Increased hypopnea, decreased OA?

[Andypap]

Hi-

My AHI numbers have been going up past 11 recently. I bought a Resmed S9 to replace my older Respironics One machine, and I've noticed the obstructive apnea is going down, but the hyponea numbers are getting higher (8 hours HY vs 1.6 OA).

What would cause that, and, is it better to have higher HY and lower OA?

I can post last nights' chart if that would help?

Thanks.

Andy

[ChicagoGranny]

I can post last nights' chart

Yes.

A pressure adjustment might help. But, the data needs to be seen.

[Andypap]

Here's the past week - quite the mess!

[LSAT]

I would raise the pressure to Min 15...Max 20. In fact, if this doesn't work for you, a different machine may be the answer. Bipaps are used for higher pressures.

[Pugsy]

is it better to have higher HY and lower OA?

You don't really want higher either.

Are these the same settings as you were using on the Respironics machine? How high were the OAs on it?

You need more minimum pressure for sure.

You may need that 15 minimum that LSAT suggested...maybe not. 3 cm is a pretty big jump in terms of comfort though. If it were me I would maybe consider upping that minimum 1 cm for a couple of nights...watch the data...then another 1 cm to 14 and watch the data...and if still too many hyponeas try the 15 minimum.

Hyponeas sometimes respond a little more easily because they aren't full blockages...so you might get lucky and find that they go away/reduce with just a little more. Never know with those things.

Based on your FL graph...probably going to at least need 14 minimum though. Up to you...if going from 12 starting point to 15 is too big of a jump comfort wise...work up to it in smaller increments.
And yeah, open the max...the machine won't go there unless it needs to and sometimes we get lucky when the minimum pressure is doing a better job preventing the machine doesn't have to go up there trying to fix something after the fact.

[Andypap]

Thanks for the advice. I duplicated the settings I was using on my old machine. I noticed the higher AHI numbers on the old machine, and read that the S9 gets to higher/max pressure faster as far as algorithms go. So I bought the S9.

I'll up the min to 14 and max to 20, and see if that improves the numbers.

Not sure why I'm getting worse - I do sleep on my back, but Ive had lower numbers in the under-5 range previously, but not consistently. Very frustrating!

[Pugsy]

While the S9 auto algorithm is a bit speedier in its response when compared to the Respironics auto, it's not like the Respironics takes half an hour and the ResMed only takes 3 minutes. The actual difference might only be a couple of minutes.
Also remember that the 2 brands have 2 totally different algorithms for determining pressure adjustments that might be needed no matter how speedy one might be. There's more involved than just how fast the machine can respond...there's also what causes it to respond and probably some other stuff.
It's like trying to compare apples and oranges.

[Andypap]

I hear ya. i do think the S9 is designed way better, especially the humidifier tray/cup. The Respironics one is clunky and hard to clean. Since I used it EVERY DAY, better design is key.

[Pugsy]

When you have time you might want to update your equipment profile. It's only showing the H4 humidifier now.
The links are broken to the S9 choices but you can just manually add them to your comments section.
S9 AutoSet with humidifier is sufficient...we all know which humidifier is used with the S9.

[chunkyfrog]

Just a personal observation:
I had to limit the maximum for my S9 because it DID go berserk--thus waking me.
Some of us may need to limit our max if this happens. Maybe just a few, but worth considering.

[Pugsy]

Just a personal observation:
I had to limit the maximum for my S9 because it DID go berserk--thus waking me.
Some of us may need to limit our max if this happens. Maybe just a few, but worth considering.

This is true. While the machine won't go somewhere without what it thinks is a good reason sometimes it going there creates a worse problem than whatever it was trying to kill.
Some people just are sensitive to pressure changes or maybe pressures above a certain point.
It hurts nothing to limit the max though...and it doesn't hurt to even let the machine max out a bit if going higher creates more of a problem than it is trying to fix.

Plus sometimes just a small increase in a minimum will stop the machine from wanting to go higher. I have seen this happen often.
One in particular I remember was a woman seeing 18 max often and it was obvious her minimum needed to be increased due to the OAs and hyponeas...once we got the OAs and hyponeas better prevented her machine never went above 13 despite it still being open to 20.
We originally thought she needed a bilevel but once we had a more optimal minimum the pressures never went that high again and she was good with it occasionally hitting 13.

[Andypap]

I'll try the 14-18 settings first and see if that works better for me. Then I'll see if lowering the max makes any difference.

[ChicagoGranny]

AHI can be high and you are doing fairly well

A high AHI will cause sleep deprivation.