Hello Guest,Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address. Login or Create an Account
Is anything above an AHI of 0 considered a failure?
08-11-2016, 04:16 PM
08-11-2016, 06:36 PM
Get a copy of your sleep study. Did they do a titration study, too? As in put you on a machine for part of the night or a separate night?
I'm curious if they noticed pressure-induced central events happening during their titration. You've got some going on now and that is contributing to your high AHI.
Since you've been using it for just a short time, I suggest conferring with your sleep doc. He/she will probably want to reduce that pressure range quite a bit. This will probably decrease the central events that are happening. Don't let them stick you with an ASV until they try this first.
Apnea Board Moderator
Breathe deeply and count to zen.
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.
08-11-2016, 06:46 PM
Okay, so I was wrong about your pressure maxing out at 20.0. SleepyHead must have been showing the max pressure setting in that bar graph and not the actual max pressure (I think that's a bug.)
Uh-oh, you have clear airway apneas. Time to call the People Who Know About Those. When you feel ready to go through the steps of arranging a couple of days of SleepyHead graphs as suggested in that link I gave you, then doing screenshots and uploading those to imgur or some other image hosting site, I would suggest that you start a new thread with a title like "New to CPAP, have mixture of OA + CA, need advice" or something along those lines.
You will need only one screenshot per night. Just do a couple of nights to start with, say the most recent night's data and then for the second choice, a night where the 90% pressure and the max pressure have a large gap between them. That's unusual, so it would be good to see what's going on there. It could be that when your pressure went up to the max value it was uncomfortable and woke you up. (I'm not even sure that makes sense. I guess it does.)
Can't remember if this hint is in the info about arranging SleepyHead graphs - you can turn off the pie chart in the Preferences, then when you do a screen shot, there will be room to show all your machine settings.
I would also recommend going into SleepyHead Preferences and changing the option to use Average or Median to "Median" and see if that changes the displayed values very much.
Your leak rates are excellent. And you're using the machine. You are a robust new user.
I see that the A-Flex/Expiratory Pressure Relief setting on your machine is set to zero. (at the bottom of the page in the "Changes to Prescription Settings". Was that a setting that anyone discussed with you? It would be more typical for a machine to have that value set at 2 to start with. (It can range from 1-3 or be set to "Off"). It's called a "comfort setting" - it's not required to use it.
You did not have a second, titration-with-CPAP study, is that right? You had the diagnostic study and now are finding the correct settings by gathering data from your APAP machine?
Do you know if you had any central apneas during your sleep study? If you didn't and they are only showing up now that you are using CPAP, they may be a temporary thing. Quite a few people do get them temporarily when they first start using CPAP. They're triggered by the pressure from the CPAP machine - I'm not entirely clear if it has to do with blood CO2 levels or exactly what.
A higher minimum pressure is the direction to go to lower the number of OAs and hypopneas that you're having, but I'm not clear about what effect that may have on your clear airway apneas.
Okay, that's all. I do recommend putting the next graphs in a thread with a title referencing central/clear airway apneas so that people who are knowledgeable about those will be sure to look.
* The term "CA" as used in a sleep study means "central apnea", because they are able to detect that your brain did not signal for a breath. In SleepyHead, it means a "clear airway" apnea. The CPAP machine can only tell that you didn't breathe and that your airway was unobstructed. It can't tell anything about signals from your brain, hence the two different terms. If you had central apneas during your sleep study, I'd expect your doctor to have discussed that with you. (Look up "ASV machine central sleep apnea" for more info if you're interested.)
08-11-2016, 09:36 PM
(08-11-2016, 06:46 PM)green wings Wrote: You did not have a second, titration-with-CPAP study, is that right? You had the diagnostic study and now are finding the correct settings by gathering data from your APAP machine?
This is correct. I am not currently being advised in any way. Much of the what I know I have learned from this forum.
Based on p95 of 13-ish, I will adjust my pressure range to 11-15 and try that for awhile.
Thank you, green wings for the heads up about the CA's. I will keep an eye on those.
Next time I post I will try to have more charts and graphs for everyone to view.
I appreciate everyone's input!
08-11-2016, 11:42 PM
No, that's too high a minimum for you right now. Try more like 9. And I think you will find the 15 to be too low. But it is a start.
Apnea Board Moderator
Breathe deeply and count to zen.
08-12-2016, 08:31 AM
From the first graph you posted, I was going to suggest a minimum APAP pressure of 9.0. Looks like Paula and I are on the same page. Give it a try for a week or so, and let's see where that takes you. I would not go so high as 11.0 at this point. It's better to narrow in on the most effective range, rather than try to hit it all at once. Also, be sure to minimize or eliminate Ramp time. You want the machine to reach therapeutic pressure without delay as long as you can tolerate it.
08-14-2016, 08:57 AM
Welcome to the adventure that we all share!
I can share my experience. I am trying to get my AHI as low as possible but I realize that 0 is impractical.
Untreated I was AHI 46.
First week I was AHI 16-19ish similar to you.
Analyze and adjust and I got down to 6-9 went another week
Analyze and adjust and I got down to 3-6
I then bounced back up to 6-9 now I am trying to get back down to 2-4 and keep it there or less.
Its a process everyone is unique and different and little changes can make a big difference for some.
|Possibly Related Threads...|
|[Treatment] What is considered successful treatment?||Autarch||4||461||
01-30-2017, 05:36 PM
Last Post: PollCat
|failure to record 2nd part of night||Beej||10||475||
12-03-2016, 02:08 AM
Last Post: sonicboom
|[Equipment] Respironics blower failure||SleepyinMTL||2||363||
12-03-2016, 12:52 AM
Last Post: trish6hundred
|Flashair SD poor connection to router after power failure||Roy289||5||367||
08-06-2016, 12:54 PM
Last Post: Crimson Nape
|Is 87.5% considered too much for large leaks?||FrankNichols||11||983||
07-14-2016, 11:30 PM
Last Post: chill
|Heart Failure, Periodic Breathing, and Exercise||chill||2||569||
06-27-2016, 02:37 PM
Last Post: richb
|Electric stuff - Odd connector/adapter failure||OMyMyOHellYes||5||403||
06-14-2016, 12:16 PM
Last Post: RedCoPete