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AHI suddenly going back up?
#1
AHI suddenly going back up?
Hi! I started APAP about a month ago, I’m diagnosed with obstructive sleep apnea even though I had more centrals than obstructive events per my sleep study. I asked why I wasn’t trying ASV and my doctor said that APAP could very well solve the centrals and I’m pretty sure it has to do with insurance reasons as well. I have a follow up with an actual specialist next month for a second opinion. 

Meanwhile, I have actually had some success. I’ve adjusted to the APAP just fine, I use a full face masks and no leaks. My apneas steadily went down from 26 to as low as 4. I was sleeping through the night for the first time in years, maybe a slight improvement in my very low energy. 

Then after the new year my numbers started going back up again and now I’m at a 13. Back to waking up a lot at night, more tired and my occasional RLS has come back.

I just wanted to see if anyone has experienced this. Like I said, I have a follow up in a month or so and maybe they will change my machine or settings, but I just thought it was weird that I went down steadily and then back up. 

The only thing that has changed is that I stopped smoking medical cannabis (a pretty light user). I doubt it’s related but who knows. Thanks!
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#2
RE: AHI suddenly going back up?
The only way we can help is seeing data. We get data with Oscar, a free download at the top of the site. You need a SD card (2 to 32 gb) in the machine while you sleep. 

See the link I have in my signature having to do with charts - it also gives som information on Oscar.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: AHI suddenly going back up?
Hi Catherine,
Can you clarify what machine you are using?

Your profile states: ResMed iBreeze auto.

There is a Resvent iBreeze auto and there is a ResMed AutoSet.
However, there is no ResMed iBreeze auto.
OpalRose
Apnea Board Administrator
www.apneaboard.com

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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.
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#4
RE: AHI suddenly going back up?
Resvent, thanks, I’ll change it!
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#5
RE: AHI suddenly going back up?
Catherine, do you have a breakdown of your AHI an types of event? We have discussed before the Resvent is a poor choice for providing useful data and it would be nice if somehow you can move to a better machine like Resmed Autoset. If your AHI has reached 13 that is very high for a treated person and you are not getting a level of therapy considered efficacious, so there may be a medical necessity argument for changing the therapy. If that is 13 events then that is another matter. If you know you are experiencing obstructive events, then increasing your minimum pressure would be an important tool to improve results. You can try gradually increasing minimum pressure and see if that corresponds to a reduction in event rate.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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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.
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#6
RE: AHI suddenly going back up?
My 2¢

If you're going to treat Central Apnea, it should be with a better known brand, in this case ResMed AirCurve 10 ASV. Nothing else comes close, except the foamgate tainted Philips Respironics SV Auto, which I can't recommend.

Get your DETAILED diagnostic report and post it here redacted of personal info.

To be ready for the ASV fight, begin a sleep diary that includes all the symptoms and complaints about your current therapy. Fatigue, headaches, not well rested, untreated events, and so on. Be aware that insurance will attempt to dictate CPAP failure, BPAP without backup breath rate failure, ST failure, then to ASV, likely with another Titration for each. So if you need ASV, practice long and loud complaints to Dr. McQuack's office.

IF this plays like I'm guessing, if you get to BPAP and ST they will be pretty TERRIBLE.

This is supposing for now. Let's see the event count and type from the test.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: AHI suddenly going back up?
Hi and Welcome Another central apnea person here.

As the others have said, we really need to see the data (or at least what percentage of events are central). The trouble with central events is that they are consistently inconsistent. I, too was put onto CPAP primarily to see if it would help my centrals (i literally had 5 I think obstructive events over the entire study, versus 80+ central per hour). It does, to a degree - from an AHI of 80+ to between 20 and 60, averaging in the mid-30s. But that's the thing. One night it can be as low as an AHI of 10 or 12 and maybe stay there a few days, then boom, back up to an AHI of 45 or 50. Nothing changing. no different meds, nothing. Adding in oxygen lowered them a little more, averaging an AHI of 15 but varying between 7 and 35. And tonight, I am going to start on ASV because after 11 months of trials and waiting and failing, that's pretty standard for centrals.

I guess that if you smoke the cannabis, then cutting down might result in better ventilation, and that might worsen your centrals potentially, but again, without seeing the data, it could just be the normal variability of centrals.

That said, I hope that you can ask your doctor to get you onto ASV - and definitely ask for the Resmed Aircurve Pacewave if you can.
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#8
RE: AHI suddenly going back up?
I was told by someone on here that OSCAR wouldn’t be compatible with my machine. I actually have my memory card in an envelope ready to send back to the medical supply stuff so that they can look at my data, but I’ll go ahead and try to copy the data from that before I send it back and just try it with OSCAR.
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#9
RE: AHI suddenly going back up?
Okay yes, I’m still on the Resvent, I’m under the impression that it won’t work with OSCAR? I’ll try. I’m going to ask for a different machine at my follow up appointment. I’m taking notes….I haven’t met this specialist, so I don’t know what he’s like. I’ve found that a lot of (bad) doctors don’t like when you educate yourself and form opinions about your own treatment. So I know I’m going to have to be strong going into this.

Oh god, I hope it doesn’t take me 11 months. This process is just ridiculous. I’m going to try to get my data loaded later today. Good luck with your treatment.
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#10
RE: AHI suddenly going back up?
Oscar does not support the Resvent machine and will not be able to import the data. You may want to copy your data and have a second SD card in order not to lose the data by sending it to your medical supply staff. The real solution is to get a better machine. This link shows you what kind of data your supplier can see with the Resvent Cloud software. It is very basic and not useful in diagnostics. Pay attention to the text on the left side of the page describing the software. If this lack of skill in English is representative of the software, you get an idea what you are up against with this Chinese import http://www.resvent.com/en/product/341.html
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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