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Newbie MyAir Score 93 with AHI of 34
#1
Ok, so I don't know much. But if I am doing everything else right and still having 34 events per hour should I be raising my pressure settings or what? I did not get any info about this when they briefed me. Any help will be quite welcome on using my ResMed AirSense 10 AutoSet.
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#2
Hi dgdmn,
WELCOME! to the forum.!
Hang in there for answers to your questions and good luck to you with your CPAP therapy.
trish6hundred
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#3
Welcome!

34 is way too high. Have you tried talking to your healthcare provider about this? We will need data to help you. You can download an application called SleepyHead from the link at the top of this page. That will allow you (and us) to analyze the data that your machine collects.

Useful links for SleepyHead can be found in this message:
http://www.apneaboard.com/forums/Thread-...#pid184302
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#4
Go near the top of the page and follow the link to get your CPAP Setup manual. This will explain how the settings may be reviewed, and as necessary, adjusted.

That, plus showing us some screen shots from SleepyHead will enable us to give you feedback on what changes might be helpful.

Also, how well is your mask fitting? Any leaks that you detect? Those may interfere a bit with accurate recording. That will show up on the SleepyHead screen shots, too.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#5
(12-07-2016, 06:59 PM)dgdmn Wrote: Ok, so I don't know much. But if I am doing everything else right and still having 34 events per hour should I be raising my pressure settings or what? I did not get any info about this when they briefed me. Any help will be quite welcome on using my ResMed AirSense 10 AutoSet.

You have a very good auto CPAP that has been set in a single pressure CPAP mode. It is capable of increasing and decreasing pressure as needed in autoset mode, but not in CPAP mode. However, an AHI of 34 is very high, and the type of events matter. If this is predominately clear airway and hypopnea, rather than obstructive apnea, then increasing pressure is not the right approach. SleepyHead software can help you and us to better understand the problem.

You should have a follow-up appointment with your doctor soon. We can help, but with events at this rate, you need to alert him that something is not right.
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#6
I am downloading the software. Not sure I know how to use it, but will figure it out. When you say I need to make an appointment with my doctor, does that mean my GP? Because I went to a sleep clinic to be diagnosed and they prescribed the actual setting.
After writing my initial post I called my CPAP provider who had some specialist call me back who then took my info and asked someone after which she told me it was simply because I had just begun and the therapy hadn't had enough time to work. I pushed back on that so she said she would ask someone else. She then came back and said I was having very high Central Apnea and needed to have my pressure increased and would fax info to my GP.
But you say increasing the pressure will ot help.
None of this inspires confidence. I really wish I had someone to see I thought knew what they were doing.
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#7
Let's take a look at your results once you have the software available. The prescribing doctor for your CPAP probably will have a follow-up appointment scheduled sometime within 90 days of dispensing the equipment. This is normally required by insurance to determine you are using the equipment, and benefiting from the therapy. If that is not the case, we can help you to understand what is going on, and optimize your settings to get the best possible results. I'm concerned that you may have mixed sleep apnea that can occur to about 15 % of patients that are prescribed CPAP, especially if they did not undergo a titration study.

The objective is to get AHI to less than 5 events per hour, and preferably much lower than that. If your problem was simple obstructive sleep apnea, I would not expect to see 34 events per hour at 10 cm H2O pressure. The data is the best way for us to get to the bottom of this problem and give you some guidance. That may take you back to your doctor, or we might work it out. Meanwhile, if you have results of your sleep study a summary here would help. Specifically, the number and types of events. Also, did you undergo clinical titration with CPAP?
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#8
(12-07-2016, 10:28 PM)dgdmn Wrote: She then came back and said I was having very high Central Apnea and needed to have my pressure increased and would fax info to my GP.
But you say increasing the pressure will not help.

Central apneas are not treated with more pressure and can actually be made worse by increasing pressure.

I second Sleeprider's advice.
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#9
When I was initially diagnosed back around 1993, I was told I had a mixed, central apnea and prescribed protryptilline (ex Vivactil). This helped for a long time, until I progressed into mainly obstructive apnea.
                                                                                                                                                                                  
Please organize your SleeyHead screenshots like this.
I'm an epidemiologist, not a medical provider. 
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#10
(12-07-2016, 10:28 PM)dgdmn Wrote: ...She then came back and said I was having very high Central Apnea and needed to have my pressure increased and would fax info to my GP.
But you say increasing the pressure will ot help.
None of this inspires confidence. I really wish I had someone to see I thought knew what they were doing.

Sounds like this sleep therapist or technician studies at the Whack-A-Mole institute of sleep therapy. An abundance of central sleep apnea upon starting CPAP therapy may be resolved by lowering pressure to see if CPAP can be better tolerated. Pressure is brought down to where obstructive apnea begin to appear. If that cannot resolve this very high central apnea index (CAI), then normally a titration study should be scheduled to evaluate bilevel and ASV (adaptive servo ventilator) machine therapy. These look just like your CPAP but have the ability to monitor your breathing and provide additional pressure support as needed to cause you to inhale, when you are not making the effort. This is called a backup breath rate, and there are a number of members of this forum that use ASV to treat this problem.

Start doing some self-research on Central Sleep Apnea, Complex Sleep Apnea, CPAP induced Mixed Apena. This will uncover lots of information for you. You need to get past the Whack-A-Mole tech and get some real help. A bilevel/ASV titration study is what is needed as soon as possible. Meanwhile, you may find reducing pressure is helpful. This is easy to do by entering the clinical menu by pressing the home button and control knob at the same time, then clicking the control knob to enter settings. The CPAP pressure setting, currently at 10, can be selected, and a lower pressure can be tried. I would suggest 8 to start, and could go lower. It is important to monitor the results in data to see if this helps or is worse.

We look forward to helping you as much as possible, but you appear to have complex sleep apnea, and if your sleep center is not interested, call your GP and explain your problem. He should refer you to a competent specialist that will study your problem and find a solution, rather than just try to whack it with pressure.
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