Sleepyhead shows AHI above 5

Hello Everyone,

I posted a thread about having a negative sleep study for apnea but still wanting to try cpap terapy

And the strangest thing happened, My AHI was 5,83 !!! I am so confused right now because I was already sceptic about everyone saying you dont have apnea just accept it. But what the !@#% is this then? Is it just a one night thing? It looks like my sleep study where I have like 16 hypoapnea's in 45 minutes that last for 40 seconds. I just can not believe nothing is wrong with me during sleep.

I feel like I am so screwed becaeause my GP and sleepdoc are confinced I dont have SDB my AHI was 4,4. But they can not find anything else on me I did everything from psychiatrist to blood research nothing comes out. Looks like this is my only option.

This is what sleepyhead says

https://www.dropbox.com/s/zirfn1ki80k6k ... 1.png?dl=0

I really hope self treating will help me, I also am convinced my obstruction is beceause of my tongue because it is very thick and long and I open my mouth wide open during sleep. My mouth is all dry and the past nights I used a ffm. I have read that in my case nose mask can be more effective if mouth is shut through tape/chin strap

Excuse my English as I am Turkish/Dutch but I really need help my life sucks right now and I need answers it is taking already so long. Anyhelp will be appreciated. Bless you

AHI numbers can vary greatly from one night to the next. It is totally believable that you had a score <5 on your sleep study, and ran a >5 on another night.

That cutoff of 5 for mild, and 15 for moderate is simply a number so that physicians and techs can assign a 'severity' to your dysfunction so to speak. How you sleep and how you feel overall is more important than a slightly fluctuating AHI score imho.

Try the CPAP for awhile if you want. If you feel better you have accomplished something. If not,...no harm. You may want to look into a recording oximeter to check your SpO2 levels every now and then.

I'm sure another member will be along shortly to say that I don't know what I'm talking about, and that I'm endangering your life with my advice. Seems to be SOP for this forum.

Congratulations for following your instincts. It certainly looks to me that OSA could be causing you problems.
I would increase the minimum pressure to 15.
See the second link below as to how best present your data.

TedVPAP wrote:Congratulations for following your instincts. It certainly looks to me that OSA could be causing you problems.
I would increase the minimum pressure to 15.
See the second link below as to how best present your data.

Thanks for the advice. What kind of mask would be best for the therapy you think?

emreee93 wrote:

TedVPAP wrote:Congratulations for following your instincts. It certainly looks to me that OSA could be causing you problems.
I would increase the minimum pressure to 15.
See the second link below as to how best present your data.

Thanks for the advice. What kind of mask would be best for the therapy you think?

Since it looks like you are having success with your FFM, I would continue to use it and focus on trying to reduce your AHI by increasing pressure. Once successful and feeling better, then I would try a pillow mask (may need chin strap and/or tape).

TedVPAP wrote:

emreee93 wrote:

TedVPAP wrote:Congratulations for following your instincts. It certainly looks to me that OSA could be causing you problems.
I would increase the minimum pressure to 15.
See the second link below as to how best present your data.

Thanks for the advice. What kind of mask would be best for the therapy you think?

Since it looks like you are having success with your FFM, I would continue to use it and focus on trying to reduce your AHI by increasing pressure. Once successful and feeling better, then I would try a pillow mask (may need chin strap and/or tape).

I set the pressure higher but I have to say it is difficult to sleep throughout the night with the CPAP! I just wake up and after 2 times I cant sleep with it anymore. I will try to persist to it. Also I have a feeling that the mask fits very well and also I do not have any problems with humidifcation it feels very nice. However I still feel shitty when I woke up this morning using the CPAP for about 4 hours total. I know I may be one of those persons that will need to use it for longer.

Also I saw in Sleepyhead that when I had my Hypoapnea's the pressure boosts up to 17cm but seems to not be able to fully exterminate the apnea.

emreee93 wrote:

TedVPAP wrote:

emreee93 wrote:

TedVPAP wrote:Congratulations for following your instincts. It certainly looks to me that OSA could be causing you problems.
I would increase the minimum pressure to 15.
See the second link below as to how best present your data.

Thanks for the advice. What kind of mask would be best for the therapy you think?

Since it looks like you are having success with your FFM, I would continue to use it and focus on trying to reduce your AHI by increasing pressure. Once successful and feeling better, then I would try a pillow mask (may need chin strap and/or tape).

I set the pressure higher but I have to say it is difficult to sleep throughout the night with the CPAP! I just wake up and after 2 times I cant sleep with it anymore. I will try to persist to it. Also I have a feeling that the mask fits very well and also I do not have any problems with humidifcation it feels very nice. However I still feel shitty when I woke up this morning using the CPAP for about 4 hours total. I know I may be one of those persons that will need to use it for longer.

Also I saw in Sleepyhead that when I had my Hypoapnea's the pressure boosts up to 17cm but seems to not be able to fully exterminate the apnea.

It is very common for higher pressure to be less comfortable. With time, you will get used to it.
The goal of auto-pap is not to exterminate the apnea, but instead the goal is to prevent it from happening. Prevention occurs when the machine senses that flow restriction is increasing so it raises the pressure to help keep the airway open. That is why it is important to set an appropriate lower level so that the pressure does not go to low.
Please post your latest data.

Can you please review the detailed report format shown in this thread for the way to organize the various graphs?
viewtopic/t103468/Need-help-with-screen-shots.html
Pay specific attention to the pressure graph and the statistics on the left side.

You slept poorly...is that correct? I suspect that some of those flagged events aren't real and instead are what we call Sleepy/Wake/Junk.
And it's no wonder you feel like crap just from the poor sleep quality.

Pugsy wrote:Can you please review the detailed report format shown in this thread for the way to organize the various graphs?
viewtopic/t103468/Need-help-with-screen-shots.html
Pay specific attention to the pressure graph and the statistics on the left side.

You slept poorly...is that correct? I suspect that some of those flagged events aren't real and instead are what we call Sleepy/Wake/Junk.
And it's no wonder you feel like crap just from the poor sleep quality.

Yes It is not that I suffocate or something but almost everynight I have that I wake up like 2-3 times and it is as if I am dreaming very lucid and every little sound wakes me up. I wake up unrefreshed every morning with headache as well and a mouth that is as dry as the sahara.

To add to that about the graphs, I have the feeling my APAP doesn't support as much features as the RESMED. It shows the AHI and FL and something called senseawake no clue what that is.

Here's the deal with cpap...if your wake ups are from some sort of breathing issue as in the airway collapsing somewhat then cpap should help the wake ups but if those wake ups are from something else then cpap isn't going to help.

I understand what you are wanting to do here but I wouldn't have jumped off the side of the pool into the deep end (with such a high minimum pressure) given what I have read about your situation.

Without seeing the pressure graph and statistics for pressure it's impossible to get a feel for pressure needs....and this is one night...is that correct?
That's all you have used the machine for so far?

Pugsy wrote:Here's the deal with cpap...if your wake ups are from some sort of breathing issue as in the airway collapsing somewhat then cpap should help the wake ups but if those wake ups are from something else then cpap isn't going to help.

I understand what you are wanting to do here but I wouldn't have jumped off the side of the pool into the deep end (with such a high minimum pressure) given what I have read about your situation.

Without seeing the pressure graph and statistics for pressure it's impossible to get a feel for pressure needs....and this is one night...is that correct?
That's all you have used the machine for so far?

Yes I also think that I maybe should start with a lower pressure rate something like 7-12 and see from there, maybe the high pressure is making me breath more difficult. My sleepyhead was in Dutch I have added a btter picture in English

https://www.dropbox.com/s/bpkmjrnsli7oi ... 6.png?dl=0

There is no graph for flow rate on my APAP. But what do you think about my pressure ? I have no clue as what to start with.

The F & P machine may not do a flow rate that SleepyHead can get. I don't remember what it shows on the F & P software. The compatibility isn't as good for the Icon with SleepyHead.

At any rate if it were me I would start with a modest pressure and get myself more accustomed to the pressure and the mask and be able to actually sleep decently and THEN worry about what pressure is needed. You gotta first and foremost get the sleep and fairly sound sleep before we can really evaluate pressure needs.
You aren't going to be able to evaluate much by going with the AHI because your AHI is going to be low anyway because you don't have a really significant AHI to start with.

If it were me I would start with a minimum of 7 ish and leave the max at 20 and see where the machine wants to go and if it wants to go high and the going higher causes sleep disturbances then I would back off on the maximum for a while and again work on sleep itself.
It takes a bit of getting used to all this mask and pressure stuff. Heck I think it was probably 3 months before my brain quite waking me up just to tell me there was an alien on my face and I wasn't having any particular comfort issues with the mask or machine.

Pugsy wrote:The F & P machine may not do a flow rate that SleepyHead can get. I don't remember what it shows on the F & P software. The compatibility isn't as good for the Icon with SleepyHead.

At any rate if it were me I would start with a modest pressure and get myself more accustomed to the pressure and the mask and be able to actually sleep decently and THEN worry about what pressure is needed. You gotta first and foremost get the sleep and fairly sound sleep before we can really evaluate pressure needs.
You aren't going to be able to evaluate much by going with the AHI because your AHI is going to be low anyway because you don't have a really significant AHI to start with.

If it were me I would start with a minimum of 7 ish and leave the max at 20 and see where the machine wants to go and if it wants to go high and the going higher causes sleep disturbances then I would back off on the maximum for a while and again work on sleep itself.
It takes a bit of getting used to all this mask and pressure stuff. Heck I think it was probably 3 months before my brain quite waking me up just to tell me there was an alien on my face and I wasn't having any particular comfort issues with the mask or machine.

Thank you very much for you advice ! I am getting the picture now . I first need to get used to the whole concept of sleeping with an APAP and THEN I can fine tune everything. I am not a very patient person so I just want it to work NOW haha. But I think I will go with your advice start low at 7 and get used to it. After I have some more data I will share and hopefully I Will have progressed by then

emreee93 wrote:

Pugsy wrote:The F & P machine may not do a flow rate that SleepyHead can get. I don't remember what it shows on the F & P software. The compatibility isn't as good for the Icon with SleepyHead.

At any rate if it were me I would start with a modest pressure and get myself more accustomed to the pressure and the mask and be able to actually sleep decently and THEN worry about what pressure is needed. You gotta first and foremost get the sleep and fairly sound sleep before we can really evaluate pressure needs.
You aren't going to be able to evaluate much by going with the AHI because your AHI is going to be low anyway because you don't have a really significant AHI to start with.

If it were me I would start with a minimum of 7 ish and leave the max at 20 and see where the machine wants to go and if it wants to go high and the going higher causes sleep disturbances then I would back off on the maximum for a while and again work on sleep itself.
It takes a bit of getting used to all this mask and pressure stuff. Heck I think it was probably 3 months before my brain quite waking me up just to tell me there was an alien on my face and I wasn't having any particular comfort issues with the mask or machine.

Thank you very much for you advice ! I am getting the picture now . I first need to get used to the whole concept of sleeping with an APAP and THEN I can fine tune everything. I am not a very patient person so I just want it to work NOW haha. But I think I will go with your advice start low at 7 and get used to it. After I have some more data I will share and hopefully I Will have progressed by then

It looks like pugsy and I are giving you different advice.
The data you posted showed many hypopneas while at a pressure of 13.5. A lower pressure will not help. Your arousals (mask comes off) seems to happen during a cluster of hypopneas and after the large increase of pressure (3.5) increase chasing after hypopneas. A higher lower pressure addresses both.
Since you tried a higher minimum pressure last night, I really wish you would post last night's data so we can see how you responded.

Ted.....I am not so sure that those events shown are real. There's a good chance that they are SWJ and the Icon could just be reacting to false events.
OP had a sleep study that didn't document many OSA events at all. Not enough to earn the diagnosis so it just isn't logical that now with the machine at these pressures that the AHI would be higher than without a machine.
Since he reported multiple awakenings and poor sleep in general that's what makes me wonder if those flagged events and the machine's response is even accurate or not.
Hence the recommendation to back up and get used to the machine and the mask and actually get some solid sleep and then worry about tweaking the pressures.

If he has anything it is UARS most likely. He didn't have enough obstructive apnea events to earn even a mild diagnosis.
The F & P trial is just his wish to try something to see if it helps him feel better.

Now once he can say he slept decently with the mask and machine...then we look closer at what the pressures are doing and what might be needed.
I don't trust the response of the Icon in this situation which is why I won't/can't advise such a big high starting pressure for someone brand new to therapy and doesn't even have a diagnosis of OSA. It's a maybe that his problems are even related to sleep disordered breathing.
Won't hurt a thing to back up and take a slower approach...he's got to get the sleep first.
He didn't have a titration study either. This is all DIYing things.