AHI & HI going up

[Herman]

I just switched from a CPAP (8 years) to an Resmed Autoset II. These are the results for the last three nights. The only change I made was after the first night I lower my EPR from 3 to 2. That shouldn't account for the increase in AHI should it?

Pres 11 10.8 10.4
Leak 0.24 0.2 0.28
AHI 2.4 4.1 4.3
AI 1 1 1
HI 1.4 3.1 3.3

[bdp522]

What brand cpap, and what settings on the autoset? Resmeds tend to record more hypopneas than other machines.

Brenda

[Herman]

What brand cpap, and what settings on the autoset? Resmeds tend to record more hypopneas than other machines.

Brenda

I have a Resmed Autoset II. Minimum pressure 6.6, max is 20. EPR was at 3 and I lowered to 2. Though I am very complaint with my CPAP and have had 4 sleep studies in the last 8 years, I really haven't had much relief other than no snoring. I have COPD/chronic bronchitis and asthma (never smoked it's a hereditary condition ), my sleep studies recorded no apneas, but 30 hyponeas and arousals. The pressures during the 4 studies were 14, 14, 12, 10. The diagnosis was UARS. I have purchased so many masks over the years to find one that won't leak, I can probably going to the DME business. I've tried pillows, but could not stop the leaks and I have a long nose with a very narrow bridge, which prevents me from using most masks since the pressure point at the top of the mask has only a narrow spot and it won't displace the mask pressure. This results with bad pressure sores even with all the tricks (mole skin, bandages, pads, etc).

I am probably going to buy the software to see if I can narrow done the events. The only suggestion I received from another forum was to lose weight and eat better and I could probably be cured. I'm 5'10, 165 lbs and my diet is really good. I have a beard and that is limiting on mask selection , but my wife is adamant about me not shaving it off.

[Hawthorne]

I don't know much about Resmeds but I know that they seem to record more HI than other machines. I see that your AI has remained the same and that is a more important stat.

I note that, for the 3 nights, you had 3 different pressures. Are you using the machine in auto mode and are these the average pressures or are you using it in cpap mode and changing the pressure? Maybe I just don't know how Autoset works since I am more familiar with Respronics machines.

If you are changing your pressure each night, then, it appears that the higher the pressure (at 11 you had the best data) is better. The lower the pressure, the higher the HI and, therefore, the higher the AHI. In all 3 cases your AI stayed at 1.

[ozij]

You can expect your result to vary from one night to the other, even when you don't make any changes in the machine.

I would nudge the minimum somewhat higher, e.g. 8 to have it closer to the last titrated pressure.

I take it you changed the EPR because you felt the pressure drop on exhale was too much - but that may also be hint that your minimum is too low.


O.

[Goofproof]

And with nasal masks, there is always the mouthbreathing factor to consider. Jim

[Herman]

I have the machine in auto mode. Since I don't have true OSA, my inspiration flow limitation varies depending on my COPD, so for the short term I think I'll leave it in auto. Good point about raising my minimum and the affect on the EPR. I'll try that tonight. The DME had it set to 4 and was reluctant to up it to 6. I raised it to 6.6 the second night. Unfortunately, the literature on COPD, asthma and UARS doesn't reflect great success. Still need to research the leak rate. I'm using the standard mask setting since Resmed doesn't have a setting for their own Mirage Vista mask. Maybe I need to check with them on what is a typical leak rate with a Vista.

Thanks

[feeling_better]

I just switched from a CPAP (8 years) to an Resmed Autoset II. These are the results for the last three nights. The only change I made was after the first night I lower my EPR from 3 to 2. That shouldn't account for the increase in AHI should it?

Pres 11 10.8 10.4
Leak 0.24 0.2 0.28
AHI 2.4 4.1 4.3
AI 1 1 1
HI 1.4 3.1 3.3

It is possible that EPR reduction could increase HI for those who are sensitive to the CO2 content (and centrals). It might be worth trying with EPR back at 3. In any case, get 4+ days of data before you make changes, there are daily variations all the time.