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New Guy! High AHI - Printable Version

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New Guy! High AHI - dahornor - 08-12-2019

Hi, Y'all,

I'm new at this (one week in), and would like some advice, please.  I did an at home sleep study and my AHI was 34.  I've also been dealing with AFib for 20+ years.  Mostly (not not always) the AFib is controlled with Flecainide. 

Anyway, after the first couple of nights I got the hang of using the full-face makes (ResMed F20) and I've got very good mask seal, usage hours, and rarely remove my mask. Typical myAir score is 95+

But the best AHI I've seen is 10; usually it's more like 15-17.

Your thoughts greatly appreciated! 

Thanks


RE: New Guy! High AHI - bonjour - 08-12-2019

Welcome

We do our best work with data.  What we recommend will depend on the specific events that are occurring, when they are occurring, the pressures they occur at, how closely they are together, how are they related to Flow Limits, Snores, and pressure increases.  Centrals are avoided with the exact opposite actions taken to manage obstructive events.

Download OSCAR and post a set of daily charts (see the organize link in my signature.)  That will give us enough info to get you started.

Read the Mask Primer (my signature) and find the manufactures video for fitting your model of mask, these videos contain good hints.


RE: New Guy! High AHI - Melman - 08-12-2019

It sounds like you off to a better start than most with respect to comfort and compliance. Its hard to advise you without more data. Please download free OSCAR software from the link at the top of the page and post a daily chart per the instructions in the links below. Please follow the instructions for how to format and organize your chart so we willl have the most useful data. Also, see this link for how to access the clinical settings https://www.apneaboard.com/resmed-airsense-10-aircurve-10-setup-info
One immediate change I recommend is that you increase the minimum pressure to 6. Most feel starved for air at 4 and your machine can respond more quickly to apnea events from a slightly higher pressure. We may recommend other setting changes once we see your data.


RE: New Guy! High AHI - dahornor - 08-12-2019

Thank you, Mr. Bonjour.  And may I say to all, bonne nuit! I will working on getting OSCAR going. 

Thanks

Thanks


RE: New Guy! High AHI - dahornor - 08-14-2019

[attachment=14452]

Here you go.  My first effort at this.  Hope it worked ok.

Thanks!


RE: New Guy! High AHI - bonjour - 08-14-2019

Great job,. Now your charts call for an expanded close up view of 10 minutes during the CSR segment. Click in the middle of the CSR until only 10 minutes is showing. Post that view

We need to see if that is actually CSR or just periodic breathing. Your heart history calls for this check

Also post your original sleep study and your titration study, the full study with the charts and tables, not just the summaries.

All this data may, or may not indicate that you need a different device and will help structure you will likely be having with your doctor.

For tonight
Set max pressure to 8 and
Set EPR to 0

Both of these should help reduce your Central apnea.


RE: New Guy! High AHI - dahornor - 08-14-2019

Thanks!  Will do.  I never had a titration study.  Scheduled to see the sleep doc early next week.   I'll work on zooming in and changing those setting per you suggestions.

DH


RE: New Guy! High AHI - dahornor - 08-14-2019

[attachment=14491]10 Minute of CSR


RE: New Guy! High AHI - dahornor - 08-14-2019

[attachment=14492 Wrote:dahornor pid='306967' dateline='1565835223']10 Minute of CSR



RE: New Guy! High AHI - bonjour - 08-14-2019

That has some sets that are typical CSR and some that are not. Same thing but 1:00 am to 1:10 am please, that is a denser bunch of CAs. It is not a steady stream of classic CSR which typically means you have a heart condition with CHF being common. Classic CSR is nearly sinusoidal in waveform and is very distinct.

Is this typical of what you have been seeing as far as Centrals and Obstructive events with some variation of course. And could you show the full view of the previous night?
If it is similar I'm going to ask you to set your EPR=0 then show tonights chart, looking to see a significant drop in Central Apnea.

thanks