Heating Plate issue and AHI Increase

[Movieman]

Hi Everyone,

I searched through older topics, but couldn't find this exact issue I'm having. As brief background, I was diagnosed with moderate/severe sleep apnea in 2018 and was put on cpap. I've struggled since then to tolerate the therapy and only used the machine intermittently since being diagnosed. After 3 docs and some rough times, I finally have been successfully treating my sleep apnea for five months. Most recent doctor changed my life and treatment by sending me for a sleep study with titration in a facility and not relying solely on my original at home sleep study (thanks insurance for only covering at home testing). New doctor got insurance to cover sleep study in a facility. Turned out the other docs had pressure set too high and too wide a range and never bothered to try and adjust settings when I complained about headaches, very high AHIs and removing my mask at night without knowing it. New doc said this happens a lot. Some sleep doctors set the cpap with a wide pressure setting and don't bother to try and adjust as needed.

My issue with equipment: My cpap had been working fine in the past five months and I felt good in the mornings. My AHI had been between 0.1 to 2. Then, in the past couple of weeks I've been waking up with a dry mouth on and off, headaches and excess gas. Also, my AHI went up to between 5-10. I even removed my mask twice sometime in the night without knowing it until morning. Per my most recent sleep study, the pressure settings are 7-10 which had been working great. I use a resmed air sense 10 auto set and have had it since 2018; however, due to above issues I haven't used it for the full five years regularly. My humidity is set to 5 and do not use a heated hose.

The only thing I noticed upon inspection of the machine is that the heating plate under the humidifier chamber only gets slightly warm. I've never felt or paid much attention to how hot the plate should get, but I'm assuming it needs to get somewhat hot to be able to push humidity through the tube. I don't think slightly warm would be enough to produce sufficient humidity up the tube. I have an appointment tomorrow to get equipment looked at, maybe replaced since it's five years old.

My question is, can reduced humidity cause my recent symptoms? I know it can cause the dry mouth, but I was surprised at removing mask and AHI increase (although increase isn't too bad). I figured since I am getting the right pressure I wouldn't pull off mask. Still feel better on cpap then without, but don't want to go backward. Any insight would be appreciated.

Thanks.

[chunkyfrog]

Unfortunately, it is common practice to prescribe pressures that are not optimal,
after any titration study. (Providers in CYA mode)
I had to use my Autoset to find my best pressure range over time.
Just keep trying--your efforts will be rewarded.

[Respirator99]

The only thing I noticed upon inspection of the machine is that the heating plate under the humidifier chamber only gets slightly warm.

This is normal - it only needs to get warm enough for the water to evaporate - it's not trying to boil it. If there is a humidifier fault, a warning should appear on the machine's screen.

My question is, can reduced humidity cause my recent symptoms? I know it can cause the dry mouth, but I was surprised at removing mask and AHI increase (although increase isn't too bad). I figured since I am getting the right pressure I wouldn't pull off mask. Still feel better on cpap then without, but don't want to go backward. Any insight would be appreciated.

If the humidity is too low, obviously you can get dry mouth, which in itself may be sufficiently uncomfortable for you to remove the mask. It's unlikely to give you a higher AHI, though to be very honest, nothing surprises me any more.

You might like to post an Oscar chart or SleepHQ link so that we can look in a bit more detail and see if anything else stands out as a problem.

[Movieman]

Hi Respirator. Thanks for confirming exactly what my DME provider told me about the heating plate. DME checked pressure output and heating plate. Equipment is functioning fine. Definitely don't want the water to boil. DME said I may need to adjust humidity settings if weather conditions change. So, I raised humidity settings and got rainout.

I agree with you about AHI and humidity settings. I think the issue is mask leakage. A couple of times My Air showed large leaks (over 20). My mouth was dry and AHI was up. The other times my AHI was up, My Air registered leaks at or just below 10. To confuse me further, other times I had dry mouth and higher AHI, My Air registered minimal air leakage below 5. Inconsistent at best.... Mask. leakage still seems to be the likely culprit.

Unfortunately I don't have OSCAR. I tried to download it a couple of times, but my computer says that it isn't a trusted source. I can usually bypass that message; however, my computer won't let me with OSCAR. I have a MAC, and I did download the MAC version.

I'll have to take a look at sleepHQ and see if I can figure out how to upload data to it. I don't have an SD card, which I think I need in order to upload the data. I've seen some guy's Youtube videos on sleep apnea and he seems to work with or be part of SleepHQ. He's from your homeland! His videos have been very helpful to me on several issues. I forget his name, but he seems to be very knowledgable about sleep apnea. I think he might have sleep apnea and maybe works in a sleep clinic? Not sure though...

Would OSCAR or sleepHQ be more accurate with mask leaks than My Air?

Last couple of days my mouth has been fine, my AHI went back down and that's turning my humidity to 4 where I originally had it.

Thanks for your help!

[ozij]

I don't have an SD card, which I think I need in order to upload the data

First and foremost, you need it to record the detailed data. Any night without an SD card is a night of lost details, so get a card and put it in the machine ASAP.

Would OSCAR or sleepHQ be more accurate with mask leaks than My Air?

Absolutely.

OSCAR has instructions about how to handle the security warnings for PC. Nothing like that for your MAC?
Did you check this:
https://www.apneaboard.com/wiki/index.p ... _Apple_Mac

[Respirator99]

I'll have to take a look at sleepHQ and see if I can figure out how to upload data to it. I don't have an SD card, which I think I need in order to upload the data. I've seen some guy's Youtube videos on sleep apnea and he seems to work with or be part of SleepHQ. He's from your homeland! His videos have been very helpful to me on several issues. I forget his name, but he seems to be very knowledgable about sleep apnea. I think he might have sleep apnea and maybe works in a sleep clinic? Not sure though...

Get yourself a card ASAP - a couple of dollars from any shop that sells electrical stuff.

The guy you're thinking of is Nick Dundai. Yes, he's a sleep tech and is the brains behind SleepHQ. He does have sleep apnea himself, as do all his family.

Would OSCAR or sleepHQ be more accurate with mask leaks than My Air?

Yes indeed! MyAir is basically rubbish, and can give highly misleading output. Both Oscar and SleepHQ will give incredibly detailed charts and graphs which show exactly what's happening on a breath-by-breath basis. As Ozij said, there is a "security" workaround documented in the Oscar help files. For SleepHQ you don't need to install anything on your own computer, so there's no need for the workaround.

[Movieman]

OSCAR has instructions about how to handle the security warnings for PC. Nothing like that for your MAC?
Did you check this:
https://www.apneaboard.com/wiki/index.p ... _Apple_Mac

[/quote]

Thanks ozij and Respirator. I tried the instructions with no luck. I don't get the same warning box as in the instructions. My MAC only gives me the option to move the program to trash. I used to get a warning when downloading programs like OSCAR saying that MAC can't verify the program is safe, but I could always bypass the message and install the program. My MAC had a recent update, so I'm not sure if that has something to do with the issue.

I got my SD card today and will start using it tonight. I may need to use SleepHQ until I can figure out OSCAR.

[palerider]

Unfortunately I don't have OSCAR. I tried to download it a couple of times, but my computer says that it isn't a trusted source. I can usually bypass that message; however, my computer won't let me with OSCAR. I have a MAC, and I did download the MAC version.

The only reason that happens is because it costs a bunch of money to get "certified", and since the Oscar team doesn't take any money from anyone, there's no money to pay Apple to stamp it as 'trusted'.

There's nothing wrong with the code, get it and give Apple the finger.

[Movieman]

The only reason that happens is because it costs a bunch of money to get "certified", and since the Oscar team doesn't take any money from anyone, there's no money to pay Apple to stamp it as 'trusted'.

There's nothing wrong with the code, get it and give Apple the finger.

LOL. I love my MAC, except for times like these. It's always about money....Apple/Microsoft don't like anything for free. Once I can figure out how to bypass the security on Apple, I plan on downloading OSCAR and giving them the finger. This one time