Going after Hypopnea events

[quote="timbalionguy"]Not trying to hijack this thread, but it looks like several people are trying to pursue different but closely related scenarios here. Here is my scenario.

After a little over a month of therapy, I am finding that the lion's share of my AHI events are hyponeias. My AHI so far has averaged right around 11.... with an AI of typically less than 1, and an HI typically around 10. Pressure range is currently 10-15, and i was originally set up with 10-13. Sleep doctor said I was 'hard to titrate', and told me it might take a while to find the right numbers.

Typically, I will experience a string of hyponeia events, to which my IntelliPAP machine (seems popular on this thread!) responds by raising the pressure. Usually, they stop, but not until I am near the top of the current pressure range. When the hyponeias stop, the machine lowers pressure gradually. Snoring is (usually) infrequent, but when I snore, I will often see AI's, HI's and possibly even a central event (IntelliPAP reports as an 'NRI").

I noticed the same thing with the IntelliPAP it does have a habit of raising the pressure near the top of the range when I wake up which was not the case with the other Auto CPAP. What was your 90% or 95% pressure average?

I note my tidal volume is 600-800 mL with 14-15 BPM while falling asleep. Average tidal volume is 450-570 mL with an average BPM of 16 while (supposedly) asleep. There seems to be no correlation with HI rate and sleeping tidal volume that I have yet observed. Quality of sleep varies from night to night, but have not experienced any really bad restless nights.

steady tidal volume should not have any effect on the CPAP operation. Your sleeping breathing volume is half of mine but that could be normal for you.

Is a hyponeia possibly a type of flow limitation, possibly caused by nasal congestion? (I use a Quattro or Hybrid FFM with similar results) Or, is it always a fundamental breathing problem?

hyponeia is a type of flow limitation caused by restriction in the airway path causing flatting in the breathing waveform as shown by by old ResLink software on my old Spirit Auto machine and makes no changes in pressure when your breathing volume changes. Breathing against pressure should not cause any meassured flatting in the waveform. I am still learning how the Intellipap works in certain situations. On my second machine the GoodKnight 420E flow limitation is sometimes called runs on that machine.

A "run" on a 420E is a chain of flow limitations.

Because of how it identifies flow limitations, a 420E will find dozens of flow limitation where a Resprionics machine finds none - and I am referrring to the same person.

Because it is so trigger happy about flow limitation runs in some breathing patterns, the 420E has a switch that tells it to ignore flow limitation runs entirely.

O.

yep I had to do that switch change on mine as well or it will run away with pressure and you will end up feeling bloated. One more thing on the on the 420E there is command on apnea telling what the maximum pressure can be in response to an apnea event. On the old ResMed auto CPAP with the A10 program it will never ever response to any apnea events for a pressure increase once the pressure is already at 10 inches or greater.