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moderate AHI wiht severe desaturation.
#1
Sad 
I used to develop a chronic fatigue since i was young.
My BMI range 21-22.5 all the time.
Untill last year, I am too tired and felt dizzy to live a normal life and work.Brain fog is heavy and black.

I got 3 PSG test in a row.....looked for many Drs and Hospitals.

Before PSG, my physical exam is fine, blood test is normal.
Some ENT Dr, even said I am OK from my mouth and nose.
Many people, even many Drs, just tought that I had depression, even I expressed I have no any unbearable pressure ,or any terrible ideas in my mind, but just tired and fatigue.

Drs gave me some pills, of course it not worked at all.
I have no sleepless night, eat great, normal constant weight BMI 21- 22.5. No alcohol, cigarette.When I felt tired , sleepy, dizzy, my brain was nothing there but like to rest.

Finally, PSG showed
AHI=28, lowest SpO2=52, optimal pressure 10 cm.
Having used S10 for about 6 monthes.
But I never got rest since the first day I used S10 with a normal AHI <5.
Sometime even worst, sleepy and fatigue all day long.

Drs told me I have a big tongue, MMP grade III, very narrow PAS 5mm, long soft plate, tonsil is OK.a little jaw receding (X-ray films)

Drs can not answer me why a moderate AHI with a severe saturation, and why a normal S10 AHI <5 does not make me have a normal sleep.


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#2
That is a remarkably low SpO2 during your PSG, and the AHI is moderate. It might be interesting to use a pulse-oximeter sensor to see how well ventilated you are with CPAP therapy. Also, I think you need to see some data that goes beyond AHI to see if your sleep is "optimized" at 10 cmH2O pressure.

What machine do you have? It appears to be a Resmed Airsense 10, but it would help if you specified CPAP, Elite or Autoset. The CPAP will not give you useful data. If it is one of the other machines, you can download and use Sleepyhead to see things like leaks, snores, flow limitations, tidal volume and get some insights into the AHI events. http://www.sleepfiles.com/SH2/ Also, what mask are you using, and are you controlling leaks?

Welcome to the forums and best of luck in optimizing your therapy.
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#3
I would say that your AHI isn't super bad it's not good but I have seen much worse but you oxygen level is really scary. I would be asking my doctor about adding oxygen to the cpap at night. I would also get sleepy head if your machine is data capable. That will give you an idea of what is going on at night with your therapy. Hang in there it will get better it will just take some info and some tweaking with hardware.
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#4
Hi whshy,
WELCOME! to the forum.!
Much success to you with getting your health problems straightened out.
Hang in there for more responses to your post.
trish6hundred
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#5
Hi Whshy,

The advice you are getting here is good.
You need to get back on the machine though because in the long run that will save your life
and the machine needs to be optimized for you. (which it sounds like the docs dropped the ball here)
If the machine is set up in a sloppy way it may do you a *disservice* because:
1. It wont help you has much as it could.
2. You stop using it because of reason #1.

So...

#1 priority:
What *model* S10 is it?

We need to know that in order to figure out if you need a more capable machine to suit your needs.

Wink
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#6
(08-09-2015, 07:34 AM)Shastzi Wrote: Hi Whshy,

The advice you are getting here is good.
You need to get back on the machine though because in the long run that will save your life
and the machine needs to be optimized for you. (which it sounds like the docs dropped the ball here)
If the machine is set up in a sloppy way it may do you a *disservice* because:
1. It wont help you has much as it could.
2. You stop using it because of reason #1.

So...

#1 priority:
What *model* S10 is it?

We need to know that in order to figure out if you need a more capable machine to suit your needs.

Wink

Wishy I gave the same fast desats you do when i have OAs. Down to 58_ 60 range. Only takes one long one to do it.
AHI doeznt tell the whole story. Under 5 doest get it done for me either. Under 5 means im averaging less than 5 events an hour. 4 events an hour will have O2 running about 75, because my O2 recovers slowly and I feel like crap.
I have to running a ahi of less than 2.to feel much better and 1 or less to feel really good.
Getting to 1 or under is quite doable. Just need to get sleepyhead or other sofware , track what is going on and tweak your pressures to get your Ahi to 1 or less.
I know most folks feel and do fine at ahi of 3 4 etc.
For a few of us those numbers dont get it done.
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#7
(08-08-2015, 11:25 AM)whshy Wrote: Drs can not answer me why a moderate AHI with a severe saturation

The AHI is only a measure of event frequency -- how many apnea events per hour on average. It does not take into account the duration (length) of those events. So you could even have an AHI in the mild category but still have deep desaturations if those events last a long time.

Quote: and why a normal S10 AHI <5 does not make me have a normal sleep.

Do you know for sure that your AHI is <5 when you use your machine? Are you looking at the data recorded by your machine? Which AirSense 10 model do you have -- Autoset, Elite, CPAP, other....? The model name is on the front of the machine, bottom right.

Also, some people do not really feel good and rested until their AHI is well below 5. Sensitive folks can feel the difference between AHI of 3 or 4, and an AHI that stays closer to 1.00.

And sometimes it can take a while to start feeling improvement -- how long have you been using the machine?
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#8
Thank you for all great suggestion and ideas.

I rechecked what in my airsense 10 SD card.
ResScan does show something I though that might be interesting.
Since optimal CPAP pressure 10 was titirated by PSG report, Dr's prescription is 12 for APAP.(Before I accepted SMR +RF turbinate reduction)

AHI number almost around 3.X~5.X on average, no matter what max pressure I set in APAP mode ( set Max to 13, or 16 )

For one of my typical nights.

OI 2.8 + CI 1.2 + HI 0.2 =4.2
Leak 95th 2.4 Maxi 6.0
Pressure Medi 8.6 95th 10.2 Maxi 11.0

Apnea duriation still up to 20, 30,50 even near 60 seconds.(central apnea almost about 1x seconds)
midnight awake one or two times, not many.

Dr and I think central apnea might be misreading.
Cause I got "0" AHI when CPAP pressure is 10 in sleep lab, and AI did decrease when S10 pressure goes up.
As I've known, CI is nothing about CPAP pressure.

It is weird, cause AHI seems not possible to go down less 2.X or 1.X.

I had SMR + RF turbinate reduction for reducing nasal resistance 3 months ago.
Dr told that will decease CPAP pressure,even septum deviation is slight, then It did reduce about 1 on average at first.
Now turbinate seems grow back.








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#9
Min pressure setting is more where you eliminate OAs. If you got 0 ahi at the lab try setting your min pressure at or very near 10.
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#10
(08-08-2015, 11:25 AM)whshy Wrote: I used to develop a chronic fatigue since i was young.
My BMI range 21-22.5 all the time.
Untill last year, I am too tired and felt dizzy to live a normal life and work.Brain fog is heavy and black.

I got 3 PSG test in a row.....looked for many Drs and Hospitals.

Before PSG, my physical exam is fine, blood test is normal.
Some ENT Dr, even said I am OK from my mouth and nose.
Many people, even many Drs, just tought that I had depression, even I expressed I have no any unbearable pressure ,or any terrible ideas in my mind, but just tired and fatigue.

Drs gave me some pills, of course it not worked at all.
I have no sleepless night, eat great, normal constant weight BMI 21- 22.5. No alcohol, cigarette.When I felt tired , sleepy, dizzy, my brain was nothing there but like to rest.

Finally, PSG showed
AHI=28, lowest SpO2=52, optimal pressure 10 cm.
Having used S10 for about 6 monthes.
But I never got rest since the first day I used S10 with a normal AHI <5.
Sometime even worst, sleepy and fatigue all day long.

Drs told me I have a big tongue, MMP grade III, very narrow PAS 5mm, long soft plate, tonsil is OK.a little jaw receding (X-ray films)

Drs can not answer me why a moderate AHI with a severe saturation, and why a normal S10 AHI <5 does not make me have a normal sleep.
I know this is an older thread but I was wondering how you are doing? Did your doctor figure out what to do for you? The more I think about it you may need an invasive type respirator instead of a CPAP machine. This is one that will do the breathing for you. Your desats are scary and I hope you are doing better.
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