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What's the problem?
#1
What's the problem?
Hi,
   My problem is the following: every evening the same AHI 14-20. I review SleepyHead's graphs each morning and find out that after falling asleep there is a period of 20-30 minutes in which the machine works at a maximum, but the apneas turn one after the other. Typically reports about 40-50 apneas . Then there is a 2-3 hour period when there is almost no apnea or 2-3 and the pressure drops to a minimum. Ater that then I usually wake up. Then the same is usually the same and the result is 14-20 AHI. 
   Is the maximum pressure possible to cause apnea?
   Is it possible for the minimum pressure to predispose to the appearance of new apneas?
   I am new and I hope some with more experience to help me where the problem is
   In one of my attempts to lower the maximum pressure on 16-18, I find lower AHI which suggests that 20 is a high pressure but I do not know how much I should decrease it to be normal given that the average pressure of all days 13-14. At first I thought the pressure did not enough, which made me think that I needed high pressure or BiPaP.
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#2
RE: What's the problem?
G'day slaterslater. Welcome to Apnea Board.

I'm a bit confused about your situation, so please bear with me... It sounds like you have a variable pressure setting, but your profile lists a pressure of 12 - is this a fixed pressure? Please let us know what your pressure settings are (maximum and minimum, or fixed). Can you also let us know exactly which model of machine you have - the name will be printed on the lower right and could be "CPAP, "Elite" or "AutoSet".

It's not uncommon for apneas to occur in clusters or episodes during the night. You might have a period with no apneas, then several in a row. This can be due to the stages of sleep (REM and non-REM) or due to your sleeping position (back or side), or a bunch of other reasons.

It is possible for therapy pressure to cause central apneas. There are two basic types: 1) Obstructive, where the upper airway collapses and physically blocks the air going in and out 2) Central, where the "breathe now" message from your brain to your lungs doesn't get through. Sometimes CPAP therapy can trick your brain and cause central apneas to occur.

To go into further detail we need to see some actual data from your machine. You have ResScan software, so please post a screenshot showing the events, pressures and airflow graphs. The best way is to upload them to a photo site like Imgur and link to the image. You won't be able to post a clickable link till you have at least four posts, so please put a space in the address eg htt p://imgur.com/xxxxx
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#3
RE: What's the problem?
i have an obstructive apnea and min pressure is 8 and max is 16 last night 
no post image because i am newbie in forum

sorry update my profile for correct info
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#4
RE: What's the problem?
http://imgur.com/0Ub1ZHT
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#5
RE: What's the problem?
On the night that you have displayed the charts for, did you go to sleep right away or did it take you a while to fall asleep? The reason that I ask is that a lot of your apneas look like what we call sleep-wake junk and maybe partially due to restlessness. Without the apneas near your 2 start times. Could you pick one of those 2 areas and zoom in on an OA in one of them until you only have 5 minutes of flow rate graph showing. I think it would be helpful to have a closer look at these OAs.

Another thing that may be making this picture more confusing is the high leak rates you are encountering during these 2 periods. This may be affecting the apnea results. Your F20 mask is doing great leakage wise when the pressure is down around your median pressure of 12.4 but leaking at the higher pressures. I recommend that you use the mask fit feature on your machine to adjust the mask so that the high pressures will not cause major leaks.

Keep us apprised of how you are doing.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#6
RE: What's the problem?
Hi slaterslater,
WELCOME! to the forum.!
Good luck with CPAP therapy, hang in there for more responses to your post.
trish6hundred
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#7
RE: What's the problem?
HI, all Thank you in advance for the help and I am glad that there are people like you who are going on at such times.
   The strange thing is that this night for the first time gives me AHI 8 but it gave me leaks of 6 l / minute which according to the standards is not so much as I know and my mask was quite free in the sense I was not attached it as usual and change my pressure : min 10 / max 14 . 

Here's the chart you wanted PaytonA.
http://imgur.com/xIh0aeN 
http://imgur.com/jR1nqDL
http://imgur.com/Z7xW4OV
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#8
RE: What's the problem?
You did reduce the leaks by reducing the pressure. Did you adjust your mask tighter too? Would you give me another chart that is zoomed in on one apnea as far as it will go. That may prove instructive or maybe add more confusion.

Best Regards,

PaytonA

Admin Note:
PaytonA passed away in September 2017
Click HERE to read his Memorial Thread

~ Rest in Peace ~
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#9
RE: What's the problem?
This is a apnea with largest leak from same night with 15 AHI

http://imgur.com/EJIt7N3
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#10
RE: What's the problem?
Is it possible that the release of air after the apnea leads to high pressure in the mask and from there to a large leak. 
    Result: maximum pressure from the machine + high pressure from the release of air after the apnea = double high pressure in the mask  = very large leaks
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