Occasional high AHI readings

[Magicdave]

I've been a CPAP user for nearly 6 months and seem to have adjusted well to sleeping with my full face mask.

Generally my AHI readings have been good - around 5 or less with good mask fit. However I've had a few occasions where the AHI reading has been considerably higher - one reading of 25 and another of 43 !!!!

I can't understand what's causing this. On those particular nights I have done anything different to my bedtime routine.

Has anyone else experienced this and, if so, have you discovered why the readings are occasionally so high ?

[Magicdave]

Sorry - my high reading was 34 not 43 !!! Even so it's higher than I would like.

[caffeinatedcfo]

I have not. Are there more data graphs you could upload to help?

Any new meds or lifestyle changes?

[Magicdave]

http://https://www.dropbox.com/s/trtg83 ... 4%2006.png

[Pugsy]

I can't get the image of your report to open for some reason...

What is the AHI breakdown per hour for each category when you have one of these high AHI nights?

How often does this high AHI happen? Once a week....once a month...twice a week????

[Magicdave]

Sorry - will try and get image posted successfully. Will also download data to sleepyhead and try posting that too. Apologies for confusion.

[DavidCarolina]

Can you correlate increased events to leak?

Do you keep an eating diary? What foods do you eat when you have high AHI? For example, MSG RUINS me in processed foods.

What chemical comibinations might contribute?

Are you taking naps on the days of increased AHI?

[PST]

The graph should help a lot, and it would be useful to know something about your equipment and settings, especially if you have a constant pressure or automatically adjusting (APAP). Pressure necessary to keep the airway open varies by position and sleep stage. One possibility I can think of is that your pressure level works most of the time, but once in a while you find yourself in a combination of position and stage -- like REM sleep on your back -- where it can't quite do the job. If these were bad apnea events, they would probably wake you up enough to knock you out of REM and maybe get you to roll over as well, but instead you end up with a crazy run of hypopneas that produce a shocking AHI but don't actually disrupt your sleep too much. Just a theory, obviously.

[sleeptimeinNY]

I've been on CPAP for a little over a year and there have been at least 3 nights where I had crazy clusters of hypopneas of 28 or more. Never did figure out what happened (aliens??!!) I also figured I would not worry unless it was something that was happening consistently, which it wasn't.

[Magicdave]

https://www.dropbox.com/sh/21gzi5vcur2k ... eep%20Data


Hope this works - two graphs from Sleepyhead - one showing overview and second showing detail of high AHI. I can post any other data if that would be helpful.

[Stormynights]

I am certainly not the smartest one here and maybe shouldn't even try to give any advice on this but you definitely need to raise your minimum pressure. Seeing your leaks will help a lot.

[Pugsy]

Question...on the nights where you have such awful high AHI and clusters of OAs ....how would you rate your sleep quality?
Wake up often...trouble going to sleep and/or staying asleep??
It's really odd that you have such really good nights (and mostly they are really good) and only occasionally the ugly night.
Makes me wonder what changed to make such a drastic difference in the reports. That's a really drastic change...
Most common culprits...for real OAs would be supine sleeping or REM stage sleep or combination of both.
Any mention of either in your prior sleep studies as to maybe having more events during either? It is possible that you just need more minimum pressure during those times if they are real.
For not real OAs...poor sleep, lots of awake time on the machine..lots of tossing and turning.

During the past week...how many nights with AHI above 5? any of them really ugly at above 10?

Can you manipulate SH so this sort of image is shown...the AHI bar graphs on the left (you can turn the pie chart off) and these graphs on the right? They can be resized by hovering the mouse over the bottom line of each graph till you see a little short double line and then you just click and drag to resize. SleepyHead will remember.

Turn off the AHI graph and the mask pressure graph (found in preferences/graphs tab...remove check mark).

Doing this let's you resize and bring up the leak line graph into viewing area.
It helps to see, in one image,
Events graph
Flow rate graph
Pressure graph
Leak line graph
Flow limitation graph if there's much showing on it.

So you end up with an image that looks like this.

[Crazy Eddie]

I've had the same issue lately. I thought maybe it was leaks because I'd loosened my mask, but there seems to be no correlation. Have high total leaks on night both with high and low AHI.

Some things that may correlate:

1. Drinking - one of the nights with a particularly bad AHI I had gotten quite drunk.
2. Staying up late - I work at home in a company distributed worldwide and was working with someone in Germany, so lots of late nights during that period.

My worse AHI was on Friday when I only got 4 hours of sleep and had fallen asleep on the lazy boy first. Had a spike of 43 and avg of 15.

I'd also not been clearing out my nose with irrigation before bed, so I started that again. Tightened the mask a little, but the leaks didn't change. I think this mask is not for me. It had also been hot those days...

So anyway, I noticed the same thing this last week so I'm paying special attention to new stats. Last night was a good night with only 3 OA events and an AHI of 2.5

[ba7796]

It happened to me one night but my figures were much lower. Now I noticed that during that night I slept without wearing the mask while the machine was running for a while. I usually go to the bathroom 2 or 3 times a night and on one occasion I forgot to put the mask on after the bathroom.
However this not a scientific answer, could be only a coincidence. Good luck.