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Help with increasing AHI
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razheev Offline

New Members

Posts: 3
Joined: Dec 2014

Machine: resmed s9 autoset
Mask Type: Nasal pillows
Mask Make & Model: airfit p10
Humidifier: H5I
CPAP Pressure: 4 - 20
CPAP Software: ResScan

Other Comments: EPR is set to 3

Sex: Male
Location: India

Post: #1
Help with increasing AHI
Hello

I am 44 and was diagnosed with OSA 1.5 yrs back . My first sleep study revealed my AHI was 40. I was tested with CPAP on and the AHI came down to 2.9 . Since on CPAP then, My AHI is pretty much below 2 . From last 2 weeks , I see my AHI is between 3 to 5.5 . Wondering what caused all of a sudden. for last 2 weeks , I am waking up with a feeling that the pressure is high and feeling of suffocation. When i check in the morning , the Max pressure is between 13 to 14 range.
I use Resmed s9 autoset and the machine is set to auto

I did an echo yesterday and the PAP was 45mmHg. I have been doing PAP for last 4 yrs . 4 yrs back was 35, then 30 , then 35 and this time 45 . Last yr PFT showed my
lung capacity as 72%. 4 yrs back it was 62%. I quit smoking and that improved my Lung capacity . Also PFT revealed mild restriction and did a CT of lungs 4 yrs back and everything came out normal . Restriction is there every time I do PFT .

Family history, My Mom had ILD and passed away and My Dad has COPD and he is so far doing ok .

I will be meeting my Pulmo soon, But want to hear if anyone in the same boat or any expert comments as I am little concerned .

Thanks in advance
Raz
(This post was last modified: 06-11-2016 01:16 AM by razheev.)
06-11-2016 01:09 AM
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green wings Offline

Advisory Members

Posts: 552
Joined: Feb 2016

Machine: Respironics System One RemStar Pro (460)
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10
Humidifier: integrated humidifier
CPAP Pressure: 13.0 cm
CPAP Software: SleepyHead

Other Comments: using CPAP since Jan. 2016

Sex: Undisclosed
Location: US

Post: #2
RE: Help with increasing AHI
Hello, Raz. I am not sure I understand from your post - do get 90% or 95% pressure values from your machine or in ReScan? If you do, posting those values here would be helpful. (Typical value when your AHI was below 2 and a recent value.)

If you want to download the SleepyHead software (link at the top of this page), you will be able to see detailed daily graphs of your apnea events and your machine's pressure response, plus lots of other data.

I don't have the knowledge to respond to the rest of your post, so I will leave that for someone else.

(06-11-2016 01:09 AM)razheev Wrote:  Since on CPAP then, My AHI is pretty much below 2 . From last 2 weeks , I see my AHI is between 3 to 5.5 . Wondering what caused all of a sudden. for last 2 weeks , I am waking up with a feeling that the pressure is high and feeling of suffocation. When i check in the morning , the Max pressure is between 13 to 14 range.
I use Resmed s9 autoset and the machine is set to auto
06-11-2016 08:06 AM
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Sleeprider Online
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Advisory Members

Posts: 3,389
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: #3
RE: Help with increasing AHI
Razheev, it might be possible to improve results and reduce AHI back to your normal baseline, it could even happen without intervention. It would help to know what kind of events is contributing to your AHI and if that is distributed through the night or if it is clustered at certain times. It makes no sense recommending setting adjustments without knowing what is going on. Also, are you using your exhale pressure relief feature (EPR)?

Free Sleepyhead software mentioned above will give you that information.

______________________________________________
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06-11-2016 08:16 AM
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razheev Offline

New Members

Posts: 3
Joined: Dec 2014

Machine: resmed s9 autoset
Mask Type: Nasal pillows
Mask Make & Model: airfit p10
Humidifier: H5I
CPAP Pressure: 4 - 20
CPAP Software: ResScan

Other Comments: EPR is set to 3

Sex: Male
Location: India

Post: #4
RE: Help with increasing AHI
Thanks sleeprider .

My EPR is set to fulltime , 3 . I am using both Sleepyhead and Rescan .

If I look yesterday, which was probably the highest since 1 year with AHI of 5.98

Date Sleep Wake Hours
10-06-2016 22:54:25 05:26:03 06:31:07
Clear Airway 1.38
Unclassified Apnea 0.00
Obstructive 4.14
Hypopnea 0.46

Clear Airway 9 events
Hypopnea 3 events - 20,12,24
Obstructive 27 events

I dont know how to upload the report to this post.

Thanks
Raz
06-11-2016 08:29 AM
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Sleeprider Online
Wiki Editor
Advisory Members

Posts: 3,389
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: #5
RE: Help with increasing AHI
That helps quite a bit. With the predominately obstructive events, an increase in minimum pressure is indicated. I would suggest that your Autoset is being run wide open, and this is rarely the most effective mode. Your minimum pressure is currently 4.0. It will work much better if you adjust it up to your average or median pressure as indicated by the data. Your therapy pressure is probably close to your 90-95% pressure, so the median is a conservative move. Increasing the minimum pressure will put the machine closer to the pressure you need to avoid obstructive events, and will probably bring you right back to less than 2 events per hour, and may actually improve on that.

______________________________________________
Organize your SleepyHead Data
Post your SleepyHead Data from Imgur
Robysue's Beginner's Guide to Sleepyhead
06-11-2016 05:38 PM
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trish6hundred Offline

Advisory Members

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: #6
RE: Help with increasing AHI
Hi razheev,
WELCOME! to the forum.!
Much success to you as you continue your CPAP therapy.

trish6hundred
06-11-2016 05:44 PM
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razheev Offline

New Members

Posts: 3
Joined: Dec 2014

Machine: resmed s9 autoset
Mask Type: Nasal pillows
Mask Make & Model: airfit p10
Humidifier: H5I
CPAP Pressure: 4 - 20
CPAP Software: ResScan

Other Comments: EPR is set to 3

Sex: Male
Location: India

Post: #7
RE: Help with increasing AHI
Thank you much All.

I will bring it up When I meet my Pulmo next week and try to adjust my starting pressure to the Mean as you suggested .

I have read that OSA causes increase in Pulmonary artery pressure and our OSA need to be controlled
06-11-2016 11:33 PM
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chill Online

Advisory Members

Posts: 864
Joined: Mar 2016

Machine: DreamStation X500
Mask Type: Full face mask
Mask Make & Model: Walk-in Mask Closet
Humidifier: DreamStation
CPAP Pressure: 13-16
CPAP Software: SleepyHead

Other Comments: CPAP True Believer

Sex: Male
Location: Vancouver, Canada

Post: #8
RE: Help with increasing AHI
Has anything changed in your life in the last two weeks? Drinking alcohol, medications, allergies, local air pollution, stress -- there are many things that might affect AHI. With the settings you are using, increases in events will prompt the machine to continue increasing the pressure and that is likely what wakes you. I know it wakes me up! Using SleepyHead to get some idea of what is going on is a very good idea.
06-11-2016 11:58 PM
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