Cooperating in My Own Care

[MandoJohnny]

Someone on the message board here was nice enough to send me a PM in response to one of my posts and explain AHI and how I can track my stats and change my settings on my ResMed S8 Elite. Without mentioning names, thanks guy! Of course, my DME guy hadn't told me any of that.

This kind person also cautioned that I shouldn't go changing settings without consulting my doc, which is good advice. So I tracked my stats and then called my doc, who is great, and he pulled my chart and actually got on the phone with me. I told him I was awaking too many times at night and that my AHI's were 5 to 6 and I wondered if I should change anything. I thought he might get upset that I was digging into this level of detail, but instead he said, "OK, try kicking that pressure up from 10 to 11. Track that for a couple of nights and if your AHI's don't drop below 4, try lowering your EPR from 3 to 2. If that doesn't work, call me back and we'll figure out where we go next."

I gotta say that I feel really good that my doc is giving me the respect of having two brains to rub together and that I am participating in a meaningful way in my own care. I have to say this message board is a great help and that, combined with my doc's great attitude is going to go a long way in helping me get deal with my OSA.

[littlebaddow]

What a good story.
Whilst I'm convinced that it is possible to take responsibility for managing your own treatment providing that there are no other factors or complications, it must be reassuring to have such a good relationship with your doc.
Long may it continue for you

[JamesCPAP]

Yeah I wish I had such a good relationship with my Doc. I still over all this time have never seen the Doc. Any communications get passed down to the Respiratory Center nurses who I have to deal with

Although AHI is important, AI is the most import figure out of AHI, AI, HI. AI basically is the amount of times you stop breathing (have a full episode) and HI is a partial episode (partial blockage of airway). So make sure you know what all three figures are, but essentially the AI. I plot mine now on an Excel spreadsheet along with:-

Mode used (APAP/CPAP), Mask, Usage (hrs), Avg Pressure, Min Pressure (APAP), Max Pressure (APAP), AHI, AI, HI, Leaks, Mask Seal (was it an overly good seal throughout the night or did I keep readjusting the mask ? and how many times I awoke in the night. I then plot this data on a graph.

My AHI is usually around 3.3 to 4.3 (AI = 0 to 0.3) and the remainder is HI. I've been told this is pretty good and certainly lower than the 130-140 AHI I had pre-CPAP.

I guess it depends on what your pre-CPAP AHI was. I've tried to tweak my setup further by increasing pressure but it hasn't had any effect, but staying with the same pressure of 8-20 (avg pressure of 12.4) I do still get the odd night where my AHI lowers to 2.5. Anything below 5 I consider (and so does the hospital) as being pretty good (for my case). Obviously if your AHI was say 30, then AHI=5 may not be that good.

[MandoJohnny]

So I adjusted the machine per my doc's advice. Increasing the pressure from 10 to 11 dropped the AHI from the 5 to 6 it had been running, down to 3.9, at least for the first night. I will track it for a few nights to make sure it's not a fluke and then try lowering the EPR a notch and see what that does. It's nice to see an immediate positive result!

If I can get it to stay under 4, I won't mess with it anymore, at least until after my next doctor's appointment.

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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI