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Help getting my AHIs back down below 3
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Jeffo1 Offline

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Posts: 27
Joined: Apr 2016

Machine: Philips Respironics System One Bipap Auto SV Advanced
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: PR
CPAP Pressure: Max 25, Max EPAP 9, Max PS 15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Los Angeles, CA

Post: #1
Help getting my AHIs back down below 3
Hi!

I was diagnosed with OSA twelve years ago and in a sleep study last August, I was diagnosed with Complex SA and CSA. Initially, I was prescribed with a Resprionics Bipap ST, which brought my AHIs down to the 20’s and after another sleep study in April, my pulmonologist prescribed the PR System One Bipap Auto SV Advanced which I’ve been using since early May. After increasing my EPAP to 8 mid-June (my Rise Time is 3), I have had relatively low AHIs (below 4) but over the past two weeks, I have had 9 days of AHIs above 6 and as high as 13! I haven’t done anything differently except getting a new mask cushion, which helped for a day or two. Does anyone have a suggestion in helping me get my AHI’s back down to 3 or below?

Thanks!!

Jeffo1

http://i64.tinypic.com/2hy9krc.jpg[/IMG]

http://i67.tinypic.com/2elwgbd.jpg[/IMG]
09-13-2016 06:24 PM
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justMongo Offline

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Posts: 3,840
Joined: Sep 2013

Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
Humidifier: ResMed H5i
CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

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Sex: Male
Location: Калифорния

Post: #2
RE: Help getting my AHIs back down below 3
The PR ASV... I think we need user Sleeprider to help you.
He knows PR machines inside and out; plus knows how the ASV works.

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.
09-13-2016 06:38 PM
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Sleeprider Online
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Advisory Members

Posts: 3,315
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #3
RE: Help getting my AHIs back down below 3
Thanks for the vote of confidence JM, but much of this game is trial and error.

Jeffo1, you're still showing obstruction as a major feature. You're going to need to increase EPAP by 0.5 increments until that reaches acceptable levels. I'd leave other settings the same. Can you list your settings mode. It looks like you have plenty of pressure support to deal with centrals. FWIW the Resmed Aircurve 10 ASV seems to be easier for some people to get in sync with. If your doctor or supplier is open to trying something else, that's what I'd do.

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09-13-2016 08:09 PM
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Jeffo1 Offline

Preferred Members

Posts: 27
Joined: Apr 2016

Machine: Philips Respironics System One Bipap Auto SV Advanced
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: PR
CPAP Pressure: Max 25, Max EPAP 9, Max PS 15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Los Angeles, CA

Post: #4
RE: Help getting my AHIs back down below 3
Thanks, Sleeprider!

I've increased my EPAP minimum to 8.5 so we'll see how the next week goes. What is the highest one could go regarding EPAP minimum?

Here are my settings, as you requested. Maybe there's something that might eventually need adjusting?

Max Prep 25
EPAP min. 8.5
EPAP Max 15
PS Min 3
PS Max 15
BPM 14
Ti 1.4
Flex Type - none
Rise Time 3
Ramp Time 0
Tubing Type 15H
Humidity Level 3
Tube Temp 3

Is there anything I'm missing?

Thanks for your help!

Best,

Jeffo1
09-13-2016 10:32 PM
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Jeffo1 Offline

Preferred Members

Posts: 27
Joined: Apr 2016

Machine: Philips Respironics System One Bipap Auto SV Advanced
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: PR
CPAP Pressure: Max 25, Max EPAP 9, Max PS 15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Los Angeles, CA

Post: #5
RE: Help getting my AHIs back down below 3
Hi!

I thought maybe this copy of my Sleepy Head statistics might shed some light on why my AHI continues to recently be high:

[Image: 2wo9jea.jpg]

Jeffo1

09-14-2016 12:54 AM
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Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,315
Joined: Dec 2014

Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #6
RE: Help getting my AHIs back down below 3
Everything looks good. We don't know medical history so my only comment is on Ti max (inspiration time), with a median respiratory rate of 14-15 bpm as shown in your data, normal Ti max would be 2.0-2.1. Shorter Ti max at that respiration rate would be appropriate for restrictive or obstructive respiratory issues. You might want to try a longer Ti max and see if that keeps you from feeling cut-off and results in better sync.

Note you are also using the slowest rise time (time it takes for machine to reach IPAP pressure from EPAP), so the longer Ti may help. Both rise time and Ti are comfort features and you can experiment with what works best.

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(This post was last modified: 09-14-2016 08:34 AM by Sleeprider.)
09-14-2016 08:00 AM
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Jeffo1 Offline

Preferred Members

Posts: 27
Joined: Apr 2016

Machine: Philips Respironics System One Bipap Auto SV Advanced
Mask Type: Full face mask
Mask Make & Model: AirFit F10
Humidifier: PR
CPAP Pressure: Max 25, Max EPAP 9, Max PS 15
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Los Angeles, CA

Post: #7
RE: Help getting my AHIs back down below 3
Thanks! I'll try going to a 2.0 Ti and see how I do.
09-14-2016 10:23 AM
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holden4th Offline

Advisory Members

Posts: 238
Joined: Dec 2015

Machine: PR System One REMStar 60 Series Auto with Bluetooth
Mask Type: Nasal mask
Mask Make & Model: Respironics Dreamwear
Humidifier: Remstar Heated Humidifier
CPAP Pressure: 11- 15 APAP
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Gold Coast Australia

Post: #8
RE: Help getting my AHIs back down below 3
Reading this thread it looks like BiPap machines need far more finesse than ordinary CPAP/APAP and Sleeprider knows his stuff!
09-15-2016 05:07 AM
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