AHI is not consistent

[Chris333]

After a lot of on and off I am finally able to use my machine daily and most of the time all night long. My ahi is up and down averaging about 7. Using a S9 autoset with the pressure at min 7.5 max 11 and it rarely maxes out. Average pressure is 8.5.

If I'm very tired and basically pass out I sleep all night in the same position and my AHI is very low (few times it was 0), but this rarely happens. Most nights I move around and each time I wake up for a few seconds, sometimes check the clock and then fall back asleep. The more times I wake up the higher my AHI gets. I feel like the machine records me waking up as an event. I never wake up and leave the bed, but sometimes if I'm uncomfortable I will take the mask off and fall back asleep.

Do most peoples AHI stay consistent? And do you think I should turn the max pressure up more?

Thanks
Chris

[Sheriff Buford]

If your machine is in autoset mode, it will use whatever air it needs to treat the apnea event. If it doesn't max out, then your ok. I always set the upper pressure limit to maximum. That way, the machine will use what it needs to treat the apnea event, then back down.
I have good and bad days and my AHI is all over the place. I don't worry about it. It is what it is.

Please post your equipment in your profile. This will help the folks trying to help you.

Sheriff

[zoocrewphoto]

After a lot of on and off I am finally able to use my machine daily and most of the time all night long. My ahi is up and down averaging about 7. Using a S9 autoset with the pressure at min 7.5 max 11 and it rarely maxes out. Average pressure is 8.5.

If I'm very tired and basically pass out I sleep all night in the same position and my AHI is very low (few times it was 0), but this rarely happens. Most nights I move around and each time I wake up for a few seconds, sometimes check the clock and then fall back asleep. The more times I wake up the higher my AHI gets. I feel like the machine records me waking up as an event. I never wake up and leave the bed, but sometimes if I'm uncomfortable I will take the mask off and fall back asleep.

Do most peoples AHI stay consistent? And do you think I should turn the max pressure up more?

Thanks
Chris

Download sleepyhead and post some graphs of a few nights. Your settings do need adjustments, but probably more the minimum than the max. We do need to see what type of events you are having and when. If you are tossing and turning a lot, you may be recording what we call sleep wake junk that isn't real. But it could also be real events that are slipping past the machine and waking you up.

The graphs will help a lot.

[Julie]

Yes, generally the min. pressure setting is the one that counts - the max. setting can usually be left high as except in very particular cases.

[Chris333]

Here is a couple days ago with a higher AHI:
http://i.imgur.com/YhV047w.jpg

[BlackSpinner]

Those are "clear airway " events which your machine is not capable of treating.

[palerider]

Those are "clear airway " events which your machine is not capable of treating.

what she said. +1

[Chris333]

Well I'm sure clear airways has been beaten to death here.

Without involving a doctor does it look like I need a Bi-pap machine or am I just tossing and turning?

[Chris333]

Also wondering if a pulse oximeter monitor would tell me if I truly have CA?

[Pugsy]

If your AHI is nice and low when you sleep soundly and it's only elevated when you sleep poorly with lots of known tossing and turning and the primary component of the high AHI night is clear airway/central ....then my vote is that the CAs/Centrals are very possibly related to the tossing and turning and most likely Sleep/Wake/Junk....and thus they don't count in the grand scheme of things. There's a real good chance that awake/semi awake breathing irregularities are getting a flag. Remember the machine can only record air flow and it can't tell if you are awake or not. It's easily fooled by minor pauses in your own breathing that we do without even realizing it while awake.

Now if you had a truckload of CAs and you reported you slept soundly then perhaps a different discussion about machines would be needed.

And no...a pulse oximeter can't tell you if you had a central or not. It can only tell you what your oxygen levels were during the night.

Now with a lot of education on your part you might be able to figure out from looking at the wave form (air flow breath by breath) if you were asleep or awake during the centrals.

[palerider]

Well I'm sure clear airways has been beaten to death here.

Without involving a doctor does it look like I need a Bi-pap machine or am I just tossing and turning?

plain bipaps won't do anything for centrals.

try turning off the EPR, it might help... it's worth a try, and quick, easy and free.

[Arlene1963]

I'd be interested to see if turning off your EPR helps as Palerider suggests.

I took this advice a while back (about two weeks ago) and it has worked so well for me. My centrals are down by about 75% and they made up the bulk of my events. It was dramatic and happened overnight. From about 16 to 24 CA events some nights when the EPR was set to 3, to 6 now on the worst nights, but mostly just 2 or 3, with the EPR turned off.

Just out of interest I turned the EPR back up to 3 a few nights ago, and BAM, my centrals were way up again that night. (From 3 Clear Airway events the previous night with the EPR switched off, to 16 with the EPR @ 3,no other changes made)

All I can say is that switching off the EPR worked for me and that it is worth trying. I'm sure glad I did.

[palerider]

some people are sensitive to the extra ventilation that EPR gives, I'd say that most aren't, I know that I'm not. but if you're having problems with centrals, turning it off is an easy, quick thing to try.