Encountering some problems :-(

[reolhlains]

[Edit - now know issue isn't related to change of machines, but still don't know why AHI so high - I have gone from AHI of less than 2 for three months to between 5 and 7].

Hi everyone!
So, I did a PAP trial from mid-October and was lucky enough to feel the difference immediately.
On the trial, my AHI was (with only a few exceptions) below 2.
As you might remember after some posts on here, I bought a machine from the US, which I started using regularly last Sunday. I haven't given the trial machine back yet, but I am due to probably on Monday.
Anyway - I tried to set up my own machine with exactly the same settings as the trial machine - being the same model, I thought (hoped) things would just continue. But, since starting the new machine on Sunday, my AHI has been between 5 and 7 - in the five nights, I haven't got below 5.3.
It was only this morning I noticed this - I woke up feeling like how I used to pre-CPAP, which prompted me to load the data into Sleepyhead.
I've posted below an example of my trial machine (with really low AHI) and my own machine, which isn't so good.
I would really appreciate any help/advice you have after taking a look.
Thanks a million!!!
(going back for a nap now - just like the old days!!).
edit: sorted the images to thumbnails - sorry!

[grayghost4]

I don't see any reason for the difference ... try turning the machine upside down

at a time like this a little levity is needed

Others may have better suggestions

[reolhlains]

I don't see any reason for the difference ... try turning the machine upside down

hehe - thanks mate!

I have no idea what it could be - but it must be something. Pre-Sunday, I had brilliant AHI - swap machine, and I have rubbish AHI and feel equally rubbish!
I spoke to the people I am doing the trial with and fessed up to having bought one elsewhere. They said they are happy to take a look at it and see if they know what's going on/update the software and just charge a consult fee, which I thought was excellent. I'll do that next week if I don't get it sorted before then.

To confuse things - I am actually using the mask that came with the trial, not my own new one, so it can't be the mask...

[reolhlains]

Update - so I tried the trial machine again last night and my AHI was in the 7s - so at least I have ruled out an issue with my own machine, it just seems to be a coincidence that something else changed since I swapped them over.
I have no idea what it could be really - but that's been 6 nights of AHI over 5 and I am feeling really awful - exactly like how I felt pre-CPAP.
I'm thinking the machine made no difference the past few days at all as my AHI is similar to the pre-CPAP sleep study. Which kinda leads me to think that the only possibility is I have for some reason started opening my mouth during my sleep? Do the results show that - can they show that? I have no idea. I also don't know why things went perfectly for almost three months, then just went downhill so badly so quickly.
Should I close this thread off and start another as it's a different issue? I'll delete the "good" graphs at least , as I now know they are no longer relevant to the issue.
Cheers everyone.

[Julie]

Better to keep your history in one place so we can follow it properly. I don't know if it's come up before, but have you tried setting your low pressure a bit higher, e.g. to 8 or 9? That's often the answer to high AHI's, everything else being equal.

[reolhlains]

Thanks for the reply.
I will try an 8 (or higher if I can) tonight and see what happens.
I am not sure that'll help though, as the machine was set by the tech at 6-16 when I got it. I was getting great AHI at a min of 6, but increased it to 7 as I wasn't feeling like 6 gave me enough of a breath while falling asleep (same issue lots of people have I think!).
I really, really hope that works - can't go back to feeling like this all the time!!!

[reolhlains]

I just had a nap with the min set at 8 - which was fine to tolerate, so I'll go 8.5 or 9 tonight and see how that works out (the nap rolled into last night's numbers, so not sure what my AHI was).

Question though - is there any way to tell if I've started breathing through my mouth during the night, and if that's what causing this not to work? I'm just struggling to see why there has been such a severe difference between last week and this week.

[bonjour]

Try to post these charts. They will give a better overview of what is happening

Suggested Support Order for your charts
Event Flags
Flow Rate
Pressure
Leak Rate
Snore
Flow Limit

[Guest]

Question though - is there any way to tell if I've started breathing through my mouth during the night, and if that's what causing this not to work? I'm just struggling to see why there has been such a severe difference between last week and this week.

When mouth breathing -- leaks will go UP and AHI will go down. When leak rates are high the cpap can't detect events so you will often get an AHI of zero which some think is great but the fact is you can be having events the cpap no longer detects.

The same can happen if the hose is too long.

What position are you sleeping in?
ALL things must be the same on both cpaps including the hose, mask, and sleeping position.

[reolhlains]

Hi everyone - thanks for all the help/advice (and thanks mrpatwik/guest) - maybe it isn't mouth breathing, I just can't see why else it would suddenly go from great to back to day one.

Anyway, since my original post, I have:
- ruled out an issue with the machine (that was just a wild coincidence);
- increased my min pressure to 8.5 (I think I should be ok putting it up to 9 tonight as 8.5 was fine last night); and
- I hadn't read the post about mouth breathing, so I even taped my mouth shut last night (which again didn't feel as ridiculous as I thought it would!).

So, this morning my AHI was in the 3's - which is obviously much better than the 7's, but still not the 1s I was getting just over a week ago.

I have pasted last night's data below. Bonjour - for some reason I don't have Flow Limit graphs on my Sleepyhead data.

Thanks so much again - any help/advice you can provide would be amazing. I really feel a bit better this morning, but still not as good as I was feeling in the 1s and 2s.

Cheers

[OkyDoky]

You will probably need a little more minimum to decrease the Hypopneas. You can do that in one of 2 ways, you could raise the minimum or decrease your Flex
(which effectively decreases the time you are at lower pressure thereby increasing your overall minimum). Just try one at a time and give it a few days.

Your machine will not have a Flow Limitation graph. Respironics uses FL flags but no graph. ResMed uses FL Graph but no flags.

[Guest]

I think you need to move your Epap to 8 -- for a couple days. If that doesn't get you where you want to be move it to 9 then up to 10. See how you adjust to that.

[OkyDoky]

I think you need to move your Epap to 8 -- for a couple days. If that doesn't get you where you want to be move it to 9 then up to 10. See how you adjust to that.

He is on APAP with a Min. and Max. setting but no EPAP, that would be on a bilevel machine.

[Guest]

My fault. Saw the two traces on the pressure and the Epap min. @6.40 on the left. Take the min right up to 9 for a couple days then 10. Looks like Aflex is dropping the pressure down while events sneak in.

[reolhlains]

Thank you OkyDoky and Guest
I will put it up to a 9 tonight (and maybe try and reduce the EPR to zero - I haven't had it below a 1 ever, so not sure how that'll go!).
Just so strange that there as suddenly such a severe change - things were going really nicely then suddenly went from like 1-2 to 5-7 (literally overnight).
Really don't understand that!