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[Symptoms] Report. Displays elevated AHI including Central
#1
I went to the doctor because I am not sleeping well again after using a CPAP machine for more that a year. My settings for the pressures are set at 24 & 23. I am averaging in a month over 70 AHI and 34 Central AHI. I became very alarmed, and my doctor said he is getting authorized a new VPAP machine. He said this will help. But I still question what risk am I taking with such high numbers of daily. Events? My doctor does not seem to be very concerned with my situation.

Also, my personal condition is complicated because I have a implanted medical device (Pain Pump) which drips morphine directly into my spine. The doctor feels this is mostly the cause of the large number of nightly events. I. Question this because I have had this pain pump for over 10 years and the volume of medication is very low. I am able to drive a automobile and do most anything.

My question is how do I bring down the daily number of events and at what level of risk am I taking by having such high numbers of AHI's ?
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#2
I am confused about the numbers you quoted. Are you saying that for a whole month you have 70 events with 34 of them being centrals or are you saying that for a whole month you averaged 70 events per hour with 34 of them being centrals?
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#3
"I am averaging in a month over 70 AHI and 34 Central AHI"
Is a confusing statement. AHI stands for Apnea-hypoapnea per hour Index.
It's an average over the night. You cannot add them for the month.
(You can add total events for a month and divide by the total hours slept for a month.)
So, I'm going to assume that you're seeing about 70 AHI for a night +/-
That is in the severe classification for Sleep Apnea.
You are running high pressures -- so, you cannot gain much from a pressure change.
In my amateur opinion, I'm going to side with the doctor and say the morphine is likely an issue.
Sedative drugs like Opiates and Benzodiazapines reduce the brain's central ventilator drive; and relax muscles like those that hold the airway open.

VPAP is ResMed's name for a bilevel machine. Bilevel machines can run a wider gap between IPAP and EPAP pressures; and may help people whose breathing is shallow. Bilevel is also used for patients who have difficulty with compliance on CPAP.
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#4
Welcome to the forum~! Sadly, opioids (any doseage) and OSA don't mix well. I too am in pain MNGT, and deal with some of the same issues you do.

We do need a couple of clearer answers please?

What is your "AHI"?
How bout telling us about your "leak rate" too?
My last question? Did you doc set the pressure(s) you are using?

More people will reply soon Smile
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

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#5
Hi mdeehl,
WELCOME! to the forum.!
Hang in there for more answers to your questions and best of luck to you.
trish6hundred
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#6
(06-14-2014, 08:13 AM)mdeehl Wrote: I went to the doctor because I am not sleeping well again after using a CPAP machine for more that a year. My settings for the pressures are set at 24 & 23. I am averaging in a month over 70 AHI and 34 Central AHI. I became very alarmed, and my doctor said he is getting authorized a new VPAP machine. He said this will help. But I still question what risk am I taking with such high numbers of daily. Events? My doctor does not seem to be very concerned with my situation.

Also, my personal condition is complicated because I have a implanted medical device (Pain Pump) which drips morphine directly into my spine. The doctor feels this is mostly the cause of the large number of nightly events. I. Question this because I have had this pain pump for over 10 years and the volume of medication is very low. I am able to drive a automobile and do most anything.

My question is how do I bring down the daily number of events and at what level of risk am I taking by having such high numbers of AHI's ?

Let me try clear my confusion. I am daily having 60-70 ahi daily.
Additionally I am having 25-34 central ahi for total daily of close or more than 100 events daily. What I was quoting, is selecting the reporting within a 30 day period average. So my daily ahi in total exceed a total of 100 events. I was so alarmed when I realized this I am now scheduled for a new sleep study which will be completed at a sleep center in my local area tomorrow. After that I will be getting a new auto VPAP. My deepest concern is I have never heard of of any person having such extreme numbers, with my current ResMed machine settings set at the upper level of its capabilities. I feel I am in danger of having a heart attract or stroke. Because I am experiencing ofter jerking of my arms, legs and my entire body is acting like I am having a seizure by contracting into a spasm. This happen many times a night my wife says.

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#7
(06-14-2014, 11:06 AM)Peter_C Wrote: Welcome to the forum~! Sadly, opioids (any doseage) and OSA don't mix well. I too am in pain MNGT, and deal with some of the same issues you do.

We do need a couple of clearer answers please?

What is your "AHI"?
How bout telling us about your "leak rate" too?
My last question? Did you doc set the pressure(s) you are using?

More people will reply soon Smile

My daily ahi is 70 plus and 35 central for totals over a daily amount of 100 ahi. I am very concerned how this is effecting my body. I haver never heard of these high numbers. The medical supply store I go to to get my monthly mask liners and all other replacements parts told me I am her most serious client. I was told by the store manager they recommended I go to the Mayo Clinic. Can you shed any light on my condition? Thank you!
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#8
(06-14-2014, 12:33 PM)trish6hundred Wrote: Hi mdeehl,
WELCOME! to the forum.!
Hang in there for more answers to your questions and best of luck to you.

Thank you for your confidence in my situation. I do not feel too bad. Just tired all day and my mussels hurt because of the body is spasming all nigh repeatedly, due to the large number of events.

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#9
(06-14-2014, 08:58 AM)PaytonA Wrote: I am confused about the numbers you quoted. Are you saying that for a whole month you have 70 events with 34 of them being centrals or are you saying that for a whole month you averaged 70 events per hour with 34 of them being centrals?

I am daily having over 100 total events ahi. But I was also looking at a monthly average report as well, that is slightly lower than the daily number of ahi I was talking about. I hope this clears up the misunderstanding. These high number of events have me very concerned. What do you think?
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#10
There are a couple of things... First, AHI reports average number of events per hour. So if you're seeing a number of 100, then that says 100 events per hour, not 100 events a night. Then there are the actual OA events. You may be saying 100 OA's (OA's + CA's + Hypop's) per night. That would be a very large difference.

But I think the more important issue is with your mask. We need to know what your leak numbers are. You're using a full face mask and often if it is not doing what it is supposed to do all other numbers can become a little suspect.

Also we need a better handle on what your set pressures are. 24 - 23 does not resonate with me since you are using a Resmet S9. Anyhow get us as much data as you can and let's see where we can go from there.


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