new user with concerning data

[dwh]

I was diagnosed with mild apnea(AI-8) and started cpap(resmed elite II,pressure-8) two nights ago. First night: Leak-0, AHI-25.3, AI-10.8, HI- 14.5, second night: Leak-0, AHI-24.4, AI-12.7, HI-11.7. Should I be concerned with these high numbers while on cpap?

[Lee Lee]

Yes, you should be concerned. Something is wrong. What kind of mask are you using? Who determined your pressure?
Go to your profile and fill in your equipment. Then we can be more helpful.
Whatever you do, don't give up!
Lee Lee

[OutaSync]

Your AHI is higher now than before therapy? Yes, that is a big concern. Especially since you aren't showing any leaks. Have you called your doctor about this? If your doctor is not helping you, get a copy of your overnight study and post it here. Someone will be able to help you.

And do go to your profile and fill in the equipment you are using, so that it appears on every post and makes it easier for people to help you.

Bev

[dwh]

A sleep dr (who I never met) prescribed the pressure after my titration study indicated I did well at that pressure. The results were sent to my ent who did the prescription. Would my ent be able to change the prescription for pressure? Or should I contact the respiratory therapist of my dme? I use mirage quatro full face mask, plus 4i humidifier.

[rested gal]

hi dwh, and welcome to the board!

I'd do exactly what OutaSynch suggested:

get a copy of your overnight study and post it here.

When you ask for the copy of your study, ask for the "full NPSG report" (Nocturnal Polysomnogram) -- the pages that the sleep lab sent to the sleep doctor. Not just the one page summary report that the sleep doctor prepared from the lab's report.

The report the sleep doctor sent to your ENT may, or may not, have been the full NPSG report. You might want to start by asking your ENT's office for a copy of the report they received. If it's just one page (or two pages, if two nights of sleep studies) then it's not the full report. The ENT's office would then need to contact the sleep doctor or the sleep lab, to ask for a copy of the full NPSG report.

If your study was for just one night (a split night study -- diagnostic for the first few hours of sleep, then CPAP used on you for the remainder of the night) that's all you, or the ENT's office, need to ask for: the full NPSG report.

If your study happened on two nights (one night with no cpap used, a different night with cpap used all night), then ask for the full NPSG reports for both nights.

In the meantime, while waiting for a copy of the full report, I'd do this (I'm not a doctor, it's just what I'd do if I were using the Elite and had been prescribed a pressure of 8, but was getting that high an AHI at home)...

I'd try a couple of nights this way:

Pressure 8
EPR turned off (or EPR set for "ramp only" if you use "ramp" at all)

If that didn't show considerable improvement in the AHI (particularly in the "AI" -- the "Apnea Index") then I'd try this:

Pressure 10
EPR fulltime set at "2"

If that didn't show improvement, I'd try pressure of 10 with EPR turned off or EPR set for "ramp only."

If none of those settings drop the AI (apnea index) a LOT, then I'd start wondering -- not "worrying", just "wondering" -- about the possibility of CompSAS (complex sleep apnea syndrome) which can occur in a few people when CPAP is used. If that's the case, I'd think it would have shown up during the titration part of the sleep study, when CPAP was used on you. So, that's why it would be good if you can get the full NPSG report -- to see what happened during the titration part.

Anyway, that's just what I'd do. You may not want to experiment yourself. I would, but that's me.

If you decide you want to try those things, here are some links about how to access the clinical menu on ResMed machines:

http://www.cpap-supply.com/Articles.asp?ID=130

http://www.apneaboard.com/CPAP%20Adjustment.htm

Brenda's post:
viewtopic.php?t=22776

My post:
viewtopic.php?p=226375#226375

Good luck, dwh! Keep us posted on how it goes.

[Joel8]

If you decide you want to try those things, here are some links about how to access the clinical menu on ResMed machines:

http://www.cpap-supply.com/Articles.asp?ID=130

http://www.apneaboard.com/CPAP%20Adjustment.htm

Brenda's post:
viewtopic.php?t=22776

My post:
viewtopic.php?p=226375#226375

Good luck, dwh! Keep us posted on how it goes. [/quote]




Those links were a great help. Thanks.

[elader]

Boy you people give some crazy good detailed advice. Where else in the world could someone get support like this? Kudos folks!

[dwh]

Does changing my pressure settings on my own affect my compliance as far as insurance is concerned?

[yardbird]

Compliance just says you used the machine for the minimum number of hours per night (usually 4 hours)

If you use it at least 4 hours a night, you're 100% compliant.

You can be 100% compliant and still be getting no benefit from the therapy.

Insurance companies are stupid.

[kebsa]

i am relatively new to all this and my initial study did show severe sleep apnea and i did a tiration study that showed i still had less than ideal results and i was dx as having complex sleep apnea with the central component being due to MS- anyway when i was sent home with a machine for trial for a month actually got worse results than on either previous studies! as i had a lot of central i was sent home with one of the respironics auto SV and my AI ranged from 94 to 105 depending on the settings- eventually they swaped it for the resmed vpap adapt sv and my AI is now 0 and AHI has been as high as 2.4! a vast difference!

so my first thoughts were similar to Rested Gal re why it got worse with treatment not better- i wonder if the sleep lab did the same as my did, even though they felt the results had indicated complex apnea they stuck to a standard ( and fairly basic cpap) for the titration with the idea that we could sort it out at home! But what seems to have happened is that although both machines are aimed at complex apnea the algorithms are sufficiently different that some people do better with one and the rest do better with the oppositte one! I had not been given detailed results of my studies and it made it very hard to understand what was happening and why my results got so much worse!

i would be trying to get those results, and it sounds like Rested Gals ideas are a pretty good idea! you will get their eventually but a ibet at the moment you are probably thinking the same kind of thing i did- that you are not going to be able to get good results! I know i stressed over this for ages before i was told whar the problem had been

[dwh]

I am frustrated now. Here are my numbers thus far.
Day One AHI-25.3 AI-10.8 HI-14.5 Pressure-8 EPR OFF
Day 2 AHI-24.4 AI-12.7 HI-11.7
Day 3 AHI-12.2 AI-4.3 HI-7.9
Day 4 AHI-16 AI-2.5 HI-13.5
Day 5 AHI-7.6 AI-0.6 HI-7.0
Day 6 AHI-23.2 AI-5.8 HI-17.4
Day 7 AHI-16.2 AI-6.8 HI-9.4 Pressure-10 EPR- 2
Day 8 AHI-22.8 AI-9.2 HI-13.6

I will try to get my detailed report next week and look for complex apneas per rested gal's suggestion. You guys are the greatest!

[dwh]

I forgot to add that leak rate is usually o.o and has never been above.06.