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apnea vs hypopnea
#1
I've been on CPAP for around a dozen years at a constant 7 cm.

I generally averaged <1 AHI.

About 3 months ago I swapped out my DeVilbiss and moved to a PR Dreamstation. My last set of data from me DeVilbiss showed a bump from around 1.5 AHI to 4.something. My results with the Dreamstation are similar.

I wasn't able to get a breakdown from my Devilbiss data like I am from my Dreamstation, so i don't know how much of the AHI was A and how much was H.

My Dreamstation data has been showing that my apneas are usually <1, and my hypopneas have actually been creeping up over the last 3 months.

What's the real difference between the two, and is there something that causes a rise in hypopneas with age? Seasonal issues? Physical issues? I haven't gained any weight recently, and healthwise not much has changed. I do know that I've had some pollen sensitivity and that might be playing a role.

Yesterday I switched from fixed 7 cm to auto 7-9 and will see what happens over the next month or so.
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#2
Keep us posted how the new settings go. The type of events also is important, and without the data, it's not possible to speculate why events have increased. Each machine senses and records events a bit differently, so it's not unusual to see more hypopneas with a Respironics machine than some other brands.
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#3
my last 6 month averages (the lifetime of the data on the PR machine)"

AHI = 3.35
Obstructive Index = 0.24
Hypopnea Index = 3.06

If I can figure out how to add an image, I'll past what my AHI graph looks like. I have nearly all hypopneas. I thought it night be just the way the PR calculates them vs the way my old Devilbiss calculated them, but I looked back at a report I made just before I switched over and it showed the last night at around 4.x AHI. That 4.x AHI was much higher than the 1.x that I used to get.
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#4
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur
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#5
Thanks, I might be able to figure it out from that.

Hypopnea - my understanding is that it's more of a period of shallow breathing vs an obstruction (apnea). Or is it shallow breaths caused by a partial obstruction? Or both?

I looked at my graphs more closely last night. It does appear that my apneas are actually very low, but I have a lot of hypopneas. If it's a partial obstruction, then a pressure change might help? But if it's shallow breathing, how does CPAP or APAP fix that?

I first thought that the new machine was just recording events differently than my old machine. But I did find one report of one day on my old machine that showed a higher than average AHI, and ever since on my new machine I've been seeing similar results. It's almost as if something happened one day and has been with me ever since.

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#6
(10-07-2016, 12:55 PM)KSMatthew Wrote: But if it's shallow breathing, how does CPAP or APAP fix that?

Hypopnea is a decrease in flow by more than X% for more than Y seconds. It can be obstructive or central in nature.

We naturally vary our "depth" of breathing as we are in the various phases of sleep.

If you wish to consider just the question: "...if it's shallow breathing, how does CPAP or APAP fix that?" Then that can be increased by increasing the Tidal Volume (TV). A larger split between IPAP and EPAP will generally increase TV. Some people are put on bilevel to achieve a greater split. Although that's not the only reason for bilevel.



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.
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#7
(10-07-2016, 02:30 PM)justMongo Wrote:
(10-07-2016, 12:55 PM)KSMatthew Wrote: But if it's shallow breathing, how does CPAP or APAP fix that?

Hypopnea is a decrease in flow by more than X% for more than Y seconds. It can be obstructive or central in nature.

We naturally vary our "depth" of breathing as we are in the various phases of sleep.

If you wish to consider just the question: "...if it's shallow breathing, how does CPAP or APAP fix that?" Then that can be increased by increasing the Tidal Volume (TV). A larger split between IPAP and EPAP will generally increase TV. Some people are put on bilevel to achieve a greater split. Although that's not the only reason for bilevel.

Bi-level = 2 different pressures, one for inhale, one for exhale?

And "Flex" settings also make an adjustment on the exhale, but it's not necessarily a fixed pressure, it's more of a decrease in whatever the inhale pressure happens to be at the time?
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#8
Flex is a Phillips-Respironics term. Their Flex is similar to ResMeds EPR -- but, they work differently.
Bilevel is indeed one pressure for inhale and a (lower) pressure for exhale. To a degree this can be accomplished with EPR or Flex; but the splits are not as wide.

For example, my IPAP - EPAP is 5 cm-water.
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.
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#9
If the hyponpea is obstructive in nature, CPAP assists the airway in remaining open fully, similar to how it assists with obstructive apneas. It also increases tidal volume by pressuring the air you breathe and ensuring a large amount is available, despite the shallow breathing.

AFlex provides some IPAP and EPAP relief. It uses a different algorithm to match up with your breathing than CFlex.

CFlex provides only EPAP relief.

Both Flex options provide a range of 0.5 - 2.0 cm (a setting of 1 - 3), it seems.

Bi-pap is typically used for those that require a higher theraputic pressure than 16. It provides a greater variation in pressure than AFlex and CFlex. It uses a different algorithm to encourage more regular breathing.

Dsm provides a good break down between A-Flex and C-Flex here: http://www. [[ Auto Word Filter: links to DME-owned sites not allowed ]] .com/viewtopic/t23652/APAP-with-Aflex-vs-BiPAP.html#wra

(Apologies if any of this is inaccurate, I'm kind of new at it and shouldn't be sticking my nose in it. Ninja'd.)
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#10
Flex settings 1, 2, and 3. for PR machines
You can receive up to 2cm pressure relief, but is flow based.
• C-Flex – Provides pressure relief upon exhalation.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation.

From the Wiki: see top of page.
Apnea - Cessation of breathing for 10 or more seconds during sleep. There are two basic types of sleep apnea: Obstructive Apnea is caused by a closure of the air passage despite efforts to breathe; Central Apnea is a lack of effort to breathe. Obstructive Sleep Apnea is by far the most common type. True apnea during wakefulness is extremely rare.

Hypopnea - An episode of diminished breathing during sleep, caused by a partial airway obstruction, and resulting in arousal. Usually accompanied by oxygen desaturation. Hypopneas may be just as serious as apneas and have the same troublesome effects.
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