Weight Loss and AHI change

firehawk12 · Post by **firehawk12** » Thu Feb 21, 2013 5:22 pm

Hi all,

I've been losing some weight and at first I noticed that I was sleeping well and my average AHI was hovering at around the 6 range. I've continued to lose weight, but I have noticed I haven't been sleeping as well and sure enough my AHI is now at around 15.

I was just wondering if this is related to my weight loss and an indication that my pressure is too high or if it might be something else entirely?

Thanks!

BlackSpinner · Post by **BlackSpinner** » Thu Feb 21, 2013 5:30 pm

firehawk12 wrote:Hi all,

I've been losing some weight and at first I noticed that I was sleeping well and my average AHI was hovering at around the 6 range. I've continued to lose weight, but I have noticed I haven't been sleeping as well and sure enough my AHI is now at around 15.

I was just wondering if this is related to my weight loss and an indication that my pressure is too high or if it might be something else entirely?

Thanks!

With weight loss your pressure needs can go down or up. So can how your mask fits.

if you have data and software you can post it and people can give you some guidance. But it looks like you will need more pressure.

Pugsy · Post by **Pugsy** » Thu Feb 21, 2013 5:36 pm

If you report that you aren't sleeping well...you may have some tossing and turning centrals in that AHI.
Best thing is to evaluate the reports before changing anything.
If the bulk of that AHI isn't obstructive...increasing the pressure won't help and might be a problem.

firehawk12 · Post by **firehawk12** » Thu Feb 21, 2013 5:44 pm

Unfortunately I only have a Resmed S8, so I don't have any specific data on hand. I know that my yearly, half-yearly, and monthly average AHI was around 7. My average for the last week was around 6. But the last couple of days it has become 15 and I can definitely "feel it" in terms of my head being cloudy and foggy (which is how I would feel if I typically have a bad night of sleep). I have no idea if that information is useful in this case though?

(My mask leakage number seems to have stayed the same across those time periods).

I know the best bet would be to do a study, especially given my weight change, but that won't be an option for me for a while (and I'd like to believe that I would lose some more weight as well).

Wulfman... · Post by **Wulfman...** » Thu Feb 21, 2013 5:55 pm

firehawk12 wrote:Unfortunately I only have a Resmed S8, so I don't have any specific data on hand. I know that my yearly, half-yearly, and monthly average AHI was around 7. My average for the last week was around 6. But the last couple of days it has become 15 and I can definitely "feel it" in terms of my head being cloudy and foggy (which is how I would feel if I typically have a bad night of sleep). I have no idea if that information is useful in this case though?

(My mask leakage number seems to have stayed the same across those time periods).

I know the best bet would be to do a study, especially given my weight change, but that won't be an option for me for a while (and I'd like to believe that I would lose some more weight as well).

You're not giving us much information to go on.......

An S8 "WHAT"? Which specific model? The Elite and Autoset models were fully data-capable with software. Lots of people liked the S8 series.

What are your settings? (pressure, EPR, etc.)

Den

.

Pugsy · Post by **Pugsy** » Thu Feb 21, 2013 5:56 pm

Bummer.

Any chance with the change in weight that the mask is leaking much...you have leak data don't you?

You know you can always try a little more pressure...see if you feel worse or better. See if you sleep better.

firehawk12 · Post by **firehawk12** » Thu Feb 21, 2013 6:03 pm

Wulfman... wrote:
An S8 "WHAT"? Which specific model? The Elite and Autoset models were fully data-capable with software. Lots of people liked the S8 series.

What are your settings? (pressure, EPR, etc.)

Den

.

My apologies.

I have an S8 Elite 2. My understanding is that it uses a proprietary "smart card", which I do not have, so I can only access the data via the clinician's menu.

My current CPAP pressure is 14 and EPR is level 3 (also set to fulltime).

Pugsy wrote:Bummer.

Any chance with the change in weight that the mask is leaking much...you have leak data don't you?

You know you can always try a little more pressure...see if you feel worse or better. See if you sleep better.

My leak for yesterday was 0.02L/s, which is actually lower than the weekly average that is recorded in the device.
I have no idea what these numbers mean, but if they are useful... My AI is 1.9 (weekly average is 0.3) and my HI is 13.1 (weekly average is 5.8 ).

Something is definitely going on at least, I'm just not sure what it could be since the only change is my weight (and the fact that I'm exercising more as part of my weight loss).

Wulfman... · Post by **Wulfman...** » Thu Feb 21, 2013 6:24 pm

With a pressure of 14 and an EPR setting or 3, your "effective" pressure is only 11 at the point where you change from exhale to inhale. ResMed machines drop exhale pressure by a full centimeter with each number of EPR setting. You may actually NEED a certain amount of pressure at that point to prevent certain events and you should be able to find out what it is.
You might want to try reducing your EPR setting from 3 to 2 or 1 and see if that makes any difference.
It's also been said that the S8 models tended to "over-report" hypopneas.......they may be counting flow limitations in the HI numbers.
In any case, you could try a little more pressure or a little less and see what happens. If your numbers get worse, you' ll know you're going the wrong way.

I believe I've read that there was a cable that could connect the CPAP to the computer and the smart card or reader was not needed. However, I'm not a guru on those machines, so I can't say for sure. If you do an advanced forum search on the username "billbolton", you may find the answer in his posts. He's truly the guru on these connectivity things.

Den

.

BlackSpinner · Post by **BlackSpinner** » Thu Feb 21, 2013 6:27 pm

It is not only the card but the card reader that is a problem for the S8.

You could try to get a card from your dme and have them read it and give you a print out.

firehawk12 · Post by **firehawk12** » Thu Feb 21, 2013 7:22 pm

It's not convenient for me to get in touch with my DME at the moment unfortunately. I may look into the cable thing to see if that's a possibility... but seeing that S9 uses a standard SD card, I'm a bit jealous and wish I had upgraded my old device a year later than I did.

That said, if I were to adjust my pressure numbers, is it better to start adjusting up or adjusting down?

Wulfman... · Post by **Wulfman...** » Thu Feb 21, 2013 7:41 pm

firehawk12 wrote:It's not convenient for me to get in touch with my DME at the moment unfortunately. I may look into the cable thing to see if that's a possibility... but seeing that S9 uses a standard SD card, I'm a bit jealous and wish I had upgraded my old device a year later than I did.

That said, if I were to adjust my pressure numbers, is it better to start adjusting up or adjusting down?

I think I would suggest starting with the EPR number. Set it to 2 for 3 to 5 nights and see if anything noticeable happens.....then, set it to 1 for a few nights and see what that shows.
Or, you could leave EPR at 3 and increment your pressure from 14 to 15 for several nights and work upwards for a few centimeters.
If these changes start adversely affecting the numbers, then try lowering your pressure of 14 to 13 and lower your EPR to 2, etc.......and work down.
There are a multitude of settings options to try.

The ResMed machines (utilizing EPR) are somewhat like a Bi-Level machine. With a Bi-Level, you set your EPAP (lower pressure setting) to reduce the Apneas and the IPAP (higher pressure setting) to reduce the Hypopneas.

Den

.

firehawk12 · Post by **firehawk12** » Thu Feb 21, 2013 9:24 pm

Alright, I might try fiddling with those numbers. Thanks for the advice.

chunkyfrog · Post by **chunkyfrog** » Fri Feb 22, 2013 12:20 am

Remember, one change at a time--that way you know what to do next.

Otter · Post by **Otter** » Fri Feb 22, 2013 1:49 am

Take your card and a flash drive to a local DME and ask them to copy the card for you. You might get someone who thinks it's illegal for you to look at your own data, but any sane person would make the copy for you.

stage0 · Post by **stage0** » Fri Feb 22, 2013 1:58 am

The problem is not only weight loss, but also where the fat is decreasing. In your neck is the most influencial due to the airway opening. If you know your neck size before the weight loss started and can compare it to now- you will have a better idea of your higher AHI. Generally a neck size of 16.5" is good for a man....16 for a woman. The next most influencial part of the body is the belly, chest area. This is due to gravity pulling down on your lungs. Get with your doctor about havng a pressure reducton scrip for your DME. ALSO.....generally....a weight loss or gain of 15 lbs transfer to a corresponding pressure loss or gain of 1 CWP. I think your pressue is to high and is causing an increase AHI

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