Variable AHI, different thread and different machine

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Saltcedar
Posts: 4
Joined: Sat Jul 30, 2022 11:02 am

Variable AHI, different thread and different machine

Post by Saltcedar » Sun Jul 31, 2022 9:25 am

I was going to throw this post into the other member's post viewtopic/t184809/Variable-AHI.html, but thought that might be rude, so here's my own similar situation that I came on here to write today:

But first: OSCAR has not been configured for my machine: Resvent ibreeze 20a. I put the sd card into my laptop yesterday to see if I could access the infamous iMatrix report. I was unsuccessful in finding an appropriate app to open the reports.

So: Until this last week, my AHI with the machine was in the <1 to <2 range most of the time. This past week, I've seen it fluctuate as high as 12.6! This morning, it was down to 2.7, which is better, but still significantly higher than the <1 that I'd commonly experienced. Below are the readings between 7/24 and last night.

1.10 (7/24)
6.10
4.20
0.30
2.50
7.60
0.90
3.40
12.60
11.80
2.7 (7/30)

The filter is clean. I clean the hose, etc. weekly. Most recently was yesterday. I only use distilled water in the chamber. I empty this every day and turn it over to dry daily. According to the reports, mask fit is always 100% green light, as is humidity (I set it to 1 based on past times when maybe it was too high, and even caused the hose connector at the top of my head to rattle from moisture.

I strive to sleep on my side most of the time; sometimes I revert to my back. Generally, I'm a nose breather, but the last couple of nights, I have noticed my mouth is dry in the morning recently, and I do have a slight case of nasal congestion, so maybe there's something there, but I don't know if that's the chicken or the egg. (That is: Is the slight congestion causing me to breathe through my mouth or is it that more episodes are causing me to open my mouth for air.)

Any ideas?
Equipment:
APAP: Resvent iBreeze 20A -- Not OSCAR-accessible
Dreamwear under the nose nasal cushion REF 1116740
Original sleep study AHI: 7.9, but significant symptoms affecting quality of life

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Pugsy
Posts: 61627
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Variable AHI, different thread and different machine

Post by Pugsy » Sun Jul 31, 2022 10:20 am

And you get the same response the dude in the other thread got.
To have any chance in hell of having any sort of workable theory as to why anything is happening we have to have the category of the AHI events.

Central apneas....pressure changes/increases won't help.
Obstructive apneas....increasing the pressure might help.

And without knowing what your AHI is composed of we have zero idea what to offer.

I understand your machine either doesn't distinguish into the category or doesn't make it easy for you to see the different categories if it does...but it doesn't change the fact that for anyone to offer anything we still need to know the missing details.

This is just another example of why most of us want to stay with the tried and true brands that we can get to the detailed data to help us figure out something when something weird happens.

At this point I can't even blame it on the chance that you maybe are on your back more than you think and you just need maybe a pressure adjustment.
We know absolutely nothing about anything...don't even know your pressure settings except humidity settings which rarely affect AHI.

Totally flying blind here.

And I won't even go into the chances of perhaps false positive flagging of awake breathing irregularities maybe composing the higher than you want AHI. None of these machines have a way to know if we are asleep or not. They only measure air flow and if we have trouble sleeping our irregular breathing while awake can cause SWJ flagging...Sleep/Wake/Junk.
There is zero way to evaluate whatever data you have.

See all the flagged centrals/ClearAirway Apneas in the image below?
I had a really bad case of insomnia that night. Didn't go to sleep until probably after 01:30. All awake flagged events.
They don't count in the grand scheme of things because we have to be asleep for it to be sleep apnea related.
My AHI is a lot higher than it normally is but it's higher because of all the awake centrals flagged. Nothing wrong with my settings...once I go to sleep the machine does what it is supposed to. My problem was the insomnia and that was totally related to life stressors.

Image
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

Saltcedar
Posts: 4
Joined: Sat Jul 30, 2022 11:02 am

Re: Variable AHI, different thread and different machine

Post by Saltcedar » Sun Jul 31, 2022 11:17 am

Sigh (in sad resignation).**

No one is more regretful about the unavailability of actionable data than I. I'm especially frustrated that, miserable though it may be, Resvent's iMatrix might be able to tell me something, but there are no step-by-step instructions I can find about opening up the report in a readable format. (Interesting factoid: Apparently the doctor's staff had trouble accessing the data off the sd card, as well, when I took it in for my follow-up appointment about a month after I started the APAP.)

I'll see if upping the humidity helps .... hmm .... as I write this, it registers that I've been running my a/c longer at night this past week than previously. So maybe the air is drier than it'd been, hence the dry throat and, perhaps, the higher AHI. A WAG that I will test tonight since I'm stumbling around in the dark. [Edit: Belatedly caught your note re: humidity rarely affecting AHI...Erg. Thank you for your comprehensive response; I appreciate the information it contained that I can either use now or in the future.]


** Unfortunately, I did not choose this machine. At the time I was diagnosed with sleep apnea and directed to the DME provider from the doc, I didn't know enough to even think about what machine might be better. I sure as heck didn't know anything about OSCAR at that point.

A preliminary response from the DME supplier about getting a different machines was a simple, "no."

I'm guessing that I've got this machine because it was available right away - rather than waiting perhaps months for a different model, due to the Philips recall and supply chain, etc. etc.
Equipment:
APAP: Resvent iBreeze 20A -- Not OSCAR-accessible
Dreamwear under the nose nasal cushion REF 1116740
Original sleep study AHI: 7.9, but significant symptoms affecting quality of life

User avatar
Pugsy
Posts: 61627
Joined: Thu May 14, 2009 9:31 am
Location: Missouri, USA

Re: Variable AHI, different thread and different machine

Post by Pugsy » Sun Jul 31, 2022 11:44 am

Saltcedar wrote:
Sun Jul 31, 2022 11:17 am
I'm guessing that I've got this machine because it was available right away - rather than waiting perhaps months for a different model, due to the Philips recall and supply chain, etc. etc.
Well...I am adding wholesale cost and profit margin to the list of excuses for this machine being so readily available.
I hate to be a Negative Nellie but I know how these places look at profit margin real close.

But you know for years and years we didn't have data and while it does make things easier than flying blind...we used to fly blind all the time. It can be done but it sure isn't easy.

What are all your settings? Exact settings???? Mode...pressure...using any sort of exhale relief...etc.

And while AHI isn't normally going to have a direct correlation to humidity it wouldn't be impossible for it to have an indirect correlation if humidity settings themselves caused some sort of problem which in turn maybe caused a problem with sleep in general. Like if your humidity setting caused nasal congestion or other discomfort and that in turn increased a problem staying asleep and thus increased a chance for false positive flagging.
Some people need a higher humidity setting to keep the nasal mucosa happy and congestion free and some people need less humidity to keep their nasal mucosa happy.

You will need to keep a very detailed log of your own though.
Especially important is how long you might take to go to sleep and did you remember very many wake ups?
It will take a lot longer as well because you have to look for patterns.

First thing since you are new to cpap therapy is overall sleep quality. Time to fall asleep and do you remember many wake ups. How likely is awake breathing irregularities maybe causing the higher AHI...that kind of thing.

Look back on all the prior nights....how many showed a nice low AHI and how many showed maybe a not so good AHI and how many showed a pretty horrible AHI. Is there any correlation to sleep quality seen?

Is your insurance paying for the machine as a monthly rent to own purchase or did they buy it outright?
You will need to ask your insurance company this question most likely. Don't rely on the DME to always tell you the truth because they already lied to you once. They told you that this machine was the only machine available and that's not true.
Amazingly we have forum members here who did do their homework ahead of time and when their DME tells them that their only choice was a machine that wasn't what we here might recommend and they just tell them "No, I don't want that machine, I want this machine and I will just wait or find someone who can get it for me"....that amazingly the DME "finds" what they want within a short period of time. We actually had one guy report that the guy came out to his house and proceeded to set up the unwanted machine and when told to stop because he didn't want that machine...the tech said "okay, I got one out in the car you can have". Imagine that.

You might have some options or rights if you are in the rent to own plan. It's not totally yours until the end of the rent to own period. If it were me I would be having a screaming meamy fit about this machine not giving me the data that I needed or wanted and I would tell them to take the damn thing back and bring me what I wanted or I would take my business elsewhere.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

I may have to RISE but I refuse to SHINE.

Saltcedar
Posts: 4
Joined: Sat Jul 30, 2022 11:02 am

Re: Variable AHI, different thread and different machine

Post by Saltcedar » Tue Aug 02, 2022 3:06 pm

Thank you for your comprehensive response, Pugsy. I'm taking all of your questions and comments on board.

In the meantime, I did adjust the humidity to auto, and for the past two consecutive nights, the AHI did go back down to 0.6 and 0.4 respectively. So that's good news.

I'm beginning to get the sense that it's likely just part of the deal that we need to adjust the machine settings as variables change, such as ambient humidity, illness, aging-out components, etc.

I do track some data each day, such as level of alertness and how many times I got up during the night.

I have definitely seen an improvement in my quality of life since using the CPAP. I arise fewer times during the night. I don't get overly tired in the middle of the day. I can stay up later (i.e. 10:00 p.m. instead of 8:30 p.m.). Some brain fog has lifted, as have my spirits.
Equipment:
APAP: Resvent iBreeze 20A -- Not OSCAR-accessible
Dreamwear under the nose nasal cushion REF 1116740
Original sleep study AHI: 7.9, but significant symptoms affecting quality of life

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Rubicon
Posts: 214
Joined: Sun Feb 20, 2022 6:59 am

Re: Variable AHI, different thread and different machine

Post by Rubicon » Fri Aug 05, 2022 8:24 am

iMatrix looks just like the rest of the software programs. If you want to upload your file to dropbox or similar I'll try to put something together.

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Rubicon
Posts: 214
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Re: Variable AHI, different thread and different machine

Post by Rubicon » Fri Aug 05, 2022 8:28 am

Image