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apnea vs hypopnea
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KSMatthew Online

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Machine: PR DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
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CPAP Pressure: 7
CPAP Software: SleepyHead

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Sex: Male
Location: Kansas, United States

Post: #1
apnea vs hypopnea
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.
10-06-2016 07:45 PM
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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: apnea vs hypopnea
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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10-06-2016 08:22 PM
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KSMatthew Online

Advisory Members

Posts: 180
Joined: Jul 2016

Machine: PR DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: none
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Kansas, United States

Post: #3
RE: apnea vs hypopnea
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.
10-06-2016 08:34 PM
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Sleeprider Online
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Advisory Members

Posts: 3,388
Joined: Dec 2014

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: #4
RE: apnea vs hypopnea
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

______________________________________________
Organize your SleepyHead Data
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(This post was last modified: 10-06-2016 09:36 PM by Sleeprider.)
10-06-2016 09:35 PM
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KSMatthew Online

Advisory Members

Posts: 180
Joined: Jul 2016

Machine: PR DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: none
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Kansas, United States

Post: #5
RE: apnea vs hypopnea
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.
10-07-2016 12:55 PM
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justMongo Offline

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Machine: ResMed VPAP Auto (S9)
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Post: #6
RE: apnea vs hypopnea
(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.
(This post was last modified: 10-07-2016 02:30 PM by justMongo.)
10-07-2016 02:30 PM
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KSMatthew Online

Advisory Members

Posts: 180
Joined: Jul 2016

Machine: PR DreamStation Auto
Mask Type: Nasal pillows
Mask Make & Model: ResMed Swift FX
Humidifier: none
CPAP Pressure: 7
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: Kansas, United States

Post: #7
RE: apnea vs hypopnea
(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?
10-07-2016 04:07 PM
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justMongo Offline

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Posts: 3,853
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Machine: ResMed VPAP Auto (S9)
Mask Type: Full face mask
Mask Make & Model: ResMed Mirage Quattro
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CPAP Pressure: 18 IPAPmax - 11 EPAPmin, PS=5
CPAP Software: Other Software

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Sex: Male
Location: Калифорния

Post: #8
RE: apnea vs hypopnea
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.
10-07-2016 04:30 PM
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EnigmaGrey Offline

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Posts: 23
Joined: Oct 2016

Machine: Respironics DSX500T11
Mask Type: Nasal pillows
Mask Make & Model: Respironics Nuance Gel
Humidifier: DSXH
CPAP Pressure: 6-16
CPAP Software: SleepyHead

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Sex: Male
Location: Canada

Post: #9
RE: apnea vs hypopnea
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.)
(This post was last modified: 10-07-2016 04:58 PM by EnigmaGrey.)
10-07-2016 04:57 PM
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OpalRose Offline

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Machine: PR System One REMstar Auto 560 with A Flex
Mask Type: Nasal pillows
Mask Make & Model: AirFit P10 For Her
Humidifier: REMStar heated humidifier with heated hose
CPAP Pressure: Auto Cpap 10-13 AFLEX 1
CPAP Software: SleepyHead EncoreBasic

Other Comments: Started CPAP Therapy October 23, 2014

Sex: Female
Location: Northeast Ohio, USA

Post: #10
RE: apnea vs hypopnea
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.

OpalRose
10-07-2016 05:30 PM
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