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Roller coster AHI...
#1
Roller coster AHI...
During the last three days, my AS10 machine with Active LT nasal mask produces AHI of 1.65, 5.29 and 21.43:

[attachment=23434]  [attachment=23435]  [attachment=23436]

To my eyes, the statistical summary for these days aren't that far apart to justify the wide range of AHI. 

There had been no changes to the settings, including the Active LT nasal mask. No noticeable differences between the quality of sleep for these days, they were pretty much even from this perspective. Even the sleeping hours were close between, 5:30 to 6:00 hours.

Maybe someone could point out what causes this roller coaster AHI?

TIA...
"Life is dream, awakening is death..."
- Chinese proverb
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#2
RE: Roller coster AHI...
Central Apnea, it is consistently inconsistent.
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#3
RE: Roller coster AHI...
The number of events is much higher on the last screenshot.  While you have OSCAR open look in the left pane just above where it shows your AHI number.  You will see a tab for "Events".

Your events also look clustered which may mean it's positional (aka: chin tucking).  You may have just slept in an odd position the last night.  Have a look at the two following wiki pages:
http://www.apneaboard.com/wiki/index.php...onal_Apnea
http://www.apneaboard.com/wiki/index.php...cal_Collar
Jeff8356

MacBook Air (2017, Intel) | macOS Monterey (12.7) | OSCAR v1.5.1 | VM = Win10/Win11 |
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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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#4
RE: Roller coster AHI...
With the extent of your leaks, the identification of these events is very unreliable. You need to fix the leaks first, and most are the result of air escaping from your mouth. Either move to a full face mask, or consider a chinstrap like the Knightsbridge, or perhaps a soft cervical collar. There is a good chance that these events are central, and if so, CPAP therapy is not going to resolve it, however until leaks are reduced, there is a great deal of uncertainty. You may want to read the Mask Primer wiki http://www.apneaboard.com/wiki/index.php...ask_Primer
Sleeprider
Apnea Board Moderator
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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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#5
RE: Roller coster AHI...
Thanks everyone...

I consistently dislike inconsistencies... Thinking-about

On the other hand, my apnea treatment seems to thrive on it, chart from last night:

[attachment=23446]

Out of the last four days, I felt the most tired this morning, depite the low AHI. Contrarily I felt a lot better yesterday morning, despite the high AHI, go figure...

Looking at the event tab for the last four days, shows obstructive events, among other things:

[attachment=23449]

The other things are vary rather wildly, some of them even disappearing.

I've ordered two different soft cervical collars about a week ego, but has not been delivered as of yet. If I can actually sleep with the SCC on and it works as intended, that should minimize and/or eliminate the obstructive events, no?

I didn't like either of the full face masks from ResMed or Phillips, hence the reason for switching to Active LT on 05.18.20. In general, doing so decreased the leakage rate, but increased the length of time in Apnea:

[attachment=23450]

Is this normal and relates to the mask type?
"Life is dream, awakening is death..."
- Chinese proverb
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#6
RE: Roller coster AHI...
I notice that there is some correlation between large leaks and higher pressures. Given your propensity toward CAs, I'm curious whether the experts would recommend either of two experiments: (1) reduce or eliminate the EPR; (2) reduce the maximum pressure to maybe 9. I'm sure your flow limitations would increase, but your leaks and CAs might go down.
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#7
RE: Roller coster AHI...
(05-30-2020, 11:58 AM)Dormeo Wrote: I notice that there is some correlation between large leaks and higher pressures.  Given your propensity toward CAs, I'm curious whether the experts would recommend either of two experiments:  (1) reduce or eliminate the EPR; (2) reduce the maximum pressure to maybe 9.  I'm sure your flow limitations would increase, but your leaks and CAs might go down.

Thanks... I have not tried your suggestion as of yet, but will later this week.

I may have some CA, but shouldn't that show up at all the times with different types of masks?

For example, these are the AHI values for the last 13 days with nasal mask:

[attachment=23481]

These are the AHI values for 13 days prior to the nasal mask with full face mask:

[attachment=23482]

The roller coaster AHI is pretty much with the nasal mask, not with the full face mask.

Shouldn't the CA show up with the full face mask as well?

Yes, the CA is "consistently inconsistent", but not to this level. Or, maybe the full face mask hides the CA better. I don't know...
"Life is dream, awakening is death..."
- Chinese proverb
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#8
RE: Roller coster AHI...
I'm on a similar roller coaster.. looking like a FFM will be my next step to try - chin strap not working for me.

Ain't CPAP inconsistencies consistently fun... NOT. Oh-jeez
- They are not spelling/grammar errors.. I live in Australia, we do it differently Down Under  Big Grin -
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#9
RE: Roller coster AHI...
@Ockrocket...

I didn't like the Resmed AirFit F30i, nor the Phillips DreamWear FFMs; most of the nights the bottom part of the seal ended up in my mouth. This woke me up a number of times per night and had to reset the mask.

In addition of being a mouth breather, it could also be due to the FFM's frame sizes. The ResMed F30i came with the "Standard" and the DreamWare with the "Medium" frames. You may want to check on the right frame size, prior to ordering one.

The chinstrap looked too cumbersome, together with the mask headgear, instead, I've opted for the Soft Cervical Collar. I should get two different kinds of SCCs, that hopefully limits my mouth breathing at night. If it does, I may just return to the FFM and change the frame size, if needed to.
"Life is dream, awakening is death..."
- Chinese proverb
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#10
RE: Roller coster AHI...
Two nights with the SCC isn't much data, but here it goes...

The Corflex ultra cervical collar, medium 3 1/2 - 18-22 arrived; using it the first time looked promising:

   

The second night didn't go as well from the AHI value perspective:

[attachment=23560]

On the other hand, SCC did what it was intended for, stop the leaks and it pretty much did.

The change that I can see is the number of pillows used; first night one and last night two of them. Maybe that made the difference and will fall back to one pillow for tonight.

About the Coreflex...

I've been hesitant ordering this one; it looked bulky and too warm, but it is neither. The collar is soft, comfortable and not warm at all. Based on the two days data, the collar keeps my mouth shut during the night.

The Eliminator SCC delivery still pending, looking forward using it...
"Life is dream, awakening is death..."
- Chinese proverb
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