Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

thoughts to control hypopnea
#1
thoughts to control hypopnea
hello have been on apnea treatment for 2 years, ahi ranges from 6 to 12. on review find that a large portion of the ahi is due to hypopnea, wonder thoughts of settings can be tweaked to help reduce ahi. attaching screen shot for typical session and settings.  i am a back sleeper using elevated back/bed position and flat pillow for most comfort. thanks for the review.


Attached Files Thumbnail(s)
   
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: thoughts to control hypopnea
I'm a newbie, so take what I say with a grain of salt, but maybe switching to a ResMed machine and using EPR=3 might help?
Post Reply Post Reply
#3
RE: thoughts to control hypopnea
Your charts show positional apnea. Positional apnea is when you cut off your own airway by the position that you sleep. Many times it happens to people sleeping on their back as you mentioned in your post. If you have to sleep on your back you may need a collar to keep your neck in place and not cause your apnea. 

Anytime your chin drops to your Sternum you are starting to cut off your airway. Please read the link about collars at the bottom of the post. It shows the same people (Oscar) with and without a collar. 

Positional apnea is easily to control if you wear a collar. How does Oscar show positional apnea? By closely grouped clusters of either or both H or O events. As you can see that is in your chart in the H row.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
Post Reply Post Reply
#4
RE: thoughts to control hypopnea
Hi Doug,

Your minimum pressure is too low at 4.  I would suggest you raise your minimum to 7 and see how that goes.  You might even need more as your 95% pressure is at almost 10.  Rule of thumb is about 2 cm lower than 95% pressure.  Also, you have ramp set to 30 minutes at 4 cm of water.  I suggest you turn ramp off and start your pressure at 7.  You might need more min pressure but let's see how it goes.  In my case, my hypopneas reduced considerably with a slight increase in min pressure using the Dreamstation.
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: thoughts to control hypopnea
The first thing I notice is that your machine is set to the factory limits of 4 to 20 cmH2O. This is never optimal, and especially so for the Dreamstation. I would suggest changing your minimum to within a centimetre or so of you median pressure of 8.3, perhaps increasing it by a centimetre a week to get there. The maximum can be brought down to 12 or 13, since you aren't going over 11 cmH2O.

The next thing I notice is that you are using A-Flex at 3. The Dreamstation has several varieties of flex, and I am not sure which one will work best for you. You should try each of them for a week each. I'm hoping a Dreamstation user will chime in here with their experience.

Finally, by way of editorial comment, I don't understand why somebody would recommend a different machine when you haven't really exhausted the capabilities of your current choice. A CPAP machine is too expensive to just toss it away.
Apnea Board Monitors are members who help oversee the smooth functioning of the Board. They are also members of the Advisory Committee which helps shape Apnea Board's rules & policies. Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
Post Reply Post Reply
#6
RE: thoughts to control hypopnea
ok thanks for the responses, i increased the min pressure to 7 and off the ramp and will look at increasing additional, did not have any issues falling asleep, noticed on the chart event around 6am with high occurrence of ca oa. i will stay the course for a few more evenings and see how i adjust.

also will work on the adjustments for controlling the positional sleep and look into the collar.  really hoping to work with my current equipment with adjustments to improve the apnea results.

2 screen shots attached one zooming in on the 6am event.  any additional advice is appreciated.


Attached Files Thumbnail(s)
   
Post Reply Post Reply
#7
RE: thoughts to control hypopnea
Your change of min pressure to 7 is good. It should help get you enough air. 

BUT your main problem is the positional apnea with both O and H events. There is NO pressure changes that can reduce positional apnea. You need to get a collar in my opinion. Again please read the link on collars at the bottom of the post.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: thoughts to control hypopnea
You may want to lower your max pressure to 12 cmw to avoid pressure-induced CAs.

Increasing the min pressure gradually is also a good idea.

FWIW, I was recently titrated from 8 cmw to 15 cmw and the titration showed consistent hypopneas that were not responsive to increases in pressure.  When I got home with a ResMed machine and set EPR = 3 the hypopneas magically disappeared.  I'm not suggesting tossing your existing equipment without trying to work with it first, but rather I'm just sharing something that helped me solve what might have been a similar problem.  Looking at the last hour and a half of your most recent night's sleep, you're still having hypopneas even at higher pressure, which makes me wonder whether treating your hypopneas might be better done through pressure support.  Others here more experienced than me might have an opinion on that issue?
Post Reply Post Reply
#9
RE: thoughts to control hypopnea
(06-09-2021, 11:05 AM)staceyburke Wrote: Your change of min pressure to 7 is good. It should help get you enough air. 

BUT your main problem is the positional apnea with both O and H events. There is NO pressure changes that can reduce positional apnea. You need to get a collar in my opinion. Again please read the link on collars at the bottom of the post.

staceyburke, yep thanks for the second review the charts do continue to show the clustering of events, there's a lot of good information in the collar link,  i am working towards getting the collar, thinking i will add it once i run the changes of pressure changes. one step at a time.
Post Reply Post Reply
#10
RE: thoughts to control hypopnea
(06-09-2021, 11:34 AM)notam2 Wrote: You may want to lower your max pressure to 12 cmw to avoid pressure-induced CAs.

Increasing the min pressure gradually is also a good idea.

FWIW, I was recently titrated from 8 cmw to 15 cmw and the titration showed consistent hypopneas that were not responsive to increases in pressure.  When I got home with a ResMed machine and set EPR = 3 the hypopneas magically disappeared.  I'm not suggesting tossing your existing equipment without trying to work with it first, but rather I'm just sharing something that helped me solve what might have been a similar problem.  Looking at the last hour and a half of your most recent night's sleep, you're still having hypopneas even at higher pressure, which makes me wonder whether treating your hypopneas might be better done through pressure support.  Others here more experienced than me might have an opinion on that issue?

notam2 thanks for the insight, i have had nights waking to having the pressure run-away into the higher range and experienced at that pressure i will start blowing it out the mouth and that's not helping, and now im understanding it has implications with pressure-induced CAs. ill lower that max in concert with increasing the min and see how the changes help my case.

also will keep the hardware issue on the "white board" its so encouraging to hear so many have found solutions to improve the apnea nights sleep.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  VS and VS2 popping up lately, any thoughts? Phaleronic 2 112 11-24-2021, 02:11 PM
Last Post: Gideon
  Full face mask thoughts? KSMatthew 57 1,592 11-21-2021, 11:38 PM
Last Post: KSMatthew
  Hypopnea events all night? herdisleah 3 143 11-19-2021, 03:18 PM
Last Post: Melman
  Unusally high Hypopnea cluster jaydee1445 8 187 11-08-2021, 08:34 PM
Last Post: staceyburke
  Climate Control, Tube Temp, and Humidity settings on ResMed AirSense 10 donwbc 6 1,148 10-25-2021, 12:23 PM
Last Post: Sleeprider
  Do FlowLimits/Hypopnea always disrupt sleep ? DaveCar 9 398 10-20-2021, 01:06 PM
Last Post: CorruptAlligator
  Your thoughts? Joe Bezz 22 597 10-07-2021, 08:39 AM
Last Post: Joe Bezz


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.