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Noob- Large flux in AHI?
#1
Question 
Hi Guys!

I'm currently on a bipap for moderately sever sleep apnea. I am going on month two with the machine. Thankfully I adjusted to the machine quickly! 

I have a question about my AHI though. It varies greatly from night to night. I don't drink or take any medication currently
My AHI varies from the lowest at 3.2 to the highest at 22.5 and everything in between. Last week was 5, 13.2, 7, 4, 20, 9, 16. I'm not experiencing leaks. I'm a lucky person who finds a position, falls asleep, and just does not move during the night so I don't knock around or push off my mask. I sleep with a nasal mask and chin strap.

I just find this type of flux kind of crazy. I tend to go to bed and wake at the same times. I can't find anything that would account for such wacky numbers.
My pressure is 13-9

Any help or recommendations would be greatly appreciated! Smile
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#2
You need to post some sleepyhead type graphical data to get any meaningful comments, as there are three different types of events that are added to get the AHI.
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#3
Hi annajazz,
WELCOME! to the forum.!
Hang in there for more answers to your questions.
Good luck to you with your CPAP therapy.
trish6hundred
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#4
Thanks for the advise! I'll get those stats up Smile
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#5
(05-10-2017, 09:14 PM)annajazz Wrote: Hi Guys!

I'm currently on a bipap for moderately sever sleep apnea. I am going on month two with the machine. Thankfully I adjusted to the machine quickly! 

I have a question about my AHI though. It varies greatly from night to night. I don't drink or take any medication currently
My AHI varies from the lowest at 3.2 to the highest at 22.5 and everything in between. Last week was 5, 13.2, 7, 4, 20, 9, 16. I'm not experiencing leaks. I'm a lucky person who finds a position, falls asleep, and just does not move during the night so I don't knock around or push off my mask. I sleep with a nasal mask and chin strap.

I just find this type of flux kind of crazy. I tend to go to bed and wake at the same times. I can't find anything that would account for such wacky numbers.
My pressure is 13-9

Any help or recommendations would be greatly appreciated! Smile

For some more data:


My total Clear Apneas are usually pretty high: usually between 40-80 per night
My total obstructive apneas are the lowest of the three: 0-20 per night
My Hypopneas are the middle guys: 11-35 per night

An example night being:
Sleep: 7.2 hrs
AHI: 10.9
Clear: 52
Obstructive: 9
Hyponeas: 19
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#6
If those results are typical I would suspect a complex apnea and suggest you visit with your sleep doc and look into an asv type of machine. However, still need to see those charts because the there is a possibility of just junk at the end of sleep cycles looking like CA.
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#7
annajazz,
In order to better advise you, download SleepyHead software, then see the tutorials below in my signature line. This will guide you on how to organize your graphs and upload here.
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

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.




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#8
Here we read the charts to see what may be causing your issues. So please download SleepyHead and post your data
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#9
Hold on a minute. The suggestion this is complex apnea and might require ASV is possible, but we're getting way to far ahead of the game.

You are using BiPAP pressure of 13/9 on a Dreamstation BiPAP-S and experiencing CA. The simple solution is to reduce pressure support, which should significantly reduce CA, and possibly increase EPAP pressure which can resolve OA and hypopnea. If you are comfortable with making setting changes, then set EPAP to 9.5 and IPAP to 11.5 and let's see where that takes us. This gives you a pressure support (PS) of 2.0 cm. This should be comfortable, while eliminating a significant part of the CA you are having with PS of 4.0 cm. At the same time, raising the exhalation pressure (EPAP), will give you a bit more support to deal with OA and hypopnea.

We don't really need to see data to suggest this. Your problem with PS is very very common. On the other hand, there is a reason you have a BiPAP and not CPAP. Were there centrals in your sleep study or titration?
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#10
(05-11-2017, 06:58 AM)OpalRose Wrote: annajazz,
In order to better advise you, download Sleepyhead software, then see the tutorials below in my signature line.  This will guide you on how to organize your graphs and upload here.

Thanks for the suggestion of Sleepyhead!! This software is awesome. Definitely shows a lot more data than my Dreammapper app.
I shall get some graphs up soon
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