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Update on 3rd visit
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Scared Offline

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Other Comments: Diabetic Type 2 high bood pressure, Diverticulitis, Arthritis

Sex: Female
Location: French Alps

Post: #1
Update on 3rd visit
Hello all, just an update on my progress and to see what you all think.
My new readings are (remember these are in french). Computer machine P.218. M945. observance 8,07 IAH 4.8

P90=9,4. RCS=0,6. AC=0,1. AO=1,7.

My IAH seems to have gone up to 4.8 from 4. so he has set the machine at 9.4 constantly it was 4. - 10 and I do not see him now until I return from the states (Chicago) on July 4th, Will I be ok? He said its normal for things to go up and down,

Thank you all, hope You are all well
05-07-2015 06:59 AM
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Sleeprider Online
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Post: #2
RE: Update on 3rd visit
Wow, those are some odd acronyms for us English speakers.

Your AHI increase from 4 to 4.8 is not particularly significant. Your 90 percentile pressure is 9.4 cmH2O. It looks like your AHI consists of 0.6 Hypopnea, 0.1 Clear Airway and 1.7 Obstructive apnea. (just a guess, and it doesn't add up to 4.8).

It is common practice to set the CPAP pressure to the 90% pressure of an APAP trial. This should actually be a pretty effective prescription, and is consistent with the advise you were given on this forum...to raise your minimum pressure. Let's see what the results are on CPAP at 9.5 (Philips machines do not adjust in increments smaller than 0.5). Keep in mind, it was recommended you try APAP at 7.0 or 8.0 and this should have similar results. If you continue to see obstructive apnea with the new setting, the advice would still be to change to APAP with a minimum of 8.0 and a maximum of 14 and let the machine continue to treat automatically.

You will be just fine, but the tools to optimize your treatment have been in your hands all along; you just have to be willing to use them.

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05-07-2015 10:34 AM
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trailrider Offline

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Post: #3
RE: Update on 3rd visit
I agree with Sleeprider. However, if your AHI was 0.4 and now is 4, that is an increase, but can be explained by increased CAs (ACs in French) as you are going into therapy. To address that, your pressure should be adjusted up a notch. I think 4 is far too low a starting pressure for you.
05-07-2015 04:48 PM
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Scared Offline

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Machine: philips Respironics Remstar Auto A-Flex System one
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Post: #4
RE: Update on 3rd visit
(05-07-2015 04:48 PM)trailrider Wrote:  I agree with Sleeprider. However, if your AHI was 0.4 and now is 4, that is an increase, but can be explained by increased CAs (ACs in French) as you are going into therapy. To address that, your pressure should be adjusted up a notch. I think 4 is far too low a starting pressure for you.

Hi, he has left it perminately at 9.5 now and will not be checking it until I com back from Chicago at the beginning of July, do you think I should ring him and get him back? still panicking.....shouldn't read some stuff on the internet !!!
05-08-2015 03:58 AM
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OpalRose Offline

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Post: #5
RE: Update on 3rd visit
Scared,
Your AHI went from 4 to 4.8. (Post #1) That is not a hugh increase to worry about, although I agree with most posters here that your starting pressure of 4 is too low. When your starting pressure is that low, it takes the machine longer to reach optimal pressure to clear apneas.

Let us know how you do with the fixed pressure at 9.5. It may work out for you, but
I believe you can see better results if your pressure was set at a range of 8-12.

I know you came here looking for answers and you are worried, but know that it gets easier once you get your pressure settings where they need to be.
Smile

OpalRose
(This post was last modified: 05-08-2015 07:42 AM by OpalRose.)
05-08-2015 07:41 AM
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Scared Offline

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Machine: philips Respironics Remstar Auto A-Flex System one
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Sex: Female
Location: French Alps

Post: #6
RE: Update on 3rd visit
(05-08-2015 07:41 AM)OpalRose Wrote:  Scared,
Your AHI went from 4 to 4.8. (Post #1) That is not a hugh increase to worry about, although I agree with most posters here that your starting pressure of 4 is too low. When your starting pressure is that low, it takes the machine longer to reach optimal pressure to clear apneas.

Let us know how you do with the fixed pressure at 9.5. It may work out for you, but
I believe you can see better results if your pressure was set at a range of 8-12.

I know you came here looking for answers and you are worried, but know that it gets easier once you get your pressure settings where they need to be.
Smile

Thank you Opal, I did show him what people said on here but dont know if its the breakdown in the language but he just said he would set it for 9.5 all the time but i can turn it down to 4.5 and it would gradually go up to 9.5 but I have left it at 9.5 so when I put my mask on its at 9.5 all the time, I have also switched to the smaller mask see if that works, its still full face as I breath through my mouth.

When I reach the correct settings, will I have no apneas or centrals? I am just concerned as am taking the grandkids to Florida for a week on my own while over there. Dont want them finding me dead in bed......!!
thanks Lynn
05-08-2015 08:23 AM
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Scared Offline

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Posts: 38
Joined: Apr 2015

Machine: philips Respironics Remstar Auto A-Flex System one
Mask Type: Full face mask
Mask Make & Model: F & P simplus Meduim
Humidifier: None
CPAP Pressure: 9.4
CPAP Software: Not using software

Other Comments: Diabetic Type 2 high bood pressure, Diverticulitis, Arthritis

Sex: Female
Location: French Alps

Post: #7
RE: Update on 3rd visit
(05-07-2015 10:34 AM)Sleeprider Wrote:  Wow, those are some odd acronyms for us English speakers.

Your AHI increase from 4 to 4.8 is not particularly significant. Your 90 percentile pressure is 9.4 cmH2O. It looks like your AHI consists of 0.6 Hypopnea, 0.1 Clear Airway and 1.7 Obstructive apnea. (just a guess, and it doesn't add up to 4.8).

It is common practice to set the CPAP pressure to the 90% pressure of an APAP trial. This should actually be a pretty effective prescription, and is consistent with the advise you were given on this forum...to raise your minimum pressure. Let's see what the results are on CPAP at 9.5 (Philips machines do not adjust in increments smaller than 0.5). Keep in mind, it was recommended you try APAP at 7.0 or 8.0 and this should have similar results. If you continue to see obstructive apnea with the new setting, the advice would still be to change to APAP with a minimum of 8.0 and a maximum of 14 and let the machine continue to treat automatically.

You will be just fine, but the tools to optimize your treatment have been in your hands all along; you just have to be willing to use them.

Thanks sleeprider, I am leaving it at 9.5 all night, I don't have any problems with, so a constant 9.5 may work, He doesn't speak much English and my french is not good enough, just hope it works, have switched to a smaller mask to see if that makes any difference. Thank you
05-08-2015 08:29 AM
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OpalRose Offline

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Post: #8
RE: Update on 3rd visit
(05-08-2015 08:23 AM)Scared Wrote:  
(05-08-2015 07:41 AM)OpalRose Wrote:  Scared,
Your AHI went from 4 to 4.8. (Post #1) That is not a hugh increase to worry about, although I agree with most posters here that your starting pressure of 4 is too low. When your starting pressure is that low, it takes the machine longer to reach optimal pressure to clear apneas.

Let us know how you do with the fixed pressure at 9.5. It may work out for you, but
I believe you can see better results if your pressure was set at a range of 8-12.

I know you came here looking for answers and you are worried, but know that it gets easier once you get your pressure settings where they need to be.
Smile

Thank you Opal, I did show him what people said on here but dont know if its the breakdown in the language but he just said he would set it for 9.5 all the time but i can turn it down to 4.5 and it would gradually go up to 9.5 but I have left it at 9.5 so when I put my mask on its at 9.5 all the time, I have also switched to the smaller mask see if that works, its still full face as I breath through my mouth.

When I reach the correct settings, will I have no apneas or centrals? I am just concerned as am taking the grandkids to Florida for a week on my own while over there. Dont want them finding me dead in bed......!!
thanks Lynn

Lynn,
Just to let you know, I was very much like you when I started. I was very panicky and afraid. It wasn't until I found the very helpful folk on this forum and started to take their advice, that I realized I was going to be just fine. Smile

No one can really say that you will have no apneas or centrals, but once you find the
right pressure settings, we would hope that the centrals would decrease and your overall AHI would be lower.

Enjoy your trip and your grandkids. There is nothing more important than spending time with family, but be sure your use your CPAP every night while on your trip.
Check back with us soon.

OpalRose
05-08-2015 10:37 AM
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TyroneShoes Offline

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Post: #9
RE: Update on 3rd visit
Concern is healthy. Being a little overconcerned is still healthy, but uncomfortable and stressful. Which category do you fall in? Is it possible you are not in the right one?

The odds of you dying in your sleep from SA are miniscule. Certainly still higher than for someone not suffering from SA, but miniscule none the less. It is only when you multiply those odds by 365 x any number of years that it should be a real cause for concern.

IOW, you are motivated to get this under control quickly, and that is a good thing, because you also have the luxury of having woken up and smelled the propane, and now you are doing something about it. I slept through that alarm (and apparently not all that well) for decades. Better to be in your situation than in the blissful ignorance of mine.

One foot in front of the other; you'll get there.

Again, it's OK to be scared; just don't be afraid and become paralyzed and then not do what you have to do. Use the uncomfortableness of being concerned as your motivation to act.

Stating an AHI or an increase means little in the vacuum of us not knowing if that refers to a single reading or a trend. Trends are what is important when parsing your data. I am at 1.43 over 135 days, with things going steadily down for the most part, but I still might have a 3 in there every couple of weeks. AHI is really only significant if it is high or if it is over a large sample, such as a couple of weeks or (hopefully) longer than that. A 4 really means nothing significant without that frame of reference.

Still, we rejoice at the zeroes and frown at the 3's and 4's, but guess what: all of that still means you are treated 100% effectively because anything under 5 counts as fully treated.

Go through the motions; make all of this happen. You are on the right path.

And yes, you should NOT read certain things on the internet if your goal is to become more comfortable with this situation. Stay here with us instead.
05-09-2015 01:14 AM
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Post: #10
RE: Update on 3rd visit
(05-07-2015 06:59 AM)Scared Wrote:  Hello all, just an update on my progress and to see what you all think.
My new readings are (remember these are in french). Computer machine P.218. M945. observance 8,07 IAH 4.8

P90=9,4. RCS=0,6. AC=0,1. AO=1,7.

My IAH seems to have gone up to 4.8 from 4. so he has set the machine at 9.4 constantly it was 4. - 10 and I do not see him now until I return from the states (Chicago) on July 4th, Will I be ok? He said its normal for things to go up and down,

Thank you all, hope You are all well

Other posters are helping you with discussion of how to find a best range or setting. But, I hear a question that you are asking - if (since) I have decided to just let the doctor control my settings, am I ok where my settings are.

Scared, I would say "you are fine to continue through July 4 without a change." Probably even beyond that.

Reading the data as you present it is harder due to language differences. But, here is my interpretation:

apnea and hypopnea (IAH) = 4.8
apnea = clear airway apnea (AC) and obstructive apnea (AO) = 0.1 + 1.7 = 1.8

therefore: hypopnea = 4.8 minus 1.8 = 3.0

ACS reading does not figure in the calculation.

The fact that clear airway apneas are only 0.1 this night suggest you are not likely to have negative effects of the constant pressure of 9.5 cmH2O.

Just enjoy the sleep.

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
05-13-2015 05:23 AM
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