AHI & Leaks

[qjosea]

I have Resperonics DS700HS bipap, w/swift LT mask. I think my AHI is high, AHI 30.5, with a leak of 22.3. My setting are 5 exhale and 9 inhale. I feel better somewhat, but still foggy during the day. I feel like I'm going to colapse around three in the afternoon. Even with the machine I still stop breathing. This happen mostly when I am to fall asleep. Went to apria last week explained to them, based on my reading about central apnea that I need a defferent machine. They said that they would need a presciption from doctor, still waiting. Hopefully I will get relief soon.

[Scarlet834]

Yes, your AHI is very high. I'm told the gold standard we're all working toward is below 5. I'm not familiar with the Respironics equipment and have CPAP with Cflex, but I bet wiser members will chime in on the leaks. I will share my own experience in that for the first maybe week and a half of CPAP I felt different but still horrible, just awful, really, and was frantic imagining how I was going to function at work (I was on vacation). At that time my AHI was around 20. In a bit of desperation after scouring this forum I tweaked two settings, slightly higher pressure (as in 0.5 cm higher) and I lowered the Cflex setting, which would be a bit like moving your exhale closer to your inhale, I think. This worked for me big time. I am still fighting excessive leaks (which is maybe one reason why I needed higher than my titrated pressure) but at least I feel night and day better than I have for months, maybe years. I hope you will find the same true of yourself.

As you have medical folks actively helping you, I hope you will find the setup that is right for you and that you, also, will be feeling better soon. Just wanted to offer some encouragement.

[jules]

what does your sleep study indicate for AHI and how is that divided between Obstructive and Centrals?

what is the recommendation of your titration? is this a bipap trial before a fancier machine?

[qjosea]

Thank you scarlet834. I will be calling my dr Monday morning to see what he can do for me. I still feel like I need a machine that will give me a breath when I stop breathing. I spoke w/the apria rep and told him my symptoms and he agreed with me, he said that based on what I told him I might have central apnea. He said he would write it up and forwarded to my doctor to see if he would write a prescription for a machine that would be more beneficial for me. I have really good insurance. I'm retired military, that may have something to do w/my sleep apnea. I went thru many excersices about sleep deprevation. The longest way 36hrs. This was constantly they would use us a guieny pigs. The rep said that I could use a bipap with sv since that tracks your breathing and when you miss a breath it will initiate one.

[jules]

a bipap with SV is one of the fancier machines

again, get a copy of your titration study and post information out of it

[ozij]

Ditto to what jules said.

O.

[jules]

there are these hoops people have to jump through sometimes because insurance likes us to jump through rings of fire.

Some people have to make this journey to get an APAP - fail cpap. Others need to fail cpap to get a bipap. In this case you have to fail bipap to get a specialized machine that will treat centrals.

Each insurance puts in place a hoop which is smaller in diameter than then average XPAP patient's waist size, and then adds everclear to the liquid recepticies around the edge of the hoop, then mounts fireworks rockets onto the hoop that are aimed towards the center of the ring. Just as the patient enters the hoop, the everclear is lit , spreads fire all over the ring and this ignites the firework rocket.

If you can survive this test without any problems - no scratches = no asthma attacks - no getting drunk off everclear that didn't ignite, then you can have a new titration for the next machine. .

[Julie]

If you're sleeping (unaware) with your mouth open, that mask won't help anything because all the good air's going out instead of down. Have you tried a full face mask or taping? That would allow you to 'mouth breathe' without losing therapy. Turning up your pressure may only make it worse unless you take care of the source.

[SuperGeeky]

If you're sleeping (unaware) with your mouth open, that mask won't help anything because all the good air's going out instead of down. Have you tried a full face mask or taping? That would allow you to 'mouth breathe' without losing therapy. Turning up your pressure may only make it worse unless you take care of the source.

Julie makes a good point. Clear indication is 'dry mouth' and very large spikes in leak graph. If you can, post your Encore Reports.

My AHI has always been below five with BiPap Therapy and I certainly don't feel well in the 3-5 AHI range. That's how sensitive I am to the Apnea.

I fall into this trap of either feeling run down and not making the effort to work with the Doctor. Or, trying to do too much of the Doctor's job by researching the problem myself.

I'm so glad you called your Doctor! The seriousness of your problems warrants their immediate attention. I use a Bipap and had been titrating myself by using the Auto function.

I had a Sleep Study a month or so ago and was very proud of how close I was in titrating myself. However, I was very surprised how the new prescription settings from the Doctor made a huge difference on how I currently feel.

The titration changed from 11.5/9 to 12/8 and made a huge difference in AHI and how I feel. I'm particularly concerned of titrating a BiPap on my own considering how Carbon Dioxide is managed. I'm not an expert on how the BiPap regulates my exhaling.

Blue Carpenter Tape is an excellent choice for managing open mouth leaks. Make sure your sinuses are irrigated, check out other posts to discover what's best for you.

sleep well,

SG

[qjosea]

In response to your question if I sleep with my mouth open. I never open my mouth when sleeping, I did ask during my sleep study and they responed that I didn't. That is the reason they suggested I get a nasal pillow mask. I may have to adjust the straps a little to see if that helps with the leakage. As for my high AHI numbers I check my machine and it's still 30.5. I remember during my initial sleep study the tech. mentioned something like AHI 57. Sleep Apnea is something that the medical field as a whole are not very knowledgeble about. If not for this type of forum where would we be. The little I know about my apnea has been from my own research and these forums. This is my situation in a nutshell. Felt like crap, life sucked, saw dr. (primary physician), requested I have a sleep study. Got appointment, pulmonologist, (dr. had no people skill), sleep study done, then wait, wait, and wait. Apria contacted me. got cpap, tried to use for 18 months, gave up. In Aug. this year thought I was going to die. Chest tight, jitters, shortness of breath. three or four days no sleep, scared I would stop breathing and not wake up. another sleep study, got bipap auto, w/humidifier. Still the same problems, two years later here I am. How long will the agony last, new machine or death. Since last titration have no contact with my doctor. Have called and told me he would see me in late November, wait until time pases he said. I would eventually get used to this machine. Have requested copy of my sleep study and titration, as soon as I get it I will post for further analysis.

[SuperGeeky]

Qjosea, my heart goes out to you and I feel your frustration. AHI of 30.5 is completely unacceptable! No way are you going to feel even close to 'Normal'.

For me, I have to realize the dangerousness of my situation and act upon accordingly. When you see how the heart reacts to a Apnea, the deprivation of oxygen to the brain, the damage is obvious. The excessive daytime sleepiness is dangerous to you and others.

I have to say to myself over and over, enough is enough!! I need help now!! If you don't give it to me now, I need to find others who will get the job done.

If I had that AHI, I could not think clearly enough to solve my problems from the internet or some sort of Support Group. Doctor/Nurse is going to have to tell me over and over again until I get it right!

There you go, I'm off my Soap Box!

Good luck,

SG

[Autopapdude]

An AHI of 30 plus is almost like untreated Apnea. I agree with the previous posters that an AHI below 5 (mine averages about 3-3.5) is the standard to strive for. Sounds like you have huge mask leaks or your pressures are totally incorrect. I'd check for both.

[jules]

it could be that OP has lots of centrals and they are not being addressed or they are being caused by pressure on machine

many unanswered questions -------------

need that titration report for a start ---- maybe all of them including ones from the past -

[Autopapdude]

Yes, I'd guess you are right. A good look at the sleep study would clear a lot up. Somehow it seems like pressure (although I am not a professional), so a lot of factors need to be considered.

[qjosea]

Greetings to my fellow hosers. Today I called Apria my DME, the receptionist said she would pass on the message to the rep. that is assigned to me. Then I called my Dr. None them returned my call, so I took your advice and did a follow up call to both. Finally DME called me and said they needed me to bring in my machine with everything, they needed to download my data so they could forward it to my Dr. I told them that my machine has a smart card, they didn't know that my machine came with one. Well I took everthing in and the rep he looked at it and just took out the card and gave me another one. Hopefully I will get some relief soon. My AHI is still above 30, I adjusted my mask and asked my wife to check if I was breathing thru my mouth. She told she didn't notice any mouth breathing last night. If I don't get any help I will return my machine and get a new Dr. I think two years is enough time for them to get it right.