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When is it a matter of concern?
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GrammaBear Offline

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Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
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CPAP Pressure: 12.2 - 16.2
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Other Comments: Type 1 diabetes - using Tandem T-slim insulin pump, Dexcom G4 CGM

Sex: Female
Location: northern Illinois

Post: #1
When is it a matter of concern?
I have the S9 Autoset and for the most part my numbers have been in the decent range from 0.3 to 3.0. Recently in the last month or so my AHI numbers have increased to 5.5 to 7.0. Is this increase something I should be concerned about?

There was a mix up from my supplier so I went for a while without a new mask or nasal pillows. I also have noticed that the hay fever and increased pollen seem to be affecting me as well. I definitely don't feel well rested in the morning.

Thank you for your response.
09-08-2013 03:17 PM
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zonk Offline

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Location: Australia

Post: #2
RE: When is it a matter of concern?
Whats the breakdown of AHI (AI, HI, CAI) and any changes to 95% pressure/leak rate

At times when feeling stuffy, you can use full face mask and doing the sinus rinse is good too
09-08-2013 04:13 PM
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GrammaBear Offline

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Posts: 381
Joined: May 2012

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Air Fit P10
Humidifier: ResMed H5i heated humidifier
CPAP Pressure: 12.2 - 16.2
CPAP Software: SleepyHead

Other Comments: Type 1 diabetes - using Tandem T-slim insulin pump, Dexcom G4 CGM

Sex: Female
Location: northern Illinois

Post: #3
RE: When is it a matter of concern?
I'm sorry but I don't have any software to be able to download my CPAP machine. I'm aware that the forum offers the software, but I'm not technically literate to be able to use it.

Thank you for the tip on sinus rinse. Is this something that I should be doing all the time and how many times a day is advisable. I just bought a new sinus rinse bottle today and will use it tonight before I go to bed. I do know that the fatigue I feel today feels just like before my diagnosis with sleep apnea.
09-08-2013 04:46 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #4
RE: When is it a matter of concern?
(09-08-2013 04:46 PM)GrammaBear Wrote:  Thank you for the tip on sinus rinse. Is this something that I should be doing all the time and how many times a day is advisable.

Once you get used to using it, you can pretty much do it whenever you feel like you need it. I go months without using mine, but then if I get a cold or congestion from allergies I'll do it once a day, or sometimes more.

When I have a really bad cold I'll do it three or four times in one day, if I'm home.

Sleepster
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www.ApneaBoard.com


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.
09-08-2013 05:04 PM
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alby_c Offline

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Machine: resmed s9 autoset
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Location: Brisbane, Australia

Post: #5
RE: When is it a matter of concern?
I have been doing sinus rinses a long time. Use it at least twice a day, but then I have had sinus issues long term.
I try to use it at least 2 hours before bed time as it can increase post nasal drip, and clearing that with a mask is unpleasant. you want your sinuses to fully settle down before you mask up.

When its hay fever time I try to rinse at least 3 times a day and if I pick up an infection as often as I remember. There is good advice on other boards but, if you want to stop buying the outrageously price sachets for the rinse bottle and make your own, its not hard. I get rock salt - so there is no iodine, or anti-caking agent which most powdered salt has, but if you can find pure powdered salt get that. I then grind it fine in a mortar and pestle and sieve it through a tea strainer. then you mix in a small amount of baking soda (again - get a brand without any anti caking additives etc) roughly one teaspoon to every quarter cup of salt powder - put it in an airtight container and mix thoroughly. About a quarter of a teaspoon of this in a 250ml bottle is enough. (it burns of you have too much, and stings with too little but with the right amount it is neutral- should feel like the sachets do for you at least )
Use filtered or distilled water - tap water can have bad things in it for noses. Warm the water to about blood temp - I do 20 seconds in the microwave of filtered water.
and you are good to go.

As far as software - if you have a friend with a computer literate child/grandchild handy - bribe him with chocolate cake or whatever delights him to read your card for you and print the graphs at least a few times. The information is revealing.
09-08-2013 05:54 PM
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me50 Offline

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Post: #6
RE: When is it a matter of concern?
(09-08-2013 04:13 PM)zonk Wrote:  Whats the breakdown of AHI (AI, HI, CAI) and any changes to 95% pressure/leak rate

At times when feeling stuffy, you can use full face mask and doing the sinus rinse is good too

I use a nasal spray 2 times per day when I feel it is needed. My humidifier I keep at 80. Right now, my nose feels dry on the inside and I will use Ayr for the nose. Hope this helps.

what does this tell me please?

median leak o.o
95% 0.0
maximum 33.0

apnea index 0.6
obstructive 0.5
hypopnea 1.0
AHI 1.6
09-08-2013 06:18 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #7
RE: When is it a matter of concern?
(09-08-2013 06:18 PM)me50 Wrote:  what does this tell me please?

median leak o.o
95% 0.0
maximum 33.0

apnea index 0.6
obstructive 0.5
hypopnea 1.0
AHI 1.6

It tells you that, for the most part, your therapy is very effective. Excellent, in fact. We like to see the AHI below 5.

Your leak rates are excellent most of the time, but on occasion are rising above the recommended maximum of 24 L/min. 95% of the time your leak rate is zero, so the other 5% of the time you do have a leak rate that sometimes rises as high as 33 L/min.

apnea index 0.6 + obstructive 0.5 + hypopnea 1.0 + unknown apneas = AHI 1.6.

The unknown apnea index is 0.5, so you are having, on average, 0.5 unknown events per hour. In other words one every two hours, on average. This would not be a concern but I suspect these unknown events are occurring when your leak rate is too high (above 24 L/min).

I suspect your mask is slipping off at times when you're asleep.

It could be that this will fix itself as you get used to the mask, or it may be that you need to try a different mask that fits better.

Time will tell, but for now I wouldn't be concerned about it. Just keep an eye on it and see if the leak rate gets better or worse.

Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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.
09-08-2013 06:48 PM
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me50 Offline

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Machine: resmed S9 VPAP Auto
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Post: #8
RE: When is it a matter of concern?
(09-08-2013 06:48 PM)Sleepster Wrote:  
(09-08-2013 06:18 PM)me50 Wrote:  what does this tell me please?

median leak o.o
95% 0.0
maximum 33.0

apnea index 0.6
obstructive 0.5
hypopnea 1.0
AHI 1.6

It tells you that, for the most part, your therapy is very effective. Excellent, in fact. We like to see the AHI below 5.

Your leak rates are excellent most of the time, but on occasion are rising above the recommended maximum of 24 L/min. 95% of the time your leak rate is zero, so the other 5% of the time you do have a leak rate that sometimes rises as high as 33 L/min.

Thank you!! I haven't had a lot of success with the "old" respiratory therapist helping me. I have a "new" DME and therapist I will see next Tuesday and hopefully much more helpful! I haven't mastered the REsScan information yet so needed some guidance and I knew I would get it here!! I use my CPAP faithfully, even when I take a nap. I just need to figure out how to keep from waking up every 2 hours now! This tells me if it ain't broke, don't fix it so I will stick with the mask I am currently using and hoping that by getting the auto set CPAP that will make my numbers even better! I will not accept the Resmed Escape as I have been warned about that! Thank you so much for taking the time to help me
09-08-2013 06:59 PM
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vsheline Offline

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Post: #9
RE: When is it a matter of concern?
(09-08-2013 06:48 PM)Sleepster Wrote:  
(09-08-2013 06:18 PM)me50 Wrote:  what does this tell me please?

median leak o.o
95% 0.0
maximum 33.0

apnea index 0.6
obstructive 0.5
hypopnea 1.0
AHI 1.6

...
apnea index 0.6 + obstructive 0.5 + hypopnea 1.0 + unknown apneas = AHI 1.6.

Hi Sleepster,

I think the equations would be as follows:

(total) Apnea Index 0.6 + Hypopnea Index 1.0 = AHI 1.6

(total) Apnea Index 0.6 = Obstructive Apnea Index 0.5 + Central Apnea Index + Unknown-type Apnea Index

Solving for the sum of Central Apnea Index + Unknown-type Apnea Index:

Central Apnea Index + Unknown-type Apnea Index = total Apnea Index 0.6 - Obstructive Apnea Index 0.5 = 0.1

So, if we presume the Unknown-type Apnea Index is zero (me50 didn't say what it was) then the Central Apnea Index would be 0.1

Unknown-type Apnea events are defined as apneas occurring when our leak rate is too high (typically well above 24 L/min, I think, like perhaps above 30 L/min) for the machine to tell whether they are obstructive or central. I think these unknown-type apnea events are not included in the Obstructive Apnea Index nor in the Central Apnea Index but are included in the total Apnea Index.

Take care,
--- Vaughn

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. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
09-08-2013 07:48 PM
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Sleepster Offline
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Posts: 4,995
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Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #10
RE: When is it a matter of concern?
(09-08-2013 07:48 PM)vsheline Wrote:  (total) Apnea Index 0.6 + Hypopnea Index 1.0 = AHI 1.6

Of course, you're right. I've been outside working in the hot weather too much. I can't even add!

And you're right about the CA index being 0.1.

That unkown apnea thing that somebody mentioned the other day was stuck in my brain. I'd never heard of it before.

Sleepster
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www.ApneaBoard.com


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.
09-08-2013 07:51 PM
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