AHI Going Up With New BiPap Machine

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Stewart194
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Re: AHI Going Up With New BiPap Machine

Post by Stewart194 » Thu Jul 02, 2015 1:51 pm

Thanks for the reply kaisgram. Much appreciated. What I still don't understand is why my AHI was under 4 the first two nights with a leaky mask. As soon as I minimized the leaks it was 11,9,8,and 22. I would think that it would be the same or slightly better since the settings didn't change during that time.

Regardless, I will switch the settings tonight to the settings palerider recommended and see what happens.

Thanks again!

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kaiasgram
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Re: AHI Going Up With New BiPap Machine

Post by kaiasgram » Thu Jul 02, 2015 2:03 pm

Stewart194 wrote:Thanks for the reply kaisgram. Much appreciated. What I still don't understand is why my AHI was under 4 the first two nights with a leaky mask. As soon as I minimized the leaks it was 11,9,8,and 22. I would think that it would be the same or slightly better since the settings didn't change during that time.

Regardless, I will switch the settings tonight to the settings palerider recommended and see what happens.

Thanks again!
Couple of WAGs (wild ass guesses!) -- One guess is that when you fixed your mask leaks you were no longer losing therapy air, and with the full pressure being delivered you started throwing pressure-induced centrals.

Second guess is that fixing the mask leak was coincidental -- meaning that you were going to develop central apnea issues anyway. This can happen even when someone has had a good lab titration and a good first few weeks/months of therapy.

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Stewart194
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Re: AHI Going Up With New BiPap Machine

Post by Stewart194 » Thu Jul 02, 2015 2:16 pm

Interesting. The only other thing I can think of is that I'm trying to be a little healthier overall, and I just started cutting back on alcohol 4 days ago. Does that have any affect on sleep apnea? If it does, I figured that it would make it better, not worse. My current mask is butchering the bridge of my nose also, so having a few beers makes wearing that damn thing a little more tolerable. Then again, I didn't have any beers before either of my sleep studies, so maybe that is a moot point.

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kaiasgram
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Re: AHI Going Up With New BiPap Machine

Post by kaiasgram » Thu Jul 02, 2015 2:20 pm

Yeah, I would also expect alcohol to depress the respiratory system, not enhance it.

I can't tolerate stuff sitting on the bridge of my nose -- one night's use and I'm getting an angry red welt which if I continued would start tearing up the skin. Have you tried a nasal pillow mask yet?

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Stewart194
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Re: AHI Going Up With New BiPap Machine

Post by Stewart194 » Thu Jul 02, 2015 2:23 pm

I did during my first sleep study and I just couldn't breathe. I tried the nasal pillows and the type that completely covers your nose. They both lasted about 5 minutes at the most. The sleep tech thought I might have a deviated septum. BUT, I wasn't used to any masks or machines at that point. Maybe I should give that another shot?

Sleeprider
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Re: AHI Going Up With New BiPap Machine

Post by Sleeprider » Thu Jul 02, 2015 2:37 pm

It's counter intuitive, but I have posted some of my best AHI nights coinciding with some excessive intake of wine.

I like the advice Palerider made on the previous page. Pressure support can induce centrals in some people, and your previous success was with a PRS! Auto machine. It's not a bad idea to limit the pressure support to 2.0 and start with a minimum pressure of 12 in auto mode.

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palerider
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Re: AHI Going Up With New BiPap Machine

Post by palerider » Thu Jul 02, 2015 3:10 pm

Stewart194 wrote:BUT, I think I remember the sleep study people saying that I shouldn't mess with the settings on a BiLevel machine. Something about how they are a lot different than a CPAP or APAP and that I could possibly harm myself somehow if the settings weren't correct? Have you ever heard of that?
I've heard all sorts of FUD being spread about anything cpap related, like it's death if you do it slightly wrong.

I use the s9 version of the machine you have, and as far as I've been able to tell, they're identical in all settings....

now, if you do something crazy like setting a epap of 4 and a ps of 20, .... well, you'll hyperventilate the hell out of yourself, but I doubt you'll do it for very long.

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Krelvin
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Re: AHI Going Up With New BiPap Machine

Post by Krelvin » Thu Jul 02, 2015 4:34 pm

BTW, I looked at this thread later on a full computer and the charts resolution looked fine. On the phone when viewed using the gallery the resolution is unreadable. Using the link instead is fine.
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Stewart194
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Re: AHI Going Up With New BiPap Machine

Post by Stewart194 » Thu Jul 02, 2015 7:24 pm

Thanks again everyone. I really appreciate it. I'll change the settings right now and report back in the morning.

Thanks again!

Stewart194
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Re: AHI Going Up With New BiPap Machine

Post by Stewart194 » Fri Jul 03, 2015 6:52 am

Palerider -

I changed those settings and had an AHI of 1.92 last night. THANK YOU for recommending those settings.

Question...when I went in to change the settings, VAuto mode was already selected and Pressure Support was already at 2. You said my pressure support was at 4. Did you see that on my SleepyHead chart? I basically only changed my MinPap from 10 to 12 and my MaxPap from 14 to 25. Which setting do you think was the problem? I'm just trying to understand this better so that I can make the proper adjustments on my own in the future.

Thanks again! I did not expect to see this much improvement overnight.

Image

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palerider
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Re: AHI Going Up With New BiPap Machine

Post by palerider » Fri Jul 03, 2015 12:31 pm

Stewart194 wrote:Palerider -

I changed those settings and had an AHI of 1.92 last night. THANK YOU for recommending those settings.

Question...when I went in to change the settings, VAuto mode was already selected and Pressure Support was already at 2. You said my pressure support was at 4. Did you see that on my SleepyHead chart? I basically only changed my MinPap from 10 to 12 and my MaxPap from 14 to 25. Which setting do you think was the problem? I'm just trying to understand this better so that I can make the proper adjustments on my own in the future.

Thanks again! I did not expect to see this much improvement overnight.
well, honestly, I was trying to guess based on what was in the charts, since SH doesn't yet know how to read the pressure settings (the long crazy numbers at the top)... plus, you said the tech had said 14/10, which is a ps of 4, (14-10=4)

I think the biggest thing was that your min pressure wasn't enough, and that was causing all sorts of events, raising it to 12 gets you much closer to where you need to be.

I see that the machine is responding with pressure changes to your needs now, and that's great, that's what it's supposed to be doing.

next thing is to work on those leaks

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Stewart194
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Re: AHI Going Up With New BiPap Machine

Post by Stewart194 » Fri Jul 03, 2015 1:01 pm

I know man. Finding the right mask has been a struggle for me. I tried the ResMed Quattro FX and it leaks above my nose for some reason. I tried the ResMed Quattro Air and it was super light and awesome, but no matter how tight I pull the straps it leaks really bad everywhere. It also plugged my ears up...like when you're driving in the mountains and the elevation changes rapidly.

The ResMed Quattro Mirage is the only one I've tried that even has a glimmer of hope for me. In the last 2 months, I've only had 4 leak free nights. Some nights the leaks are minimal and other nights it's leaking almost the entire night. I've tried it with and without the padacheek liners. It seems to work better without the liners, but it's killing the bridge of my nose. I've been walking around for the last 4 days with a super beat up snout looking like an idiot. I think it's creating a permanent "hump" on the bridge of my nose also. LOL.