Post Reply 
Help Pls. AHI 29 feeling bad and not sure I am headed right
Author Message
BigBob2 Offline

Members

Posts: 19
Joined: Jan 2015

Machine: Res Med S9 vpap auto
Mask Type: Full face mask
Mask Make & Model: Aif fit f10
Humidifier: Res med H5i
CPAP Pressure: IPAP15 EPAP4 PS 4
CPAP Software: SleepyHead

Other Comments: afib with an ablacion that didn't correct anything

Sex: Male
Location: East Tn.

Post: #11
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
[img]http://[/img]
(02-08-2015 12:30 PM)quiescence at last Wrote:  @Bob - It would help a bit to show us an overview of these last 30 days, like the following:
[Image: QodtmZQ.png]

I will mimic some past posters comments about your settings and their affect on CA. Some more knowledgeable folks will be along at some point and give even better help...

If I had your scores and had not just made a change in the last 3 days, this is what I would do - (assuming your current setting is min EPAP = 4, max IPAP = 12.6, PS range = 4 min 4 max. Ramp 4 for 15 minutes.)

I would increase min EPAP to 6, leave IPAP at 12.6, change PS range to 2 min 3 max, and ramp OFF. leave for 7 to 10 days. report results.

This would start me at inhale of 8 cmH2O, exhale at 6 cmH2O.

From this change I would expect that my AHI average for the 10 days would be as low as 3 and high as 10, and the CA component of the score would be less than half. My guess is that there will be 0 days over 10, 7 days between 5 and 10, and 3 under 5.

That would be a great baseline to build upon.

QAL
I knew at some point I would need to post a chart and was dreading learning but was actually painless.
[Image: 3gLKZWO]
Thanks for all the info. your correct the current settings are:4, max IPAP = 12.6, PS range = 4 min 4 max. BUT no ramp.

I have not made changes in the past 3 days

If after viewing the chart and have any changes I should make I am open.
Thanks again,
Bob
(This post was last modified: 02-08-2015 03:46 PM by BigBob2.)
02-08-2015 03:17 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
BigBob2 Offline

Members

Posts: 19
Joined: Jan 2015

Machine: Res Med S9 vpap auto
Mask Type: Full face mask
Mask Make & Model: Aif fit f10
Humidifier: Res med H5i
CPAP Pressure: IPAP15 EPAP4 PS 4
CPAP Software: SleepyHead

Other Comments: afib with an ablacion that didn't correct anything

Sex: Male
Location: East Tn.

Post: #12
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
[img][Image: 3gLKZWO.png][/img]
(02-08-2015 03:17 PM)BigBob2 Wrote:  Sorry for the mixup But the above is my chart
BOB

[img]http://[/img]
(02-08-2015 12:30 PM)quiescence at last Wrote:  @Bob - It would help a bit to show us an overview of these last 30 days, like the following:
[Image: QodtmZQ.png]

I will mimic some past posters comments about your settings and their affect on CA. Some more knowledgeable folks will be along at some point and give even better help...

If I had your scores and had not just made a change in the last 3 days, this is what I would do - (assuming your current setting is min EPAP = 4, max IPAP = 12.6, PS range = 4 min 4 max. Ramp 4 for 15 minutes.)

I would increase min EPAP to 6, leave IPAP at 12.6, change PS range to 2 min 3 max, and ramp OFF. leave for 7 to 10 days. report results.

This would start me at inhale of 8 cmH2O, exhale at 6 cmH2O.

From this change I would expect that my AHI average for the 10 days would be as low as 3 and high as 10, and the CA component of the score would be less than half. My guess is that there will be 0 days over 10, 7 days between 5 and 10, and 3 under 5.

That would be a great baseline to build upon.

QAL
I knew at some point I would need to post a chart and was dreading learning but was actually painless.
[Image: 3gLKZWO]
Thanks for all the info. your correct the current settings are:4, max IPAP = 12.6, PS range = 4 min 4 max. BUT no ramp.

I have not made changes in the past 3 days

If after viewing the chart and have any changes I should make I am open.
Thanks again,
Bob
(This post was last modified: 02-08-2015 04:14 PM by BigBob2.)
02-08-2015 04:07 PM
Find all posts by this user Post Reply Quote this message in a reply
BigBob2 Offline

Members

Posts: 19
Joined: Jan 2015

Machine: Res Med S9 vpap auto
Mask Type: Full face mask
Mask Make & Model: Aif fit f10
Humidifier: Res med H5i
CPAP Pressure: IPAP15 EPAP4 PS 4
CPAP Software: SleepyHead

Other Comments: afib with an ablacion that didn't correct anything

Sex: Male
Location: East Tn.

Post: #13
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
(02-08-2015 01:22 PM)archangle Wrote:  Check how long your CA's last. Long ones are a lot more worrisome than short ones. Also, CA's aren't necessarily more harmful than OA's, just harder to eliminate.

Go into the daily tab on SH, go to the events tab, and break out the CA list. You can click on individual events and it will zoom in on the time and you can look at the flow rate waveform.

Thanks for the Info.
Intersting the long ones vs. the short ones but makes sence

all this is new to me and I don't know when events become long
Maybe this helps
[Image: KqJDxG9.png?1]
02-08-2015 04:40 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
BigBob2 Offline

Members

Posts: 19
Joined: Jan 2015

Machine: Res Med S9 vpap auto
Mask Type: Full face mask
Mask Make & Model: Aif fit f10
Humidifier: Res med H5i
CPAP Pressure: IPAP15 EPAP4 PS 4
CPAP Software: SleepyHead

Other Comments: afib with an ablacion that didn't correct anything

Sex: Male
Location: East Tn.

Post: #14
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
(02-08-2015 11:51 AM)sgearhart Wrote:  
(02-08-2015 11:13 AM)BigBob2 Wrote:  Your question "How often did you have desats in your sleep study?"
I don't understand the term destats
Oxygen level dropping; the desaturation of your body's oxygen level. When you don't breathe your blood will lose its oxygen. This is expressed in a percentage value. Based off of published material and observations the "normal" range is 88% to 98%. I've seen a 99% but that was after the person had hyperventilated and was getting spacey.
Had a good laugh -thanks
and thanks for the feed back lots to learn
02-08-2015 04:45 PM
Find all posts by this user Post Reply Quote this message in a reply
quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #15
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
observations -

1. your min EPAP is already set at about 6.5, and max IPAP at a good level, and you have no ramp.
2. your scores for 4 out of the past 5 nights are really good. one of the nights might have been spicy foods.
3. Jan 16, 17, 24, and 31 are essentially the same CPAP condition, but the scores are widely different. I think your body is just getting used to treatment.

The only thing I would consider is - adjust your PS range to 2 min 3 max. if you want to do it in stages, you could do the following, waiting at least 4 nights at each step. You could stop any point you saw results were acceptable.
2/9 - adjust PS to 3-4
2/13 - adjust PS to 3-3
2/17 - adjust PS to 2-3

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
02-08-2015 09:47 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
BigBob2 Offline

Members

Posts: 19
Joined: Jan 2015

Machine: Res Med S9 vpap auto
Mask Type: Full face mask
Mask Make & Model: Aif fit f10
Humidifier: Res med H5i
CPAP Pressure: IPAP15 EPAP4 PS 4
CPAP Software: SleepyHead

Other Comments: afib with an ablacion that didn't correct anything

Sex: Male
Location: East Tn.

Post: #16
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
(02-08-2015 09:47 PM)quiescence at last Wrote:  observations -

1. your min EPAP is already set at about 6.5, and max IPAP at a good level, and you have no ramp.
2. your scores for 4 out of the past 5 nights are really good. one of the nights might have been spicy foods.
3. Jan 16, 17, 24, and 31 are essentially the same CPAP condition, but the scores are widely different. I think your body is just getting used to treatment.

The only thing I would consider is - adjust your PS range to 2 min 3 max. if you want to do it in stages, you could do the following, waiting at least 4 nights at each step. You could stop any point you saw results were acceptable.
2/9 - adjust PS to 3-4
2/13 - adjust PS to 3-3
2/17 - adjust PS to 2-3

QAL

Thanks for the input. However I am not understanding item #3 (essentially the same CPAP condition, but the scores are widely different)
So much to understand, This ~ 1 Mo. for me.
I did adjust my PS fro 4 to 3 last night and will decrease to to over this week.
The centrals are my area of concern as the other events are minimal ( if I am understanding)
I will include a screen shot of last night
[Image: LGRNbp6.png]

This is typical of any night meaning: Centrals in clusters, pressures run about the same Max & 95% 8 / 12 even on high AHI days. The highest day for AHI was 44 and that day was 11/15 MAX but 95% was the norn.
02-09-2015 11:11 AM
Find all posts by this user Post Reply Quote this message in a reply
PaytonA Offline
Wiki Editor
Monitors

Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #17
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
(02-08-2015 09:47 PM)quiescence at last Wrote:  The only thing I would consider is - adjust your PS range to 2 min 3 max. if you want to do it in stages, you could do the following, waiting at least 4 nights at each step. You could stop any point you saw results were acceptable.
2/9 - adjust PS to 3-4
2/13 - adjust PS to 3-3
2/17 - adjust PS to 2-3

QAL

Big Bob has a Resmed machine which does not have a PS range. It just has a PS setting.
02-09-2015 11:31 AM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
PaytonA Offline
Wiki Editor
Monitors

Posts: 3,005
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #18
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
Big Bob,

I have a couple of questions for you with regard to your most recent graphs.

1. Once you turned the machine on when you initially went to sleep, did you fall asleep immediately or did it take a while?

2. Same as question 1 for the ime when you woke up and turned the machine off for a short period.

3. the second time you shut the machine off during the night. When you awakened that time lil you lay in bed awake for a while before you turned the machine off and when you turned the machine back on same question as 1 and 2?

Best Regards,

PaytonA
02-09-2015 11:38 AM
Find all posts by this user Post Reply Quote this message in a reply
BigBob2 Offline

Members

Posts: 19
Joined: Jan 2015

Machine: Res Med S9 vpap auto
Mask Type: Full face mask
Mask Make & Model: Aif fit f10
Humidifier: Res med H5i
CPAP Pressure: IPAP15 EPAP4 PS 4
CPAP Software: SleepyHead

Other Comments: afib with an ablacion that didn't correct anything

Sex: Male
Location: East Tn.

Post: #19
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
(02-09-2015 11:38 AM)PaytonA Wrote:  Big Bob,

I have a couple of questions for you with regard to your most recent graphs.

1. Once you turned the machine on when you initially went to sleep, did you fall asleep immediately or did it take a while?

2. Same as question 1 for the ime when you woke up and turned the machine off for a short period.

3. the second time you shut the machine off during the night. When you awakened that time lil you lay in bed awake for a while before you turned the machine off and when you turned the machine back on same question as 1 and 2?

Best Regards,

PaytonA
PaytonA, thanks for clarifying the PS setting.
Answers for:
Item.#1 Normally I fall asleep within 10 Min. last night was an exception. after ~10 Min. with the mach. on I shut it off to adjust a mask due to leaks the duration of that adj. was 3 Min. & back on with the Mach. the next brake was 27 Min later with another mask adj. for 4 min. and started the mach. again. ( rec. a new mask size large they did not have a med.)
Fell asleep shortly after. Sleep was uninterrupted for 3Hrs.&23 Min.

Item# 2 I wake and turn off mach.( no waiting) this was a bathroom break and right back to sleep.3Hrs. & 35 min. no waiting.

Item#3 was another was a bathroom break and right back to sleep no waiting

I always try to turn of the mach when awake to assist in keeping the data clean even when it is about time to get up.

Bob
02-09-2015 01:38 PM
Find all posts by this user Post Reply Quote this message in a reply

Donate to Apnea Board
quiescence at last Offline

Advisory Members

Posts: 753
Joined: Nov 2014

Machine: REMstar System One with Autoflex
Mask Type: Full face mask
Mask Make & Model: Quattro AirFit F10
Humidifier: yes typical setting = 4
CPAP Pressure: 5-13 Autotritrating CPAP
CPAP Software: SleepyHead EncoreBasic

Other Comments: CMS-50F Plus oximeter /w SPO2 Assistant software. Avowed mouth-breather switching to nose-breathing

Sex: Male
Location: US

Post: #20
RE: Help Pls. AHI 29 feeling bad and not sure I am headed right
That is all great info. And sorry on point 3, I was meaning that on each of those nights the max pressure, 95% pressure, and the median pressure were all the minimum set pressure. Therefore, the CPAP therapy was approximately the same, but different results occurred - widely different. There is always a variation of AHI day to day even under similar conditions. But, it just struck me that you might just be still getting used to the treatment.

A lot of us get more activity later in our sleep night. It is also usual to have greater amount of REM sleep and dreaming just before waking in the morning. Do you remember that you were dreaming when you awoke at 5:05am?

Other observations:

1. you will also notice that your pressures adjusted at about 00:10, 01:35, 4:45 (a bit) and 5:10, but no events seem to have tripped these off. The machine has sensed something that starts the pressure building. I think these are RERA or flow restrictions that the machine does not score, but seems to react to.

2. nearly all of your CAs are when erratic shaky tidal volume is occurring. The high volume may be resulting in a hyperventilation of sorts, which your body responds to, and the brain sends a signal to halt breathing until equilibrium sets back in. I would love to see a couple of those periods with your [respiration rate] instead of [mask pressure]. Can you post the section between 04:20 and 06:00?

3. did you feel at all panicky or out of breath when you awoke at 05:10 or do you experience that periodically?

Thanks again. Hope we can get you into a better situation!

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
02-09-2015 07:41 PM
Find all posts by this user Post Reply Quote this message in a reply
Post Reply 


Possibly Related Threads...
Thread: Author Replies: Views: Last Post
  When does the "tired" feeling go away? Cranberry Ray 8 445 11-30-2016 10:10 AM
Last Post: Cranberry Ray
  Question for those who had MMA Surgery - Feeling Hopeless voiddweller 7 305 10-30-2016 02:56 AM
Last Post: 49er
  MAOI/antidepressant patient feeling worse with CPAP CPAPstruggler 15 1,943 10-05-2016 08:49 AM
Last Post: jbsix
  Numbers Good, Still Feeling Bad, What Would SleepyHead Tell Me? crezman 7 653 09-05-2016 06:16 AM
Last Post: cate1898
  feeling like not getting enough air Grover64 14 859 07-17-2016 12:41 PM
Last Post: pupcamper
  bloated feeling bigcat 3 412 05-25-2016 08:47 PM
Last Post: Sleepster
  [CPAP] Still feeling bad - What does data show? StillHoping 13 1,207 04-14-2016 02:22 PM
Last Post: StillHoping

Forum Jump:

Who's Online (Complete List)