No Improvement w/ BI-PAP

My initial sleep study showed 150 events per hour. Was on CPAP for three years, during which time my AHI averaged around 12. AHI was never below 4. Doctor switched me to Dreamstation Auto BI-PAP in February to try and lower AHI. I currently feel worse than I ever did on CPAP. AHI is averaging 18 and is often in the 20's, and 30's. Leaks are not the issue. Generally getting 100% seal but results are pretty similar whether seal is 100% or not. I generally sleep on my back with four pillows so I'm basically sitting up. Have not seen any improvements sleeping on my side. Switch between nasal pillows and dreamwear mask. I'm slightly overweight, by about 15 lbs., but have no other significant health issues.

Any advice, recommendations​ are appreciated​. I do not have access to Sleepyhead so PLEASE do not ask.

Asking anyway, because SH is a) free, and b) acessible from here to anyone who wants to use it... and works on both MS and Macs... so if there's some other reason you don't use it, please say so... and we can help you to post, etc.

What are your pressure settings?

Don't worry about your 15 lbs, not unless they came on all at once just around the time you switched machines.

Hatehighahi wrote:My initial sleep study showed 150 events per hour. Was on CPAP for three years, during which time my AHI averaged around 12. AHI was never below 4. Doctor switched me to Dreamstation Auto BI-PAP in February to try and lower AHI.

Without knowing more about the kinds of events you continue to experience while using CPAP, APAP, and AutoBiPAP, we cannot provide any meaningful suggestions about what might be wrong, let alone any meaningful suggestions on what might need to be tweaked in order to get your AHI down to where it should be.

But it's not just the CPAP/APAP/BiPAP data that we need to know more about. We also need to know whether your diagnostic AHI was mainly OSs and Hs, or whether there were a lot of CAs mixed in. We also need to know whether your initial titration study showed any CAs at certain pressures.

And finally, with the AutoBiPAP that you are currently using, we need to know the therapeutic settings as well as what the current data says about the breakdown of events and when they tend to occur.

Any advice, recommendations​ are appreciated​. I do not have access to Sleepyhead so PLEASE do not ask.

You are asking us to provide you with advice, but without the data from SleepyHead or Encore, all we can do is speculate. And since we have significantly less data to look at than your current sleep doctor has, our suggestions are just wild shots in the dark.

Wild shot in the dark is better than nothing so fire away

You're asking people to waste their time...

If SleepyHead is not available there is at least DreamMapper online.
With DreamMapper you can get the AHI and the breakdown into each event category which is REALLY important....along with some leak numbers.

Without knowing what kind of events you are having it's more than just a wild ass guess that is a waste of time...it's a wild ass guess that could potentially make things worse and we sure don't want to do that.
Here's the deal with the AHI...it's composed of 3 things and you can't see what categories without using some sort of software.
1. Clear Airway Apneas/Centrals
2. Obstructive Apneas
3. Hyponeas

If the bulk of a high AHI is primarily Central/Clear Airway....more pressure could make things worse instead of better.

You gotta know what you are fighting before you formulate a plan to fight and make sure what you are wanting to fix is fixable with your machine.

So...how high is the AHI been that is shown on your LCD screen?
and using DreamMapper what is that AHI broken down to in terms of each category of event?
If your AHI is over 5...you are going to have to use some sort of software to get the AHI broken down into each category.
What are your current settings? Minimum pressure...pressure support (difference between inhale and exhale)....and maximum pressure. Are you using auto mode or fixed mode?

Pugsy wrote:Without knowing what kind of events you are having it's more than just a wild ass guess that is a waste of time...it's a wild ass guess that could potentially make things worse and we sure don't want to do that.

+1 for this in particular, as well as an excellent post by Pugsy.

I for one will not make wild ass guesses and shots in the dark recommendations about what to "change" when I don't have enough data to go on.