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Newbie needs advice on high AHI
#1
Dear all,

I would appreciate your kind advice please:

I have been using S9 Autoset, H5i with Full Face mirage Quattro for 4 weeks now and AHI varies from 14-40 - with no significant air leak. APAP set at 4-20.

From ResScan report average pressure ranges from 16-20.
The apnoeic episodes are <10 seconds and associated with oxygen desaturations to 84%.

Can anyone help advise on how I can reduce AHI.
Since starting CPAP I feel much more alert and less sleepy during day.

Thanks and best wishes,

Oranj
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#2
If you could post your charts so we can see the type of events and the time frame it would help. If they are clustered around falling asleep or waking vs spread throughout the night. Also important is the breakdown of obstructive vs central vs hypopnea.
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#3
(10-16-2014, 04:37 PM)Oranj Wrote: Can anyone help advise on how I can reduce AHI
Oranj

Have you tried sleeping on your side/sides exclusively? I get the same results that you mentioned when I sleep on my back but when on my sides I get an AHI of .9 usually and sometimes I get a zero. If you are back sleeping now, changing can make a world of difference.

A report graph would be helpful after you try side sleeping so we can assess the true pressures you require for maximum benefit from the cpap therapy. 4 ~ 20 is the default setting for the S9 Auto but it isn't a good setting for most people once they get their needs analyzed via a period of graphing and studying the results.

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#4
Hi Oranj,
WELCOME! to the forum.!
Hang in there for more suggestions and best of luck to you with your CPAP therapy.
trish6hundred
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#5
(10-16-2014, 04:37 PM)Oranj Wrote: Dear all,

I would appreciate your kind advice please:

I have been using S9 Autoset, H5i with Full Face mirage Quattro for 4 weeks now and AHI varies from 14-40 - with no significant air leak. APAP set at 4-20.

From ResScan report average pressure ranges from 16-20.
The apnoeic episodes are <10 seconds and associated with oxygen desaturations to 84%.

Can anyone help advise on how I can reduce AHI.
Since starting CPAP I feel much more alert and less sleepy during day.

Thanks and best wishes,

Oranj

What surferdude2 and bwexler said and welcome to the forum. It is a great place.

I presume that you meant that your apneic events are>10 seconds since the machine should not be reporting them if they are less than 10 seconds.

Of course you have no air leaks, you are using the mirage quattro mask. Sorry I just had to add that. I keep hearing so much about how great the P10 mask is, I just had to throw in a plug for the mirage quattro

Best Regards,

PaytonA
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#6
I think the first thing that I would do is validate my flow rate, stoppages, leaks (unintentional) and SpO2 through the night. Not that SpO2 of and by itself is going to tell you much asides from desats, but it may point to some significant events that need addressing. The Quattro Full Face Mask is an outstanding piece of kit and highly recommended especially if used correctly. Make sure that it is on right and that your leak rate is steady. Your standard leak rate should be in the back of the Quattro manual somewhere. Your blower needs to be able to handle this leak rate (range). I use the S9 with a Mirage Quattro FFM and would use nothing else in my circumstances as they perform wonderfully. My AHI is generally under 1 but I do not suffer from centrals or unintentional leaks of any significance. Took me a while to get the latter under control... with practice and patience. Centrals are another story and when identified need to be addressed properly - I know that I was taking heavy pain medications and sleep assists at bedtime and getting loads of centrals. I reached a compromise... less pain meds and sleep meds and less centrals. Worked well for me and still does 2 years down the road. Recently had an accident with fractured ribs and vertebrae and extreme pain at night.... everything got shot out the window with a cannon and we begin anew It may be a matter of waiting until some healing take place and pain subsides somewhat. In the meantime, my AHI is still under 5 and some nights back down to about 1, but I have to put up with some discomfort (on a scale of 1 - 10 it would be about an 8... they had my on hydromorphone heavy duty for a while but I chose not to take it unless I could stand no more). A cheap chair... screws fell out long time ago. They soldered the legs together with a blowtorch. I twisted around to see someone and down I went. All of two feet. The bucket chair (back and seat one piece) went up under my ribs and the leverage fractured them... then the back of the chair wormed its way up my spine fracturing vertebrae beyond belief as it went. Ribs are about healed but the back hurts so much that I often sleep sitting in an arm chair... get to sleep with some heavy duty help and wake up in a cold sweat when it wears off. The doctors insist on giving me just little enough to permit me to suffer through it. Go figure.
----------------------------------------------------------------------------
Educate, Advocate, Contemplate.
Herein lies personal opinion, no professional advice, which ALL are well advised to seek.



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#7
Dear all,

Thanks for your warm welcome and valuable advice.
I will try sleeping on side.
Summary report attached.
Not sure how to print and upload detailed report.

Thanks for all your advice

Best wishes,

Oranj
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#8

.pdf   Report 17102014.pdf (Size: 171.03 KB / Downloads: 113) sorry I could not see attachment- try again..
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#9
I will chime in on trying DEFINITELY something to make you not sleep on back. I was having clusters of 20 +- 10 OAs 1 to 2 times per night even with the machine.

Based on advice here, I made up a device to encourage me to not roll onto back...I found a pair of old socks with long tops, rolled one up and put it into the toe of the other. Then tied the sock to a stretchy belt that I wear high on my chest with the sock in the middle of my back. OAs have gone to near zero!

Others have done it with a tennis ball in a pocket sewed to the back of PJs.
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