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Two plus months in and AHI varying widely
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wp6529 Offline

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Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quatro AIR
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CPAP Pressure: 9-16
CPAP Software: ResScan SleepyHead

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Sex: Male
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Post: #1
Two plus months in and AHI varying widely
I've been on APAP for a bit over two months now, and while my AHI is vastly better than the 91 in my initial sleep study it is still not great many days and varies widely.

I've had a few single digit AHI days like 4.3, but most are in the 10-15 range and some a lot worse like 21 last night. When the AHI is bad, it's mostly CAs that are contributing to it. I'm running 9-16 with EPR 2, with average 11.8, 90% 13.5.

After those nights with AHI in low single digits I feel noticably better, though of course the AHI 20 nights I still feel better than the untreated 91 AHI.

Thoughts?
06-15-2015 08:43 AM
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Sleeprider Online
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

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Sex: Male
Location: Where they make Respironics

Post: #2
RE: Two plus months in and AHI varying widely
Might help if you'd complete a profile with your machine, mask and pressure information. Also, your profile indicates "not using software", and if that is the case then I recommend you download sleepyhead. Without the data, we are all running just a bit blind, but based on your pressure 9-16, I would move the minimum pressure up to 12.0 which is about your average now. This will put you much closer to your 90% pressure and I think you will get better results.

The type of events that make up your AHI matter, and software should help you break down if this is central, obstructive or hypopnea. If the events are mainly CA, then the suggestion above may not be valid as we don't increase pressure for CA events.

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06-15-2015 08:53 AM
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wp6529 Offline

Preferred Members

Posts: 34
Joined: Feb 2015

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quatro AIR
Humidifier: H5i
CPAP Pressure: 9-16
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #3
RE: Two plus months in and AHI varying widely
Most of the "bad" nights are predominantly CAs. I haven't been able to correlate the "good" nights with anything so far, I guess I need to start keeeping a diary of sorts to try to isolate what may be different in the days that result in a "good" night.
06-15-2015 09:46 AM
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lmoretti Offline

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Machine: PR System One 60 with AFlex
Mask Type: Nasal pillows
Mask Make & Model: Resmed P10
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CPAP Pressure: 9
CPAP Software: SleepyHead

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Sex: Male
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Post: #4
RE: Two plus months in and AHI varying widely
IIRC a S9 Autoset won't help much with CAs. Talk to your sleep doctor, as if you're seeing over 5 you need to figure out what's going on. You may need a more advanced machine to help with your CAs.
06-15-2015 10:25 AM
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #5
RE: Two plus months in and AHI varying widely
(06-15-2015 09:46 AM)wp6529 Wrote:  Most of the "bad" nights are predominantly CAs. I haven't been able to correlate the "good" nights with anything so far, I guess I need to start keeeping a diary of sorts to try to isolate what may be different in the days that result in a "good" night.

Did you have a titration study, or were you given an auto CPAP and instructed to self-titrate? If you had a sleep study, did centrals appear during the study, or with CPAP pressure during titration?

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06-15-2015 04:13 PM
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Crimson Nape Offline

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Machine: ResMed S9 Autoset
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CPAP Pressure: 8 - EPR 3
CPAP Software: SleepyHead

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Sex: Male
Location: Georgia

Post: #6
RE: Two plus months in and AHI varying widely
WP6529,
Are the CA's scattered or do they occur at or above a certain pressure? Are they occurring at the beginning and/or the end of your sleep cycle?

Statistics prove that people who have more birthdays live longer.
06-15-2015 04:23 PM
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wp6529 Offline

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Posts: 34
Joined: Feb 2015

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quatro AIR
Humidifier: H5i
CPAP Pressure: 9-16
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #7
RE: Two plus months in and AHI varying widely
There doesn't seem to be much correlation with pressure. Here are Slepyead shots of bad and good days:

[Image: Bad_night.jpg]

[Image: Good_night.jpg]
06-16-2015 08:46 AM
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AshSF Offline

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Machine: PRS1 D560TS
Mask Type: Nasal pillows
Mask Make & Model: ResMed P10, Bkup: Airfit F10 & Quattro Air
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CPAP Pressure: 8 - 8 w/ Aflex 3
CPAP Software: SleepyHead

Other Comments: Using APAP mode with fixed pressure

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Post: #8
RE: Two plus months in and AHI varying widely
One experiment that you may try is reduce your EPR to 1 for a week and then 0 for 1 week. The EPR can contribute to CAs since it is a type of pressure support on a bi level. If after reducing APR to zero, your average CA index for 7 days still doesn't drop below 5, then you need to be reevaluated via a sleep study for a different machine that can take care of CAs for you (probably an ASV machine). FWIW, Medicare does have a criteria for this.

My 2 cents. YMMV.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
06-16-2015 01:59 PM
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Machine: Resmed Aircurve 10 Vauto
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: Resmed Climateline
CPAP Pressure: Auto Bilevel 18/9, PS 3
CPAP Software: ResScan SleepyHead EncoreBasic

Other Comments:

Sex: Male
Location: Where they make Respironics

Post: #9
RE: Two plus months in and AHI varying widely
You may have complex apnea, and regardless of the cause, you need to consult with your doctor to discuss the options. Somehow I doubt changes in EPR alone will change the results. On a "good night" you marginally meet the criteria for being treated. On the bad night, you have moderate to severe apnea with CPAP.

You didn't answer my previous question if you had a titration study. Did you?

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06-16-2015 08:27 PM
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wp6529 Offline

Preferred Members

Posts: 34
Joined: Feb 2015

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Quatro AIR
Humidifier: H5i
CPAP Pressure: 9-16
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location:

Post: #10
RE: Two plus months in and AHI varying widely
I did the titration study (not split), and it recommended CPAP at 13. I specified the APAP since I figure one night of titration is not a real world simulation, not the variable position and adaptation once you've used a PAP for a week or two so I wanted the auto to be able to adapt and settle in at the most appropriate point. I started at 6-16 and tightened to 9-16 after I had some data showing the average and 90% pressures. This big question is what factors are affecting the good vs. bad nights, which hopefully I might get a handle on if I start a diary.
06-16-2015 09:56 PM
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