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Please Help with AHIs Too High/Bad Insomnia
#1
I am now on my 4th Airsense 10 Auto and the humidity problems are much better - no more flooding (really was) in the hose - just mild condensation on auto climate. So...my AHIs are still not where they should be - 7 to 11.

I have developed chronic insomnia - start trying to sleep at 10-11, fall asleep at 3-4 in the morning, wake up around 11. Can't seem to reset schedule because I can't fall asleep. Mid 60s/overweight/take several meds. Doctor wanted me to take Ambien, but I don't think I am a safe candidate. Use Breeze nasal pillows and have tried about 12 other nasal and pillow masks, but can't fall asleep at all with something on the side of my face. Pressure set 8-17 - averages about 14.5 and says there are no leaks. Don't know if there's any solution to the insomnia, but I just don't know what else to try to get my AHIs down - I am So envious of folks that talk about 1-2.

I don't know how to use any of the data stuff, and don't really have a sleep doctor anymore - no good ones around here. Don't know what a sleep study would show anyway - when you don't fall asleep until 3-4 and they wake you at 5 (and refuse to adjust to accommodate), there doesn't seem to be any point in spending over $1500 for a 1 hour test (if I'm lucky). Just sort of lost and don't feel rested or feel well at all.......
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#2
bluemom, on the nights when your AHI is too high what is the central index? If it's not a big component of your AHI then some upward pressure adjustments should help bring the AHI down. Using SleepyHead software will help you in making those adjustments.

To get started with SleepyHead, click on the SleepyHead link at the top of this page. The first thing is to figure out which version of SleepyHead you need. If you're a Mac user I can probably help you with that. If not, many good folks here will help. Barring some unforeseen complication it will be more effective for you to monitor and fine-tune your own therapy than to put yourself through another expensive sleep study.
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#3
Centrals are 1-3. I have tried to take the pressure setting up to 20, but it says it is averaging 14-15 in pressure. I tried the "for her" setting, but I think I need the "regular" because of weight issues. I did briefly look at the Sleepyhead and I do have a Mac, but I don't understand how to use any of that stuff. Supposedly there is something called MyAir that can transmit to ResMed, but I don't get how that works either. If it's a case where you have to take something from the CPAP and insert it into the Mac, I can't do it because I can't easily reach behind the way my Mac Mini is set up - I would have to crawl behind the desk which is not possible or uncable everything, etc. If't its something that transmits wirelessly, then maybe.

I don't really see how the software would help - if you have an "auto" machine, all you can do is set a range and hope that it adjusts appropriately. I really think there are weird issues with the 10 anyway - I used an S9 for years and it did not have the problems the 10 has - humidifier defects and like others, even when you are awake, the thing blows at what seems like maximum pressure - doesn't make any sense. Since I'm on machine #4, getting bored with replacing it every 2 weeks. But even with the S9, my AHIs were 5-6. But sometimes with the 10, they have reached 11-15 on a few nights.

Also a few years ago I tried a Vpap and that was a complete disaster. So I guess the best choice is a regular Auto CPAP - just wish I could get the great numbers some do and most of all wish I could feel rested and not be in such horrible pain when I wake up like I have been in a fight with a bear all night. Very weird.
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#4
Hi bluemom51,

Welcome to the forum.

You might want to download sleepyhead and post screen shots so forum members can help you see what is going on with your data. You most likely will need a pressure increase but of course, without looking at your data, can't say for sure.

Here are the necessary links.

http://www.sleepfiles.com/SH2/ - Download sleepyhead
https://sleep.tnet.com/reference/tips/imgur
(10-30-2015, 09:42 PM)bluemom51

Regarding the insomnia, it sounds like you have delayed phase syndrome and are trying to force yourself into sleeping hours that do not suit you. Do you have to go to bed earlier? If you do, google light therapy for DPS.

Regarding ambien, I am not a doctor and I am not anti meds. But if I am right about you trying to force yourself to sleep hours that don't suit your body clock, I doubt the med would be very helpful.

Best of luck.

49er

dateline='1446259360' Wrote:
I am now on my 4th Airsense 10 Auto and the humidity problems are much better - no more flooding (really was) in the hose - just mild condensation on auto climate. So...my AHIs are still not where they should be - 7 to 11.

I have developed chronic insomnia - start trying to sleep at 10-11, fall asleep at 3-4 in the morning, wake up around 11. Can't seem to reset schedule because I can't fall asleep. Mid 60s/overweight/take several meds. Doctor wanted me to take Ambien, but I don't think I am a safe candidate. Use Breeze nasal pillows and have tried about 12 other nasal and pillow masks, but can't fall asleep at all with something on the side of my face. Pressure set 8-17 - averages about 14.5 and says there are no leaks. Don't know if there's any solution to the insomnia, but I just don't know what else to try to get my AHIs down - I am So envious of folks that talk about 1-2.

I don't know how to use any of the data stuff, and don't really have a sleep doctor anymore - no good ones around here. Don't know what a sleep study would show anyway - when you don't fall asleep until 3-4 and they wake you at 5 (and refuse to adjust to accommodate), there doesn't seem to be any point in spending over $1500 for a 1 hour test (if I'm lucky). Just sort of lost and don't feel rested or feel well at all.......

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#5
bluemom,

It sounds like with your pressure range of 8-17 that the machine is taking too long to stop enough apneas which is causing your AHI to be from 7-11. When you set a pressure range, the lower number needs to be set high enough so that there is enough time to raise the pressure to stop the apneas that you are having. That is why it would be helpful to post screen shots to help members help you get the right settings.

Sorry you are having so many problems with your machine working correctly. That sounds like a real hassle.

(10-30-2015, 10:18 PM)bluemom51 Wrote: Centrals are 1-3. I have tried to take the pressure setting up to 20, but it says it is averaging 14-15 in pressure. I tried the "for her" setting, but I think I need the "regular" because of weight issues. I did briefly look at the Sleepyhead and I do have a Mac, but I don't understand how to use any of that stuff. Supposedly there is something called MyAir that can transmit to ResMed, but I don't get how that works either. If it's a case where you have to take something from the CPAP and insert it into the Mac, I can't do it because I can't easily reach behind the way my Mac Mini is set up - I would have to crawl behind the desk which is not possible or uncable everything, etc. If't its something that transmits wirelessly, then maybe.

I don't really see how the software would help - if you have an "auto" machine, all you can do is set a range and hope that it adjusts appropriately. I really think there are weird issues with the 10 anyway - I used an S9 for years and it did not have the problems the 10 has - humidifier defects and like others, even when you are awake, the thing blows at what seems like maximum pressure - doesn't make any sense. Since I'm on machine #4, getting bored with replacing it every 2 weeks. But even with the S9, my AHIs were 5-6. But sometimes with the 10, they have reached 11-15 on a few nights.

Also a few years ago I tried a Vpap and that was a complete disaster. So I guess the best choice is a regular Auto CPAP - just wish I could get the great numbers some do and most of all wish I could feel rested and not be in such horrible pain when I wake up like I have been in a fight with a bear all night. Very weird.

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#6
Had not thought about the bottom pressure. Tonight I will try to raise the bottom pressure and see if that helps - thanks for the helpful idea. I would like to try to sleep from about 11-7 or 8 so I can be on the "majority's" schedule. It just makes life simpler - it feels strange waking up at 11 each day and feeling like you already missed the best part of the day. Also don't like staying up after midnight because it feels lonely and boring. So I would love to get closer to what my husband and everyone I know does - about 11-7 or so. Things like a lunch date become more like a breakfast date - it's just awkward.

I guess also I will Have to figure out how to get software results and maybe that will provide clues. Just wish I knew what I was doing - everyone on the forums just seem to know all this stuff and seem to be able to do it easily. All this awful sleep quality has made me increasingly very very depressed, and it's hard to make yourself do and learn new things when you're tired, frustrated, and feel bad. Wonder if the severe pain at night is caused by whatever my body is trying to do to breathe - probably - duh....
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#7
(10-30-2015, 11:23 PM)bluemom51 Wrote: I would like to try to sleep from about 11-7 or 8 so I can be on the "majority's" schedule. It just makes life simpler

You have to start from where you are. If your body wants to stay awake late right now then I would go with it. Once you can start going to sleep quickly and for enough hours then you will be better able to gradually move your sleep hours back towards "normal". Forcing yourself to try to sleep before it is ready is just not going to work because trying to sleep keeps one awake! Stay up until you are really tired and then go to bed.

And what's so great about "normal" anyway? All the good stuff is done by abnormal people.

Ed Seedhouse
VA7SDH

Your brain is not the boss.

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#8
(10-30-2015, 10:18 PM)bluemom51 Wrote: I don't really see how the software would help - if you have an "auto" machine, all you can do is set a range and hope that it adjusts appropriately.

Not true. Most of us who get the low numbers you're envying did not get there by just setting a range and hoping for the best. We had to learn how to use the software and understand the data so that we could fine-tune and optimize our therapy. Both the therapy settings and the comfort settings.

You titled your thread "Please Help with AHIs Too High/Bad Insomnia." So we're trying to help but it's not clear what you're willing to do or learn in order to improve your results. Could you rearrange the Mac mini so you have easy access to the SD card slot, or buy an inexpensive external card reader and attach it to the mini with an extension cable so the reader itself can just sit right on your desktop? You might even be able to use a special SD card that transmits data to your computer wirelessly -- I don't have experience with that kind of setup but others here would know more about it and could help.

MyAir is fine when things are going well, but when you're trying to troubleshoot your therapy it falls short. You can't get more info than is already available on your PAP machine's display screen. You already know that your AHI is too high, you need to be able to take a closer look at what is happening, and when. The software lets us see events on a time-based graph so we can see, for example, where was the pressure when events were occurring, and what else was going on at the time (we can look at the graphs for flow limitation, mask leak, and snore). Are your events happening in clusters during certain times of the night or are they more spread out? Examining the time-based data and using it to guide adjustments to your settings can make a huge difference.

EDIT: Good idea to increase the Min pressure a bit and see if that brings the AHI down. Also don't forget to check out your RERA numbers because RERAs don't figure into your AHI but they can sure be disruptive to your sleep. Your machine has RERA data and I'm not sure if you need to be running in "For Her" mode to see it -- someone here will chime in with that info.
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#9
keep in mind, the machine have limitation when scoring apneas, doesn't know whether you're awake or asleep
You'll need to check into the software to see if any of the events are scored while laying in bed awake
Awake events don't mean anything
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#10
(10-30-2015, 11:40 PM)kaiasgram Wrote: Your machine has RERA data and I'm not sure if you need to be running in "For Her" mode to see it -- someone here will chime in with that info.
Airsense 10 AutoSet for Her report RERAs in all three modes (AutoSet for Her, AutoSet, CPAP)

My old regular A10 AutoSet does not report RERA but been told by some members that the recent A10 AutoSet report RERAs too


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