AHI getting higher as therapy continues

[TankerBell]

First, I just wanted to say hello to everyone here! I've been reading in the forums since before my first sleep study in preparation for becoming part of this wonderful community.

I've been using my CPAP machine since Friday, Oct. 3. My AHI levels from Oct. 3 thru Oct. 6 were actually pretty great (in the 2.5 range) and I was feeling pretty rested. Then I got a bad case of viral pharangytis Monday that I'm just getting over today. The last couple of nights my AHI levels were 5.65 and 7.22. My wife said she heard me snoring again last night (I did take a half dose of pseudoephedrine 30 mg to open one of my closed nostrils up). I am over the viral pharangytis now so I am hoping my levels go back down tonight.

I loaded my data into sleepyhead and there were a lot of hypopnea markers for last night, especially bunched up into two different sections. I don't seem to be having more than 4 or 5 apneas a night, and there's only one marker so I'm guessing that means the machine is working on those.

I guess I'm just looking for some ideas on what might be going on and to get some feedback on how my numbers look and what I can do to improve now that I seem to be running into my first hurdle. Here's my sleepyhead figures:

[Julie]

Until you've been off the ephedrine (pseudo) for a couple of nights at least, I wouldn't even try to make sense of the numbers... your system has been speeded up in some areas to deal with the pharyngitis and not much is normal respiratory-wise.

[jnk...]

Viruses and treatments for viral symptoms can both cause a temporary need for higher pressure to stabilize the airway. Use of trending data from home machines is best done by comparing a few weeks of data with another few weeks of data in order to compare a long-term average to another long-term average. We all have bad nights from time to time.

[Guest]

Thanks for the replies.

[jnk...]

Thanks for the replies.

Thanks for the question!

[Day_Dreamer]

You might want to increase the minimum pressure

[Wulfman...]

You might want to increase the minimum pressure

That was my thought, too.


Den

.

[Guest]

How would I go about increasing the minimum pressure?

[Tankerbell23]

How can I increase the minimum pressure?

[Wulfman...]

How can I increase the minimum pressure?

These are the instructions I have for accessing the clinical menu.

Fisher & Paykel ICON Auto, Premo & Novo:
Move the SmartDial to the user Preferences position (tool wrench icon).
Hold down the SmartDial button with your thumb until you hear the 'tick tock' sound.
Do NOT release the middle button yet.
While holding down the button, use your other hand to rotate the dial 380 degrees clockwise until you are back at the top (12 o'clock position).
Rotate the dial one pitch counter-clockwise back to the tool wrench icon, release the middle button and you be in the Clinician Menu with additional options appearing on the left quarter of the screen.


Den

.

[Tankerbell23]

What would you recommend increasing it to? 6?

[Wulfman...]

What would you recommend increasing it to? 6?

Sure. Start there and see what the AHI numbers look like for a few days. If they're still "high", bump it up another centimeter and continue to monitor for a few more days. You MAY find that your "average" and/or "90%" numbers may increase as you increase your minimum. That's OK as long as your AHI numbers start looking better. If the "numbers" continue to look better, you'll know you're going in the right direction.


Den

.

[TankerBell]

So increasing seemed to help a lot with the number of hypop events I was having. But I had a higher amount of apnea events, as in my top pressure of 8 wasn't enough to break me out of an apnea event that occurred around 3 a.m. I would have to talk to my doctor before I adjust my max pressure, correct? I'm thinking it probably needs to be bumped up a couple, too.

Light blue is apnea events:



Link in case image isn't displaying: https://www.dropbox.com/s/j43q0ehswhtga ... 4.JPG?dl=0

[TankerBell_also]

Bump.

[Pugsy]

Yes....if you maxed out the maximum pressure at 8 cm at the 3 AM ugly time....the maximum needs to be increased..not sure how much...that's one really ugly cluster there...probably supine sleeping was a factor. Something changed significantly from that 3 AM time and the rest of the night which pretty much had nothing going on.

You didn't include the pressure graph with that flow rate chart so I don't have a feel for what the pressures were the rest of the night but whatever the machine used the other parts of the night...it was quite sufficient....but during that time frame around 3 AM things went south from whatever cause and the 2 main suspects when we see that much of a difference is supine sleeping and REM stage sleep. If it was REM sleep in your case I would think you should have more than 1 REM sleep stage..but maybe this was REM and you were on your back too for that one. The time frame works for REM sleep stage though.
Regardless..you need more pressure only during that time frame where the ugly cluster is shown.

Regarding changing the max on your own...vs the doctor doing it...that's up to you. If you are comfortable doing it...then do it but if you aren't then call up your doctor and explain things and run it by him.