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Low AHI in CPAP I still feel very bad
#1
Low AHI in CPAP I still feel very bad
Hello to everyone. I am sorry for any mistakes, English is not my native language and I don't live in the USA.

After feeling bad for about 15 years I discovered one year ago that I had severe sleep apnea in a lab sleep study. The result was:

- RDI: 123 per hour (in about 3 hours of sleep I had 138 hypopneas, 227 obstructive apneas, 5 central apneas).
- Sleep efficiency: 36%.
- Micro-awakenings: 91 per hour.
- Average oxyhemoglobin: 93%.
- Min oxyhemoglobin: 88%.
- Desaturation Index of oxyhemoglobin: 13/h.

My health insurance gives me a Resmed Airsense 10 CPAP machine and OSCAR says is a "BRICK! Sad". My doctor prescribed 11 cm-h2o with an EPR of 1 cm-H2O. A year later I am still sick. The doctor told me that I'm very fine because my AHI is under 5 and my leak is under 30 and after talking a lot with him the pressure was changed to 13 for a month and then to 15 which is my actual pressure. I am not weak up randomly in the night and I am a little better but not enough. The health insurance does not want to change the CPAP to an AUTO-CPAP. In any configuration, CPAP has always shown between 1.5 and 3.5 events per hour and leaks between 1 and 10 l/min.

I rented a Resmed Airsense 10 Autoset for a month and set min pressure 9 cm-h20, max pressure 20 cm-h20 and EPR off. The attachment images are the result of my first night (yesterday) in the rented machine and with my mouth taped and sleep on my side. I woke up in the night randomly about 4 or 5 times with a need for breath, fainting feeling and panic (same symptoms that I had with the old CPAP with 11 and 13 cm-h20). Today I am feeling very bad.

Thanks for your help.


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#2
RE: Low AHI in CPAP I still feel very bad
Hey. First of all you can change the settings yourself by holding the dial button and home button down. I would turn the EPR up to 2 or 3, which will likely improve your level of comfort with the machine and helps treat flow limitations.
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#3
RE: Low AHI in CPAP I still feel very bad
Take a look at your flow limits chart. You have a high number of flow limits. Flow limits are apnea just like O and H events  they are smaller but they can cause sleep disturbances and wake you up. 

To help with flow limits we use EPR.  Change your EPR to on full time at 3. You will find it easier to breath and you will sleep better.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Low AHI in CPAP I still feel very bad
Hi and welcome to the board - your English is fine. Smile

As the others have said, you can have many events that don't strictly qualify as full-on apneas or hypopneas, and that can still leave you feeling terrible.

Definitely turn on the EPR, and also up the minimum pressure if you're feeling like you can't get enough air.


See my comparison of Viatom/Wellue and CMS50F oximeters here.

Not a doctor, definitely not your doctor, all advice is given as-is and represents simply my own understanding as a fellow patient and OSCAR user.
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