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One year of use - Still have an AHI all over the map
#1
I've had my machine for One year now, originally received my Dreamstation Oct 2016 after about 8 months of locking down my prescription and providing information to my sleep doc (who was generally not good - never contacted me at all throughout time with loaner machine and issued prescriptions with zero feedback from me).

I have never been happy with it, but during the summer found a happy medium where more days were better than not - although it was still highly variable (AHI).  In general, I have an average AHI that is reasonable, but looking into the data on sleepyhead I see that the  majority of the night my AHI is low, and typically two times during the night my AHI skyrockets to ~15-17 (average AHI typically 3-4)

I've been struggling with this for awhile and I'm at the point where I have lost all confidence in the long term efficacy of my current setup.  I've been waking up with headaches all over again and am generally depressed with my progress.

Has anyone else experienced this spiking AHI, and is there any means to better control it?

I'm not sure what data I can best post to illustrate my point, but will respond to any

The attachments include 1 year of summary AHI data, and 2 examples of overnight data


Attached Files Thumbnail(s)
           
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#2
The data to post is indicated in my signature. Also how to arrange sleepyhead.
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#3
Apologies, working on it - need 4 posts before I can post a link
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#4
It won't be long now. You've got five posts, now you just have to wait for system to catch up with its counting.
In this case, a shot of your statistics page might be useful. Scroll it up to hide the sheep (and your ID data!) so we can see the statistics and at least the recent changes to prescription. In the bottom left, select "Report Mode": Standard, and then hit the F12 key. The screenshot will be stored in a folder in your SleepyHead data folder. Upload that to imgur and follow the Links in Gary1of2's post above.
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#5
https://imgur.com/a/HmTIK My data

I just selected randomly from the previous month and included my charts.

The summary of my AHI is as follows: avg. 7day: 6.35, 30day: 4.31, 6mo: 3.8, 12mo:4.3

My Rx started at 13cm but over time I reduced it to 10.5 (starting ~ 6m ago) and it has been left at 10.5 ever since.

I use a flex+ setting of 2. In the past when I've tried different settings (both pure fixed, and just flex) it's significantly increased my AHI.

Statistics page summary added to imgur
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#6
Hi trev121,
WELCOME! to the forum.!
Good luck with CPAP therapy, hang in there for more responses to your post.
trish6hundred
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#7
It looks like you have a lot of Ca's popping up. You can't really do much about that with a CPAP. You could try to increase your pressure a little at a time to try and knock out the Hypopnea's but you have to keep an eye on the CA count. You probably need a ASV machine.
A lot of time CA's are machine related starting off. But you've been at this for a year so you shouldn't be seeing them.
One other thing you could do is turn off the flex. That might help a little with the CA's.
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#8
I think you need more pressure to treat the OA/H, when the oa/h are sorted. Then see how many CA you are getting. You may need to see the doctor and move on to another machine. After 12 months, I can't see the CA resolving by themselves.
I also think you may have an issue with mouth breathing, do you have a full face mask to use while you are trouble shooting?

I would start with a 1cm rise and see if that is enough.
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#9
(11-03-2017, 05:47 PM)Walla Walla Wrote: It looks like you have a lot of Ca's popping up. You can't really do much about that with a CPAP. You could try to increase your pressure a little at a time to try and knock out the Hypopnea's but you have to keep an eye on the CA count. You probably need a ASV machine.
A lot of time CA's are machine related starting off. But you've been at this for a year so you shouldn't be seeing them.
One other thing you could do is turn off the flex. That might help a little with the CA's.

Any time I've turned off flex my ahi went way up.

One thing to note, It appears the data I selected randomly all had very high periodic breathing.  My median PB is 1.5% and typically oscillates between 0 and 2.

(11-03-2017, 08:18 PM)ajack Wrote: I think you need more pressure to treat the OA/H, when the oa/h are sorted. Then see how many CA you are getting. You may need to see the doctor and move on to another machine. After 12 months, I can't see the CA resolving by themselves.
I also think you may have an issue with mouth breathing, do you have a full face mask to use while you are trouble shooting?

I would start with a 1cm rise and see if that is enough.

I can try this, when I was at higher pressure in the past my H went up I believe.  

I have had issues mouth breathing, I started wearing a chin strap a few weeks ago.
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#10
The H should come down, the CA may go up a bit. We can treat the OA and H with this machine. Turning off the flex can help CA, but you don't have that many. For me it would be whether I needed flex for comfort. If there is high CA. It's time to see the doctor. There will be a med review to see if any are causing issues, another machine may be used.
new http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or charts for auto-cpap, set the min 1cm below median pressure, or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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