Regarding my AHI, Hypopneas

[beautifuldreamer]

The one trend I notice with my ASV, is that the Clear Airway and Obstructive apneas are pretty minimal, but the Hypopneas seem to be high-

A few nights ago, the hypopneas were 29.52 and zero clear airway and 6.56 obstructive (I was actually awake most of that night, dealing with some sciatic like pain).

Last night it says my hypopneas were 10.28 with zero clear airway, and zero obstructive.

At this time, I don't have access to my older data from when I was using the Bipap auto, but in my memory, I do not recall there being a significant number of hypopneas to take notice, of, they were mostly clear airway and obstructive. . .

I wonder why the hypopnea events are on the rise -

[Pugsy]

Are you maybe sleeping on your back more?

How did you come up with the current settings that you are using?
How do they compare with what you were using on the old machine?

With the PS of 0 and EPAP minimum of 8 the machine is working more like an apap until the centrals cause the PS to increase. You probably need a bit more EPAP to prevent the hyponeas if we assume they are obstructive in nature and while they can be central in nature most of the time they are obstructive.

[beautifuldreamer]

Funny, I have been mainly a back sleeper, and then when i started on CPAP, I switched to sleeping on side because I heard that was better to do, and I am not sure when it happened, but I have reverted to sleeping on my back mostly during the night . . .

The settings on my ASV were from the doctor's prescription, and the DME (Apria) put the settings on the device for me. I actually had to have the ASV replaced a couple of months ago, and they kept the same settings as far as I know. What EPAP do you think I should try?

Thanks bunches

[Pugsy]

It's possible that the difference in numbers is because you are sleeping more on your back and you need more pressure when on your back.

How much more EPAP (think of minimum EPAP as the baseline to hold the airway open well enough so that when the airway tissues try to collapse it can start from the baseline and go to where it needs to be quickly enough to prevent the collapse) I don't know. It's really no different than figuring out the minimum pressure for someone using an apap and the minimum isn't able to get the job done. You start off small and work your way up.
When you have time you might find this interesting and help you understand how the machine works.
http://www.isetonline.org/yahoo_site_ad ... 190318.pdf

I would start with a modest 1 cm increase in the minimum to see how the hyponeas respond if it were me.
Fully expecting to most likely need more but I would go small and slow with the increases if it were me.
I would also add in some PS so that I had a bit of IPAP to help out the EPAP.
Generally it's EPAP for OAs and IPAP for hyponeas but you don't really have any IPAP with the PS being 0 and it's not really doing anything until a central happens.
I don't know why they left PS minimum at 0 ....were they just letting the machine work from the default settings or was there a specific reason for that choice. It's not what is generally done for someone who has both obstructive sleep apnea and central sleep apnea. So I am kinda scratching my head as to how they come up with these settings.

[beautifuldreamer]

Thanks Pugsy,

I remember now why I shifted to sleeping on my back- Last December, while I was walking to my car in a parking lot, a hit and run driver of a pick up truck ran over my right ankle/foot- Thank God nothing else was harmed (and no broken bones), but I had to sleep on my back to keep my foot/ankle elevated. There is still some swelling from time to time, and the elevation does help.
As I continue to heal, I will likely work on shifting back to sleeping on my side. Although at the moment, I have some sciatic like pain issues, that are interfering with my ability to sleep at night . . . expecting that to be resolved in the near future too

Thanks for the tip, I put those numbers down, based on what I saw in the set up area of my ASV. I will check them tonight again to see if I recorded them correctly. I may also ask my Sleep Doc if he could email me what the settings are supposed to be