuatro & Gecko gel pad
Humidifier: H5i
CPAP Pressure: 15 EPAP, PS 5-10
CPAP Software: ResScan

Other Comments: Marfan Syndrome, chronic bradycardia, occasional Cheyne-Stokes Respiration

Sex: Male
Location: California, USA

Post: #10
RE: Getting worse
duplicate post

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 09-07-2014 08:51 PM by vsheline.)
09-07-2014 08:45 PM
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