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+--- Thread: Different AHI depending on the XPAP ..? (/Thread-Different-AHI-depending-on-the-XPAP)
Different AHI depending on the XPAP ..? - DS123 - 08-28-2018
HI everyone, I recently purchased a bipap because I can't stand my titrated CPAP pressure b/c of aerophagia.
Realized on the new machine that my AHI is higher (around 1-2 higher) than on the old machine even at the exact same settings (CPAP). Both are phillips, just the dreamstation is obviously a newer machine than the remstar. Anyone know why the AHI could be different one same settings ?
That's my question. But on a side note, realizing after six months bipap settings, that straight cpap may be better for me. Noticed that using CPAP without c-flex gives me better results than any bipap settings, and better than CPAP with flex.
RE: Different AHI depending on the XPAP ..? - Sleeprider - 08-28-2018
If you could post a comparison and define what events are showing higher with BiPAP then we could offer a better guess. I think CPAP mode kind of defeats your objective here, and getting into one of the BPAP modes will ultimately work out. For many people changing machines, an initially higher CA or H event rate should not be too alarming. I'm not a big fan of Flex comfort settings either, and it's pretty common to see higher event rates with Flex on, especially at higher settings. Everyone seems to respond a bit differently, so while some people like Flex (Cflex, Aflex Biflex) others find it disruptive.
RE: Different AHI depending on the XPAP ..? - DS123 - 08-29-2018
Thanks Sleeprider. Posting two pics -- the old machine, remstar, is the one with the lower AHI -- those were typical numbers then, b/w 0.5-1.5. Just realizing the pressure on the old one was 7 in that picture, but usually had it at 7.5 with c-flex+ at 2.
Second pic is with the new dreamstation. Not too nice, and typical AHI -- 2-3 -- also, the new machine seems to report VS2 snores a lot more than the old one. I'm a bit stumped.
Problem w bipap is I can get a higher ipap but only w a lower epap which messes up my night.
Oh btw the second/new setting is the same, cflex+ at 2.
RE: Different AHI depending on the XPAP ..? - Sleeprider - 08-29-2018
The pressure and settings at least seem identical. Your pressure chart (y-axis) does not include a range high enough to show IPAP pressure. You can over-ride the y-axis and set it to the range you want to show (4.0 to 10.0) by right clicking where the title "Pressure" is located, and then formatting the y-axis with override instead of auto and selecting the range you want.
Based on what I'm seeing here, make sure the mask setting is the same. You have an auto BiPAP and as you know are using it in CPAP mode. I think we can eliminate the hypopnea and snores with pressure support, but I don't know if you have a sensitivity that would increase CA. If you tolerate bilevel pressure, I'm going to suggest 9.0/6.0 in S-mode or EPAP min 6.0, EPAP max 8.0 and PS min 3.0 PS max 3.5 in Auto-B mode. Either approach will provide PS of 3, and should help a lot with the events we are seeing.
RE: Different AHI depending on the XPAP ..? - DS123 - 08-29-2018
Oh yes, the resistance control setting was on X1 for the old machine and it's off for the new one. Never did figure that one out though..
I have a resmed quattro air. Any idea what the right setting for that would be ? Can't find online..
Tried the BIPAP settings you're recommending for a while previously -- AHI was still much higher than fixed CPAP. I could try increasing the PS more and going up with IPAP more (~10), as I haven't tried that.
RE: Different AHI depending on the XPAP ..? - Sleeprider - 08-29-2018
What bilevel settings did you try, and what events were higher?
All full-face masks are X1 in Philips. They usually advise turning Resistance off for non-Philips products, but X1 is correct for your mask.