Apnea readings higher over the past few months.

[bob007]

Hi,

I've been on CPAP since March 2010. It's been a long road but over the past couple months I can honestly say I've been feeling better. Less fatigue and more good days than not so good.

My year averages look like this: AHI 2.4, TAI 1.6, CAI 1.4. ; 6 mo. Avr: 2.7, 2.5, 2.0; 3 mon. Avr: 3.2, 3.1, 2.4; 1 mo. avr: 4.1, 3.8, 3.3; 1 wk avr: 4.9, 4.7, 4.2 and last night: 7.5, 7.4, 6.9.

My pressure is set from 8.0 to 17.0, max ramp at 20 min, start pressure 4, EPR full time, EPR level 3.

As you can see, my AH's seem to be increasing with time and particularly over the past week.

I'm trying to figure out what to do at this point. I am beginning to feel that old "fatigued" feeling again and don't want to slide down that slope.

I've a call in to my sleep doc but of course try getting hold of a doc on Friday LOL.

Any suggestions?

Thanks,
Bob

[Julie]

Hi, well a couple of ideas for you here. You might be better off either raising your low pressure (8) or lowering your high one of 17, because the machines tend to work better with a more narrow range, e.g. 8-12, or else 12-17 (if you need it that high). Also, have you ever tried just not using the ramp feature at all? It's only there to help people ease up to their scripted pressures, and most of us stop using it very quickly once we are used to the pressure, plus starting at 4 is very hard to breathe at for anyone.

You also have a nasal mask, but it's possible your mouth opens when you're asleep and you could be losing all the Cpap air that way, effectively getting no treatment at all, or at least not very much, so you might want to consider a full face mask now.

Apart from those basics, maybe someone else will have an idea. Good luck, I'm sure you'll do better once things have been tweaked.

[Drowsy Dancer]

I believe you have a data-capable machine. Do you have the software so you can look in detail at your data?

Are you waking up with a dry mouth? Like a previous poster, I too would speculate that you might have a mouth leak. Try taping your mouth (do a search for suggestion threads--there is a lot of knowledge around here about how to do this without destroying the skin around your mouth). It's something to try immediately before you can get your hands on a full face mask.

ETA: Here is a link to information about mouth leaks and taping: viewtopic.php?t=8011

DD

[DoriC]

What was your titration? You made need a narrower pressure range with the minimum set closer to your titration. If you have software it should tell you where your 95% pressure is landing.

[pj2448]

I would agree the higher AHI over time is likely a setting issue with your machine. The advice about the range being too wide and and ramp still being used is good. I would disable the ramp and close up the range to maybe something like 8-13 and try that for a while. I don't know a thing about your situation but I know few if any people breathe in a range of 8-17, not to be confused with Bi-level users if the setting is inhale-exhale. If that range is left like that, the auto will find its opportunity to go as high as its allowed in situations where there is a leak or moisture gets in the tube (fools the auto into thinking there is an obstruction) and that will hurt your AHI and your results. Long range, you ultimately may do better on Bi-level and not auto mode if the EPR of 3 is the only relief that feels natural. Separately, I would continue with a nasal only mask unless you know for sure you're leaking out your mouth. I've never heard of anyone who lowered their AHI by moving to a FF mask if there was no mouth leaking. Its usually the other way around. *Edit, I take it for granted you're not mouth leaking since you did not report that was occuring*

[prefer2breathe]

Hi,

I've been on CPAP since March 2010. It's been a long road but over the past couple months I can honestly say I've been feeling better. Less fatigue and more good days than not so good.

My year averages look like this: AHI 2.4, TAI 1.6, CAI 1.4. ; 6 mo. Avr: 2.7, 2.5, 2.0; 3 mon. Avr: 3.2, 3.1, 2.4; 1 mo. avr: 4.1, 3.8, 3.3; 1 wk avr: 4.9, 4.7, 4.2 and last night: 7.5, 7.4, 6.9.

My pressure is set from 8.0 to 17.0, max ramp at 20 min, start pressure 4, EPR full time, EPR level 3.

As you can see, my AH's seem to be increasing with time and particularly over the past week.

I'm trying to figure out what to do at this point. I am beginning to feel that old "fatigued" feeling again and don't want to slide down that slope.

I've a call in to my sleep doc but of course try getting hold of a doc on Friday LOL.
Any suggestions?

Thanks,
Bob

To me, it looks like its mainly reading them as centrals. I know for my particular situation, I was having this same problem. What I did, was I lowered my upper limit, because what I found was that my machine would increase pressure on my flow limitations and it would tend to take off and centrals increased (or so the machine said). I lowered my upper limit to a much narrower range and I have more flow limitations but my AHI decreased. Make sense?? I'm not sure if it does but that was what worked for me.

[prefer2breathe]

My titrated pressure is 10. I originally set my auto to a minimum of 10 with an upper limit wide open to 20. As I said in my previous post, most nights my ahi consistantly was recorded as centrals. Now, I realize that its not necessarily centrals and I had no report of them in either of my sleep studies, but nonetheless, my ahi increased with a higher upper limit. My maximum pressures would go up to 15 at times because of flow limitations. My leaks are or were never a problem however. I did notice on resscan that my flow limitations were pretty well non existent though. After about a month or so, I lowered my upper limit to 15 seeing that my pressure never really went up over that anyway. Pretty much the same result as before. Tried that for about a month and lowered my upper limit to 12.6. My flow limitations are more but my ahi is lower. Even though its showing that I have flow limitations, its not enough to create an event. So, I'm not sure if its better that I have more flow limitations with lower ahi or less flow limitations with higher ahi.

Sorry about bringing that up because we're focusing on your question on this thread not mine.

[Pugsy]

Do you have the software so that you can see the detailed data reports? If so can you post last nights report for review? If not, do you wish to get the software?

[bob007]

Hi guys,

Hey, thanks for all the tips. I'm going to review all of them again to be sure I make the right tweak on the machine. Sounds like getting rid of the ramp and narrowing the pressure would be good first steps. I'm aware, from reading other posts, that I need to tweak pressures gradually and not too frequently. I'm not sure about mouth leaking but I don't wake with a dry mouth. I'll be checking that one for sure.

Last night the readings were still high. My pressures are consistently between 9-10, lowest 9.0 highest 10.6. Leaks vary but I've had low apnea readings with high leaks (leak 18 with readings apneas in the 1.4 range) and high apnea readings with low leaks (leak at 0, apneas in the 5.5 range).

I don't have the software but would like to know how to get it. I keep a written log of date, pressures, leaks, how I'm feeling.... but there has to be an easier way LOL.

Thanks again,

Bob

[Bobby269]

Do a search for uncle_bob. Below his signature you will find the download for the ResScan software.

[bob007]

Thanks for the software lead.

I got it running but there are no detailed reports, just summary. Is there a way to turn on that feature on the S9 or the software?

I briefly looked over my summary reports for the past year and it seems to indicate that I have very few obstructive apneas and mostly centrals :[ Not liking what I'm reading about them on the web. I can't seem to find detailed information on cpap.com on centrals so far, and information on whether it might be a hardware malfunction with the S9 or a tweak needed to the settings.

Last night I turned up the pressure from 8 to 10 and removed ramp. The numbers dropped but again, according to the software, it was a high central (3.1) and low obstructive (.7).

Any suggestions on what to do next?

Thanks,

Bob

[bob007]

BTW, my sleep doctor never mentioned anything to me over the past year about centrals just that my AHI numbers were within acceptable range (below 5.0).

[Pugsy]

I got it running but there are no detailed reports, just summary. Is there a way to turn on that feature on the S9 or the software?

Detailed data must be selected prior to the download process on a separate screen choice because the default for download is summary only.

See if this tutorial helps.
http://montfordhouse.com/cpap/resscan_tutorial/

[bob007]

Hi guys,

Thanks to many helpful tips from users here at cpaptalk.com I've figured out the software and have posted links to last nights details and summary's going back to July 2010.

My apneas are increasing over the past couple months and the details show centrals. I went to my sleep doctor a couple weeks ago and her report said my centrals were low.

I can't seem to figure out the discrepancy or wonder if my S9 is not working properly.

Last night I went to bed at midnight and woke up at 8:00. The graphs show the recorded sleep and wake time wrong and this is consistent on my graphs (I checked several nights). I also have the S9 bug that skews the graphs but I lined them up for this report.

Any ideas? I'm a bit concerned about these centrals and can't figure out why my apnea reading are going up since I've started using CPAP. I can say that overall I'm feeling better but I don't want to regress.

Please let me know if there is other info you need to know to answer.

Thanks,

Bob
https://picasaweb.google.com/vccrwp/CPA ... zr0aDcqAE#

[avi123]

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