Need help: AHI all over the place no matter what.

[NickD25]

Ok, I haven't been around a lot but I'm really starting to get sick of my treatment. I just can't get my AHI to drop below 5. My best night, so far, was a 4.2 but since I've switch to a BiPAP Auto, it's been worse in terms of overall energy. For example, this morning, I woke up at 8am but was so tired that I went back to sleep and woke up at 11am and tired! I went to bed at around 12h30~1am. So I basically slept 10 hours!! It's actually the first time since I started my therapy that I've slept this long in a row. When I woke up I look at my data and I had a 5.7 AHI, which is still bad but I shouldn't feel that much tired.

I remember when I had my CPAP back in December, I would go to bed late and always wake up around 9-10am no matter what. I was struggling with my mask but, for some reason, I was feeling better. Now it seems like a drug, the effects have fade away. Speaking of my mask, it's strange because ever since I've eliminated my leaks, I've felt worse for wear too. I thought that it could be something else but it doesn't make sense that I would lose almost every positive effects from my PAP machine in about 2 weeks and have something else.

I really try to stay positive but I'm struggling to keep a happy face. Just the fact that I can't find any pressure that seems to fit (right now I'm at 17EPAP - 21IPAP) or 21 for those of you reading who have a CPAP (although it's impossible to get 21 on a CPAP I know but you get my drift).

Anyway, is there any suggestions you guys could give me to help have a better titration or something because right now, I feel like hell and I feel like I'm sleeping without a machine even though I'm 100% compliant.

Any help would be greatly appreciated


Thanks

Nick

[Snoredog]

How is your Bipap setup?

What is the IPAP Max=?
What is the EPAP Min=?
What is the PS set to?
What was your old CPAP pressure?

I would set the machine in Auto Biflex mode, EPAP Min should be close to your old CPAP pressure or set it 2 cm below it. Set IPAP Max=20 until the machine finds the value there. I would set PS=4 to 6 for starters.

You need the EncorePro software to see what is going on, you need to find out what that AHI is made up of, is it Apnea or Hypopnea or FL's?

If OA is above 2 you need to increase EPAP, if that score is HI, you need to increase IPAP. IF FL's are showing up you might want to increase PS=8 or maximum setting, it all depends what what is showing up on your daily reports.

[NickD25]

Sorry for the lack of info.

Right now I'm running in BiPAP, no auto

IPAP is 21 right now (it was my 90%)
EPAP is 17

My old CPAP pressure was 17 but still couldn't get a reading below 5 even when raising it up to 18 and 19 (since my OSA was too high)

One of the problem is that my scores are all over the place ie: One night, I get a 3.6 OSA but a 2.8 HI, then another night, I have a 5.7 OSA and a 1.3 HI without even changing my settings! I never could figure this one out.

The only time it was right was when I started on auto and put it at 10-22, got an AHI of 4.2 but felt tired nonetheless. Also had a FL of 1.8 with the PS set at 8.

I would post an Encore Pro page but even after a resize in Photoshop, it's way too big for the forum and a lower resolution is unreadable.

Btw, thanks for the crash course on BiPAP. I actually had no idea what the PS was for...

[fehler]

NickD25 what operating system do you have on your computer, i have Vista and it has a program on called snipimage that works great for transfering images.

[NickD25]

XP but what I do is really a print screen paste onto a sheet in Photoshop, then I resize it but for an acceptable size to be posted, it becomes unreadable. Unless I would start using thumbnails in this posts with bigger graphics on Imageshack.

[fehler]

If you goto http://WWW.photobucket.com you can upload your images there and we can view them there its free.

Frank