AHI of 52.67 on APAP (Airsense 11)

[oystagoymp]

Hi,

I was recently (2 months ago) diagnosed with severe sleep apnea with an AHI of 102 during my sleep study. The doctor mentioned that it seemed to mostly consist of Central SA with some instances of obstructive SA. I purchased an Airsense 11 APAP and they set it to a range of 5-20, according to my GP who ordered the sleep study.

I noticed my AHI went down to 5-10 but I couldn't sleep with the full face mask. I bought the nasal mask and it fit well but I still had some difficulty falling and staying asleep. I finally went with the nasal pillows however I noticed my AHI reached 20-30. I went back to the nasal mask and it still keeps climbing. Last night it was at 52.67.

I notice when I start to nod off, I just stop breathing and honestly, I'm feeling pretty terrified. I just had a procedure done on my heart to correct an AFib and I get arrythmias and tachycardia when my AHI is this high.

Can anyone shed any light on the situation? I'm going to schedule an appointment with a doctor / sleep specialist but it's Sunday today.

https://imgur.com/ZUSmE1r

[Pugsy]

Was there ever any discussion about what to do if this machine couldn't deal with the central apnea??

How did you come about getting the AirSense 11? Where/who did you buy it from? Insurance pay for it or self pay?

Do you have a copy of your sleep study? If not, you should probably be getting it.

Where are you located?

First thing tomorrow morning....schedule that appointment with the sleep doctor.
I think this machine is very likely not going to be able to do anything for your central sleep apneas. You probably need a different machine.

[oystagoymp]

Was there ever any discussion about what to do if this machine couldn't deal with the central apnea??

How did you come about getting the AirSense 11? Where/who did you buy it from? Insurance pay for it or self pay?

Do you have a copy of your sleep study? If not, you should probably be getting it.

Where are you located?

First thing tomorrow morning....schedule that appointment with the sleep doctor.
I think this machine is very likely not going to be able to do anything for your central sleep apneas. You probably need a different machine.

The only discussion were treatment options and how CPAP / APAP would be the best fit. At the time I didn't really know much about sleep apnea so didn't know what to ask. She gave me a prescription, I took it to a medical store and they handed me the Airsense 11. I paid for it but I'm submitting it to insurance. I'm located in Denver, CO. I will definitely schedule an appointment with the sleep doctor and I heard elsewhere that I would need an ASV. I wonder if I should wear the mask tonight as I heard CSA can develop into Complex SA with the wrong machine.

Thanks for the response!

[Pugsy]

I am thinking ASV is probably the best option here because it can auto adjust to deal with both any obstructive apneas you might have as well as breathe for you when you have the central apneas.

The AutoSet will do a good job dealing with the obstructive stuff but nothing at all for the centrals stuff.
As for the wrong machine creating complex sleep apnea....you really already had that without any cpap machine.
You had both central apnea and obstructive sleep apnea at the diagnostic sleep study.
Complex sleep apnea is nothing more than when people have both central apnea and obstructive apnea.

Now is it making things worse...if your AHI was around 100 without cpap and it's around 50 now....I don't think thinks are worse and might be better. Without knowing all the details we don't know but maybe your obstructive apnea is being somewhat treated now with this machine because the obstructive apnea index isn't all that bad at roughly 4 per hour. That's the OAs plus the hyponeas.

The lower AHI with the full face mask...I don't know what to make of that unless you simply didn't sleep all that much and without sleep not much happened.

There are a couple of things you can try just to see if anything changes. Just something to try and I doubt seriously if we will see marked improvement but there's a remote chance you might get lucky.
Even a remote chance is worth trying.

Sometimes auto mode with big pressure changes/ranges isn't always a good idea for keep centrals away....and using EPR isn't always a good idea either.
You didn't include the overall picture of your detailed graphs so I can't get a feel for what the pressures did but it looks like the highest it went to was close to 11 cm...and the median average seems to be around 8.5 cm.

If it were me I would try a really tight range....and turn EPR off...and see what happens.
Something like minimum of 7 and max of 8.
If you just have to have EPR to be comfortable and get to sleep then change it to ramp only and make use of the ramp.

Again...in all honesty I can't promise anything other than I don't see it being any worse than what you are seeing now.
I would give it a try if I were in your shoes.
Your choice of course.

[palerider]

I notice when I start to nod off, I just stop breathing and honestly, I'm feeling pretty terrified.

That's actually 'sort of' normal.

many people frequently have a brief period of central apnea when their bodies switch over from 'awake' to 'asleep' breathing (and back again). This is often referred to here as 'sleep wake junk', but you start breathing when your asleep breathing system takes over.

It can bey very worrying, but that particular thing is nothing to worry about.

I just had a procedure done on my heart to correct an AFib and I get arrythmias and tachycardia when my AHI is this high.

Have you been checked for heart failure recently? I'd like to think so, with the other procedure.

Can anyone shed any light on the situation? I'm going to schedule an appointment with a doctor / sleep specialist but it's Sunday today.

https://imgur.com/ZUSmE1r

First thing I'd *try* tonight is turning off EPR, and seeing if that helps tonight.

[joshdog]

I have a little idea of what you are going through. I have AFIB and sleep apnea also. They think sleep apnea is what caused my AFIB. I had heart ablation surgery 3 years ago for the AFIB, the surgent said my heart was worse than they thought. I am not a candidate for a pacemaker because I would be totally dependent on the electronics. I walk between 3 to 4 miles a day now. I only get mild AFIB attacks about one or twice a month now. I have difficulties sleeping also because of various pains and difficulties breathing along with CPAP masks. But I feel like I am doing good for my age. I was wondering if your AHI was all night or per hour. The hospital sleep apnea tests on me showed 89 per hour, I was not concerned, but should have been. I went to a different sleep lab a year later and it was 92 per hour. I have been on CPAP equipment since, 4 years now. My AHI now varies from 3 to 15 per hour. Good luck

Joshdog

[oystagoymp]

Hey! Thank you for the response. The doctor said the same, that my heart rate sedated was 120 and naturally at 140 and I was much worse off than they thought. After the ablation, the doctor said I would need to get my sleep apnea under control and then we could discuss another ablation. I've started to walk on the treadmill every day but when I feel the arrhythmia or see my heart rate rise I start to panic. Hearing your story makes me feel better.

My AHI reaches 130 during the early early morning so there is a lot of variability.

[dataq1]

check your private messages on this forum

[Miss Emerita]

Dataq, it would be helpful if you could post publicly so that others can benefit from, and comment on, your thoughts.

[zonker]

Dataq, it would be helpful if you could post publicly so that others can benefit from, and comment on, your thoughts.

+1

[Dog Slobber]

Dataq, it would be helpful if you could post publicly so that others can benefit from, and comment on, your thoughts.

Or most importantly scrutinise them, though that's what you might have been alluding to with "and comment on".

Bad advice is sometimes given here, private comments through PMs can't be scrutinized.

[zonker]

Dataq, it would be helpful if you could post publicly so that others can benefit from, and comment on, your thoughts.

Or most importantly scrutinise them, though that's what you might have been alluding to with "and comment on".

Bad advice is sometimes given here, private comments through PMs can't be scrutinized.

again, +1

[Deborah K.]

In other words, you are way better off listening to advice from Pugsy, Palerider, and Dog Slobber rather than to the person who will only talk to you by private message.

[zonker]

In other words, you are way better off listening to advice from Pugsy, Palerider, and Dog Slobber rather than to the person who will only talk to you by private message.

another +1.

[dataq1]

Dataq, it would be helpful if you could post publicly so that others can benefit from, and comment on, your thoughts.

I simply asked a potentially off-topic question, nothing for the public to scrutinize.