Can't get AHI below 38

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
clearyt
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Re: Can't get AHI below 38

Post by clearyt » Sun Jul 05, 2015 8:28 pm

Mask is Philips Respironics Amara View. It just came out about a month or so ago. It's comfy but leaks. My iMac doesn't have DVd or card slot?? Weird!its the big desktop.

clearyt
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Re: Can't get AHI below 38

Post by clearyt » Sun Jul 05, 2015 8:32 pm

Julie, mask is Philips Respironics Amara View. I think it has only been out a month or two. Comfy but leaks for me.

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LSAT
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Re: Can't get AHI below 38

Post by LSAT » Sun Jul 05, 2015 8:34 pm

stcrim wrote:As ZooCrew said I'm betting it's your low number that's the problem. It's a long walk from 5 to 15 and the machine does it slowly, not in real time. If you are comfortable with adjusting it I would bump the lower number up to around 8 or 9 and bring the top number down to 12 and see what happens for a day or two. Then raise either as needed. To get into the clinician menu press and hold both the knob and the home button until you hear a beep. The rest will be intuitive.

The machine you have responds slowly to your needs so the numbers need to be closer to your starting needs. Bringing the upper number down a little was helpful to me because the machine tends to over-shut...

By the way how do you feel at an AHI or 38?
I agree...it's the lower number that is probably causing the problem. The upper number won't matter. Adjust the lower number to 6 for a day or two then go to 7 for a day or two then to 8. No further adjustments until yo get the software going so you can see exactly what is happening.

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clearyt
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Re: Can't get AHI below 38

Post by clearyt » Sun Jul 05, 2015 8:47 pm

Thanks, I'll adjust the numbers a little till we can get the readout for you all to see. I still don't find the Sleepyhead software, and I downloaded it. I'll work on it tomorrow!

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Julie
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Re: Can't get AHI below 38

Post by Julie » Sun Jul 05, 2015 8:52 pm

Definitely try other masks - the Amara is known to have leak problems.

clearyt
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Re: Can't get AHI below 38

Post by clearyt » Sun Jul 05, 2015 9:07 pm

Stcrim, I have the knob and the arrow that adjusts the humidity level. I held those down, but no beep. Don't seem to have any other button/control on the machine. Suggestions?

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kaiasgram
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Re: Can't get AHI below 38

Post by kaiasgram » Sun Jul 05, 2015 9:07 pm

clearyt wrote:Kalasgram, I have downloaded the software on my iMac, but now can't find it. I don't think my iMac has a card reader. I will get one, so I can post the info that will help you to help me. Thank you so much!
One more place to look -- the back side of the iMac:

Image

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kaiasgram
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Re: Can't get AHI below 38

Post by kaiasgram » Sun Jul 05, 2015 9:08 pm

clearyt wrote:Stcrim, I have the knob and the arrow that adjusts the humidity level. I held those down, but no beep. Don't seem to have any other button/control on the machine. Suggestions?
Use the links below in my signature box to the video tutorials -- they're very helpful with getting access to all the menus and features of your machine.

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Krelvin
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Re: Can't get AHI below 38

Post by Krelvin » Sun Jul 05, 2015 9:57 pm

Recently obtained for an older Macbook which had no SDCard. Uses a USB port which it should have.

http://www.amazon.com/gp/product/B0046TJG1U

Works great, cheap and reliable.
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clearyt
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Re: Can't get AHI below 38

Post by clearyt » Mon Jul 06, 2015 5:27 am

Koalas gram, that is what my iMac looks like. I'll try that slot. Thanks

astrodeb
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Re: Can't get AHI below 38

Post by astrodeb » Mon Jul 06, 2015 8:08 am

My Amara View mask also tends to leak, but does so less if I wash it (with very gentle soap) frequently and wash my face before going to bed. I also note that the soft part of the mask around the nose stretches over time and may not make it 3 months before needing replacement. If your machine has a "check mask fit" setting, do that while lying down in your usual sleep position before going off to sleep. It's a comfortable, but finicky mask. If you get into large leak territory for a long period every night, your therapy won't be effective. SleepyHead will let you know if this is happening.

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tedburnsIII
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Re: Can't get AHI below 38

Post by tedburnsIII » Mon Jul 06, 2015 10:49 am

Placing cart before the horse.

Foundational question: Did OP have an overnight sleep study performed in a lab and more importantly did OP have an overnight CPAP titration performed in a lab, and if so, please post it, or recite what it contains.
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Julie
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Re: Can't get AHI below 38

Post by Julie » Mon Jul 06, 2015 11:02 am

"Recite"?

Do you think putting Please in front of your commands excuses them?
Last edited by Julie on Mon Jul 06, 2015 5:11 pm, edited 4 times in total.

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Pugsy
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Re: Can't get AHI below 38

Post by Pugsy » Mon Jul 06, 2015 11:26 am

Postby kaiasgram on Sun Jul 05, 2015 8:28 pm
Wait! Before any pressure adjustments are suggested --

clearyt, what is the typical breakdown of apnea event types (obstructive apnea, hypopnea, central or "clear airway" apnea)? We don't usually start recommending pressure changes until we know more about what's going on because not all apnea events should be treated with more pressure. Let's take this one step at a time.
Ditto to what Kaiasgram has said.
When trying to fix a known problem it is really helpful to know exactly what the problem is first and the potential cause of the problem.
In this situation we know the AHI is too high and while the knee jerk reaction is to increase the minimum pressure when using apap or overall pressure when using cpap mode it isn't necessarily the best reaction because we don't know what that AHI is made up of.

Now it might all be obstructive in nature and more pressure is the usual way to go but if it is primarily central (Clear Airway) in nature then more pressure won't fix it and could potentially make the problem worse if the pressure is the trigger for the centrals.

Since data via software is available to show us that AHI event category breakdown....let's use it if all all possible so we can see for sure what the problem is and thus figure out the best course of action.

It's always a good idea to have a copy of any sleep studies done on hand to answer potential questions....especially if that AHI ends up being central in nature.

Odds are that a simple minimum pressure adjustment will fix things but since we have data available let's make sure that what we are wanting to fix with more pressure is fixable with more pressure.

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kaiasgram
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Re: Can't get AHI below 38

Post by kaiasgram » Mon Jul 06, 2015 1:20 pm

Thank you Pugsy -- I'm glad someone was listening.
Pugsy wrote:
Postby kaiasgram on Sun Jul 05, 2015 8:28 pm
Wait! Before any pressure adjustments are suggested --

clearyt, what is the typical breakdown of apnea event types (obstructive apnea, hypopnea, central or "clear airway" apnea)? We don't usually start recommending pressure changes until we know more about what's going on because not all apnea events should be treated with more pressure. Let's take this one step at a time.
Ditto to what Kaiasgram has said.
When trying to fix a known problem it is really helpful to know exactly what the problem is first and the potential cause of the problem.
In this situation we know the AHI is too high and while the knee jerk reaction is to increase the minimum pressure when using apap or overall pressure when using cpap mode it isn't necessarily the best reaction because we don't know what that AHI is made up of.

Now it might all be obstructive in nature and more pressure is the usual way to go but if it is primarily central (Clear Airway) in nature then more pressure won't fix it and could potentially make the problem worse if the pressure is the trigger for the centrals.

Since data via software is available to show us that AHI event category breakdown....let's use it if all all possible so we can see for sure what the problem is and thus figure out the best course of action.

It's always a good idea to have a copy of any sleep studies done on hand to answer potential questions....especially if that AHI ends up being central in nature.

Odds are that a simple minimum pressure adjustment will fix things but since we have data available let's make sure that what we are wanting to fix with more pressure is fixable with more pressure.

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Machine: AirSense 10 AutoSet with Heated Humidifer + Aifit N30i Nasal Mask Bundle
Mask: Aloha Nasal Pillow CPAP Mask with Headgear
Additional Comments: SleepyHead-now-OSCAR software on Mac OSX Ventura