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Sudden increase in AHI
#1
Sudden increase in AHI
My AHI has almost always been below 5 until recently.  Now it is generally around 20.  Last night it was 17.91.  Hopefully I have added a screenshot.. Min EPAP is 9.0, Max EPAP is 15.0, Min PS is 3.0, Max PS is 15.  Unit is a Respironics ASV about a year old.  I have had a stroke.  Please help!

Note:  For some reason I can't seem to post a screenshot.  The file is too large.  I have an Apple laptop.  I took the screenshot with Oscar but I can't find it.
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Larry
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#2
RE: Sudden increase in AHI
Here is png of file


Attached Files Thumbnail(s)
   
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Larry
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#3
RE: Sudden increase in AHI
Obvious place to focus on is the really high leak rate.
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#4
RE: Sudden increase in AHI
Is your IPAP really 30?  Did I see that correctly?  That's pretty darned rippin' up that high, and might mean a different mask or a different approach to wearing what you're using.  It does say that you have an alarming degree of 'large leaks' at the left summary table.
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#5
RE: Sudden increase in AHI
I understand that ASV machines are sensitive to leaks and, as the others have said, yours are large. You did not include your leak rate chart or the Flow Rate chart which are 2 of the main charts, so what kind of leaks are you having?
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#6
RE: Sudden increase in AHI
"Is your IPAP really 30?"

the resmed asv can display above 30 max ipap (I've had mine up to 34) to enable max epap and max pressure support to be set as high as possible for each of those 2 settings individually, but it will not produce more than 25 cmw.
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#7
RE: Sudden increase in AHI
I don't know where the leak is - I certainly don't "feel" it.  Now that I know how to do screenshots, please tell me what you think I should show and I'll show it.  You guys are probably right but maybe because of my stroke I can't seem to pick a mask.  Maybe I can get the sleep lab or doc (he's a very nice guy) to help me.

Maybe I can setup some kind of test of the hose.  Please - any suggestions for testing the mask - I use a Mirage Quattro full face mask.
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Larry
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#8
RE: Sudden increase in AHI
I just looked for the leak rate and flow rate charts and don''t see them.  How do I shiow them?  Thanks.
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Larry
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#9
RE: Sudden increase in AHI
As others have said, whatever is the cause of the large leak needs resolved. With leaking like that in place, the ASV cannot supply accurate therapy. I'd also put in question the accuracy of the graph for the same reason.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Sudden increase in AHI
(10-04-2019, 01:39 PM)LarryRapp Wrote: My AHI has almost always been below 5 until recently.  Now it is generally around 20.  Last night it was 17.91.  Hopefully I have added a screenshot.. Min EPAP is 9.0, Max EPAP is 15.0, Min PS is 3.0, Max PS is 15.  Unit is a Respironics ASV about a year old.  I have had a stroke.  Please help!

Note:  For some reason I can't seem to post a screenshot.  The file is too large.  I have an Apple laptop.  I took the screenshot with Oscar but I can't find it.

You have a Resmed Aircurve 10 ASV not Respironics. As mentioned above your leak rate is way too high at a median 45 L/min and 95% leak rate of 116.  The machine is probably having problems detecting events and the pressure support is not benefiting you if it is leaking from your mask.  You mentioned that you had a stroke, and that may have changed the shape or tone of your face resulting in a different fit.  Read the Mask Primer Wiki and consider seeing your supplier for a new fitting.  Be sure to fit the mask laying down and bring your machine so you can verify it will hold up to your 25 cm maximum pressure. 

We have seen high event rates like yours disappear when leaks are resolved.  Try not to worry too much and just focus on solving the mask fit problem.  You may find a soft collar will help stabilize your airway and hold your jaw in position so you can achieve a better mask fit. Also consider some kind of hose management system to avoid pulling on your mask.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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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