AHI Rising Steadliy

[Papillon2]

Since I started using a new APAP machine about a month ago, my AHI has been rising steadily. It was never great--around 4.9--but this morning it was up to 7.8. It seems to raise in small incremental stages. My pressure was also changed with this machine, to a range of 11-16. Has anyone else had an experience like mine, and what could be causing this elevation? Should I be worried?
Thanks for your thoughts!

[Julie]

Well, now that your pressure is higher, it is quite possible, even likely, that you're losing air while sleeping through your mouth, which is being forced open by the higher pressure. When that happens (and it happens to an awful lot of us) we need to change to a full face mask, but you can try it out first (the concept) by taping for a couple of nights and seeing if it helps, then look into FF masks if you're interested.

[KatieW]

If your AHI is rising, it means therapy is not at optimal. There are many reasons, and you will need to do some detective work. Do you have software? What is the breakdown between obstructive and central apneas, and hypopneas? Can you post your reports for feedback here?

The usual suspects are mask or mouth leaks, or the pressure settings. But there are non-cpap factors that can increase your AHI, so look at your sleep hygiene to see if anything else could be affecting the comfort or quality of your sleep.

Also look at what and when you're eating. The other night I ate a whole chocolate brownie in the afternoon, and then had a terrible sleep--the caffeine kept me awake, and the chocolate gave me acid reflux. But the brownie was delicious, so next time I'll just eat half.

[Papillon2]

Thank you both for your replies. I tried a full face mask last night, and this morning my AHI was up another .4 to 8.2. I now have a call into my sleep doc to see what might be happening. I wonder if the higher pressure could induce central apneas. I do have data on my machine, but no way to read it myself.

Again, thanks for your interest.
Papillon

[DoriC]

You need more than one night with any equipment change to come to a conclusion. How do you feel today?

[Papillon2]

DoriC, thanks for asking. I feel about the same as usual, so feeling isn't a good indicator for me. I'm just concerned about the consistent rise in AHI. I have a call into the sleep doc, but no response today. Maybe tomorrow will be better.
Again thanks,
Papillon

[timbalionguy]

Can you post your data here? You will likely get a lot of better information if you do.

[Papillon2]

I have a Respironics APAP machine, but don't yet have the new software to read the card at home. I can only see the cumulative data that the machine reads out on the front. Would that help?
Thanks,
Papillon

[newhosehead]

Since I started using a new APAP machine about a month ago, my AHI has been rising steadily. It was never great--around 4.9--but this morning it was up to 7.8. It seems to raise in small incremental stages. My pressure was also changed with this machine, to a range of 11-16. Has anyone else had an experience like mine, and what could be causing this elevation? Should I be worried?
Thanks for your thoughts!

I wanted to bring this thread back to the top and ask how you are doing? What changes have you made and has it made a difference? I am asking because the same thing is happening to me. My numbers have been good, still are really, but for the past few weeks I see a small daily increase in AHI. I had gotten down to 1.7 or so and this morning it was 2.9. I know, not a bad number, but I am very confused as to why this is happening so I wanted to see how you are progressing.

Jeanette

[oneDay@aThyme]

I am having a similar experience, using a PR System One APAP with A flex and heated humidifier. I was put on the APAP to have efficacy data. About two months of this data resulted in the following three reports:
Avg. OA Index - .8 .6 .5
Avg. CA Index - 2.8 3.5 3.3
Avg. Hyp.Index 1.7 2.0 1.9
Avg. RERA Index .2 .2 .2
Avg. AHI 5.3 6.1 5.7

My doctor considers these numbers to be acceptable therapy results. Since these reports, I am noticing the screen readings giving higher average AHI numbers, like 7 and 7.8. I will have to get a new print out from my DME to check details, but I am wondering how long I should let this go on without seeking further review by the doc. My next recommended appointment is another five months away.

I wonder if this may be related to mask leak issues as mentioned by a previous poster. I use Swift LT for her mask with a pressure range of 5-12 and have noticed some leak upon awakening with a seemingly higher pressure level as the machine is trying to make me breath. I can usually adjust the pillows to reseal them when this occurs, and my awake state allows me to consciously breath, bringing the pressure back down gradually. I'm still trying to figure this out. My initial diagnosis was complex sleep apnea so the central apnea component is important to me.

[Wulfman]

I have a Respironics APAP machine, but don't yet have the new software to read the card at home. I can only see the cumulative data that the machine reads out on the front. Would that help?
Thanks,
Papillon

That's easily remedied. You would need the Encore Viewer 2.0 (with card reader if you don't already have one).

https://www.cpap.com/cpap-software/cpap ... ftware.php

It's one of the most valuable tools a user can have to understand their therapy.


Den

[Papillon2]

Jeanette and One Day--My AHI is vacillating between 8.2 and and 7.8 in the last few days. My husband is an engineer and is calculating the daily response from the 7 day average. These numbers show that the AHI has gone as high as 10.6 in one night. I don't have any idea why this is happening. I have heard that too great a pressure setting can cause central apneas, and wonder if the pressure (11-16) could be too high. Both of you have numbers in the acceptable range, so I wouldn't be too concerned. Mine are not acceptable, and nothing seems to change that. I've tried a different mask (full face) and it made no difference.

Wulfman, I would like to buy the new software, and hope I can before long.
Thanks for all your responses!
Papillon

[Wulfman]

If, during your titration, they took your pressure up to what you're using......and they didn't see any Centrals, I wouldn't worry about pressure induced Centrals.
Hopefully, you got a copy of your sleep study and titration.


Den

[Papillon2]

Actually, Den, during the sleep test my pressure was at eight. The doctor said that the interval of sleep was too short to be sure of the data, though, and put me on a trial on an APAP machine for two weeks. From that data, he changed the setting to 8-11. Then, the DME mis-set the APAP to 8-16, and my pressure hovered at around 15, so they reset it to 11-16. What a goat rope! I don't think anybody knows what it should be, and, from what I"ve heard about DME's, this isn't atypical.
Thanks for your interest!
Papillon

[Wulfman]

Actually, Den, during the sleep test my pressure was at eight. The doctor said that the interval of sleep was too short to be sure of the data, though, and put me on a trial on an APAP machine for two weeks. From that data, he changed the setting to 8-11. Then, the DME mis-set the APAP to 8-16, and my pressure hovered at around 15, so they reset it to 11-16. What a goat rope! I don't think anybody knows what it should be, and, from what I"ve heard about DME's, this isn't atypical.
Thanks for your interest!
Papillon

Heh, heh. When I read that phrase, I looked to see if you had your location in your profile........I think only somebody from this part of the country would use that phrase.

Hang in there, "neighbor".


Den