AHI index rising

[OCNorsk]

I'm a six. I noticed my AHI's were climbing back up the last few days. Could be holiday stress...less than optimal eating. I exercise, not vigorously, but consistently. That being said, I think exercise does effect how you sleep as well as other aspects of your life, but I wouldn't think it would start to effect your sleep if it hadn't previously unless, your health is deteriorating anyway.

The C-Flex might need to be adjusted, but I don't think I'd change the pressure at this point. I did change mine once, but I put it back. Six is good for me.

All said only from personal experience, no medical background.

[papc]

Well, I went to the sleep Doc. They had me do a Oximeter test for one night. They determined that my original sleep study with a mask was not too good because I only slept a few hours during the test. They wanted me to take another sleep test. I said I did not want another sleep study test. So I told them to pump up the air pressure. They raised it from 6 to 8 and gave me another mask. The comfortlite 2 which I requested. Now my leaks are rising from 22 up to over 25. My AHI is at 6.2. When I started CPAP, I was at about 7.3 AHI. Then it went down to under 4 and I felt great. It has been rising to over 6 for about a month. Sometimes lower. But hovering around 6 or so. The nurses tell me that is good. I guess my concern is leaks and my comfortlite mask, which I like but is not as comfortable as I thought. So I went back to my Swift LT which is more comfortable than the Comfortlite 2. Here is my question. I have been on CPAP since September 09. So it's not been a long time. Should I be content with the AHI and leakage numbers? Should I be content with the masks I have? And just accept it all without trying to reach perfection with the best mask and low numbers? I don't know how to approach all of this or what to do. Or should I just forget it and settle on one mask and just live with it? Also, I have been reading about the new medication for obesity which lowers apnea events by up to 69% and reading about the apnea implant. I would appreciate any input anyone might have. Thanks all!

[Muse-Inc]

Papc, please go to the User Control Panel (upper left under the Search field) and fill out your equipment profile (select TEXT please). Without knowing what equipment you are using, it's hard to make suggestions. Please post your overnight numbers and your averages, so people know what's been going on while you sleep. A rising AHI is not good but without data, it's a challenge to know what to change. What data was reported in your sleep study? Di dypu have centrals, limb movments, spontaneous arousals, good or poor sleep architecture -- there are many things that can affect the numbers, including illness, allergy-sinusitus-congestion, and prescriptions or over-the-counter drugs.

[cotech50]

I only slept 45 min on my 1st sleep test but it was enough to indicate an AHI of 14 with a recommendation for apap set at 7-15cm to start. That pressure range was indicating a needed pressure of 11-12 cm which was confirmed at a later titration now I am at a 11cm to 14cm with a full face mask and my avg 7 day ahi is running 1.5. Yes mask leaks can be a big problem. You made no mention of a titration study, if you can run auto with a pressure range for a week or so it can point to a proper pressure which combined with a good and proper fitting mask can make all the difference in your treatment. good luck.

[SleepingUgly]

My unit is controlled by the Doctor via modem. So I don't think I can C Flex off. But I can turn it down to its lowest level.

I have the Respironics System One Auto and I have a modem. I can change my settings, and I bet you can too. However, your doctor will see that you are making these changes if he/she is closely monitoring your treatment, and I don't know how you or your doctor feel about that.

I exercised last night and it knocked me out so I think thats why I slept better. Thanks everyone for all your help. I greatly appreciate it.

Ideally you shouldn't exercise at night. This is especially true if you have periodic limb movements, but it's also generally thought to be poor for sleep even among "normals".

[SleepingUgly]

BTW, my AHIs were totally different with nasal pillows vs. full face mask. I don't know if one can even compare AHIs between masks. Does anyone know?

[Muse-Inc]

...Ideally you shouldn't exercise at night...generally thought to be poor for sleep even among "normals".

I think this is an individual characteristic. I am a night owl and typically exercise within 30 mins of sleeping; I found it has no effect on my sleep or my numbers. For me, exercise in the morning is really hard and really, really hurts.

[papc]

Papc, please go to the User Control Panel (upper left under the Search field) and fill out your equipment profile (select TEXT please). Without knowing what equipment you are using, it's hard to make suggestions. Please post your overnight numbers and your averages, so people know what's been going on while you sleep. A rising AHI is not good but without data, it's a challenge to know what to change. What data was reported in your sleep study? Di dypu have centrals, limb movments, spontaneous arousals, good or poor sleep architecture -- there are many things that can affect the numbers, including illness, allergy-sinusitus-congestion, and prescriptions or over-the-counter drugs.

Okay, I posted my equipment in text. Here are my numbers from the machine: Leaks: L/min 7day average = 26.2, 30 day average = 23.3. AHI: 7 day average = 6.3; 30 day average = 6.2. Hours slept a night: 7 day average = 8.48, 30 day average = 8.30.

I have had my AHI down under 4 at one point and felt terrific, both mentally and physically.

Now I feel just so so. During the holidays is when everything went up. Stress? Probably.

Should I just be contented with the equipment I have and the readings? Or pursue "perfection"? Thanks all!!

[ozij]

I don't think you should be content with an AHI of 7 and feeling "just so".
If you think it's stress - do you know when the stress will be over?

An alternative explanation may be that now, when you've learned to sleep with the machine and mask, you're sleeping deeper, dreaming more, and may be getting more events because of that.

Your leak rate is fine; all masks have an intentional vent rate that gets higher the higher the pressure. No need to worry about that change.

O.

[papc]

I don't think you should be content with an AHI of 7 and feeling "just so".
If you think it's stress - do you know when the stress will be over?

An alternative explanation may be that now, when you've learned to sleep with the machine and mask, you're sleeping deeper, dreaming more, and may be getting more events because of that.

Your leak rate is fine; all masks have an intentional vent rate that gets higher the higher the pressure. No need to worry about that change.

O.

I didn't know about leaks and pressure settings. So that explains that issue. As far as dreams, yes, I am having some strange dreams and lots of them lately, so maybe that is the issue there. And stress, well could be losing my job in a few months, so that is the stress issue, which could be with me for a while. Thanks!!

[Tielman]

I didn't know about leaks and pressure settings.

I'm a newbie (only 5 days into CPAP), but I don't think your Large Leak rate should be that high. Mine is 0.0 after 5 days. There are smaller leaks that happen that can be seen in the software (not on the display), but the Large leaks should be quite low (toward 0).

I would strongly suggest talking to your DME, or Dr about this, and getting a re-fit of your mask and/or a new mask. Also ask them about "mouth breathing" which may be an issue for you (in which case you'll need a Full Face mask, or a Hybrid mask).

The best thing I can tell you is to stick with the treatment, it's your health!

Wishing you the best!