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Sudden Increase in AHI Score
#1
Sudden Increase in AHI Score
I believe something has gone completely off the rails with my therapy. At the end of July, I had to ship my Aircurve 10 VAuto to be repaired. In the mean time, I had to use my Dreamstation 2 as a backup. The week leading up to when I shipped my Aircurve 10 VAuto to be repaired, my AHI averaged 1.1 with a low one night of 0.1, and for the last year I have averaged 1.0 on the Aircurve 10. Then I started using my Dreamstation 2 as a backup in which I averaged 5.8 over 9 nights. I had ordered a new Airsense 10 Autoset to become my new backup and started using it in which my AHI averaged 1.9 over 4 nights. I received my Aircurve 10 back and have averaged 4.8 over 10 nights. Last night I switched back to my Airsense 10 and my AHI was 6.47. Nothing has changed concerning my sleep (same mattress, pillow, sleeping position, same neck collar, sleep hygiene). This doesn't make sense. I have attached a screenshot of last night's sleep in which it shows positional apnea's, but I also had 15 Hypopnea's, 6 CA's, 1 RERA, 1 UA all of which is very uncommon for me. I hope someone might have some ideas to what might be happening with this sudden increase in events. I have always struggled with positional apneas, but as the 1.0 AHI average over 1 year shows, the Aircurve 10 has been able to keep them to a minimum. I would appreciate anyone's thoughts and suggestions to help me try to get this problem under control.

Thanks,
Mark


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#2
RE: Sudden Increase in AHI Score
You are having a lot of positional apnea.  Positional apnea can NOT be controlled by pressure changes.  You have to find out what position you are getting into and cutting off your own airway.  Have you changed your sleep position?  Sleeping on your back?  Using more (or new) pillows?  These things can cause positional apnea by chin dropping to your sternum and cutting your airway.  Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar.  I have a link to collars in my signature at the bottom of the page.  It shows people who are not wearing a collar and the SAME person wearing a collar.  There is a huge difference between the two.

The other thing I would do is to set your EPR to 3.
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: Sudden Increase in AHI Score
Please ignore ...
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#4
RE: Sudden Increase in AHI Score
Everything about my sleep is exactly the same, no changes. I start out sleeping on my side but sometimes wake up on my back. I know I have positional apneas and have worn a cervical collar for 3 years now. What I can't understand is why the day I shipped my Aircurve in for repair, starting that night my numbers have shot up drastically. And even though I have had a problem with positional apneas, my Aircurve has kept them to a minimum based on the fact my AHI has averaged 1.0 for over a year now and averaged 1.0 the week leading up to me shipping the machine off. But now my AHI is averaging 5.0. Does not make any sense. Thinking-about  My biggest problem has been mouth leaking and now that I have got the leaks lowered my AHI goes up. I suspected there could still be something wrong with the Aircurve after they fixed it. I reached out to the company that repaired it and they offered to have it picked up and they would re-test it. I switched to my Airsense 10 last night and my score was 6.47. So now I am wondering if something could be wrong with my body such as something has changed in my airway or something else. Of the almost 30 years of cpap therapy I have been through, this is the weirdest thing I have seen. I will probably use my Aircurve 10 tonight. Right now my settings are 11-15 cm with a PS of 2. Are those settings okay or should I try something different? I attached a screenshot on the Aircurve from 2 nights ago.

Thanks,
Mark


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#5
RE: Sudden Increase in AHI Score
The pattern shows a positional apnea.
Pressure likely will not correct it .
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#6
RE: Sudden Increase in AHI Score
Over the last few weeks I have been trying different things to get my positional apneas under control but to no success. I have tried 3 different brands of collars and have been using a shorter pillow. I have tried wearing the collars both lose and tight around my neck but nothing seems to help. Like I mentioned earlier, I have used a collar for the last three years and averaged a 1.0 AHI. But it is like something happened overnight that caused my AHI to drastically increase. Is there anything else that might could cause something like this to happen such as some kind of change in my airway? I have an appointment to see a sleep doctor this Wednesday.
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#7
RE: Sudden Increase in AHI Score
How about we confirm you are actually sleeping during these clusters. The fluctuations in tidal volume indicate you may be awake 3-minute zoomed views please.
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#8
RE: Sudden Increase in AHI Score
I have attached a chart of one of my most recent nights where I do remember being asleep during a cluster. Looking back at other nights sleep, the fluctuations of Tidal Volume all look about the same. What would a normal tidal volume amount be?


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#9
RE: Sudden Increase in AHI Score
A normal tidal volume pattern is in your fla[er sections of breathing.

Please describe your breathing in detail. Are you shifting from nasal inhale to oral exhale? If so why, what does that feel like?

Your zoomed view is showing a fairly normal inhale followed by a sharp spike exhale ending in a very flat even but reduced exhale.

This is very close to a palatal prolapse pattern.
https://www.apneaboard.com/wiki/index.ph...l_Prolapse
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#10
RE: Sudden Increase in AHI Score
I don't understand what you meant by shifting from nasal inhale to oral exhale?
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