Wrong AHI, mask off, reported on Resmed

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
ironman3
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Wrong AHI, mask off, reported on Resmed

Post by ironman3 » Tue Feb 07, 2023 5:39 am

Hi - my machine seemed fine for last few months since I bought it. I changed from a nasal plus mouth mask F30i o believe which kept leaking around my nose at night to the full mask I think an F20 pillow. I get almost no leakage now.

I have a Resmed Air11 bought myself Fromm respshop.com with a prescription, new.

First few weeks of using the new mask I had good scores with AHI below 5. I have even on my sleep study never had AHI since 5-10. Reporting of on off events and of usage time was good and my MyAir score was above 89 most nights only because I took mask off after 5.5 hours. I usually can't do 7 hours with it.

About a week ago I started seeing the AHi jump to 29-33 - and the hours used off as well as mask on off events.

I had an old wellue pulse ox sleep monitor so I put it on past two nights. As I thought it showed no drops below 91 in pulse ox. The graphs of it prior to cpap show drops to 82 and my heart rate spiking correlated to those drops. These graphs show no such activity. To me of I had 33 drops sn hour the wellue monitor would show that. The wellue reported. Last night I showed 33 drops an hour again but the wellue show 7 drops for the entire night which is 1 drop per hour.

Did I break the tube or mask, I tried a different tube didn't make any difference. Haven't tried a different mask as I don't have a spare. However I wonder if I damaged that little valve thing at bottom of mask inlet that detaches and is on the elbow. Every so often I would exhale and I would hear a pop. Could this be the mask causing the machine to misinterprets?

Screenshots can't upload they are too large.
Last night stats show 33 events per hour, 5.5 hours used in myAir. Wellue shows 7 drops all night - one to 82 perceht for 14 minutes which I think is s fluke because my heart rate didn't go up at all during that period.,

Night before stats show 5 hours used and 8 drops per hour with wellue show lowest drop of o2 st 91 no pulse rate correlated fluctuations to o2 drops, and 1 drop per hour. Wellue defines a drop as any o2 below 92%.
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robysue1
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Re: Wrong AHI, mask off, reported on Resmed

Post by robysue1 » Tue Feb 07, 2023 12:34 pm

ironman3 wrote:
Tue Feb 07, 2023 5:39 am
Hi - my machine seemed fine for last few months since I bought it. I changed from a nasal plus mouth mask F30i o believe which kept leaking around my nose at night to the full mask I think an F20 pillow. I get almost no leakage now.
It would help us help you if you would double check your mask. The F20 is a fairly conventional full face mask that does not have a forehead support. It does not have any nasal pillows or nasal cradle. (The F30i is a full face mask which combines a nasal cradle with a mask over the mouth.)
and my MyAir score was above 89 most nights only because I took mask off after 5.5 hours. I usually can't do 7 hours with it.
While 5.5 hours of usage is better than nothing, CPAP is designed as a full-time therapy---meaning: When you are asleep, you should have the mask on. By returning to sleep 1.5 hours every night without the mask, your body is still dealing with untreated OSA part of the night. AND you have trained the unconscious part of your brain to wake you up after about 5.5 hours of sleep and take the mask off. You would benefit (in the long run) if you trained yourself to get out of bed to give yourself a small break from the mask and then mask back up when you return to bed when you are sleepy after that wake-up that occurs about 5.5 hours into the night.

First few weeks of using the new mask I had good scores with AHI below 5. I have even on my sleep study never had AHI since 5-10. Reporting of on off events and of usage time was good and my MyAir score was above 89 most nights only because I took mask off after 5.5 hours.
MyAir is better than nothing, but that overall score is nearly worthless: It downplays the contribution of the overall AHI, the status of leaks, and the number of times you turn the machine off and back on when computing the score.

Oscar would be the best choice for software to analyze what's happening. But uploading the SD card's contents to SleepHQ would also help us understand what's happening so that we can make better suggestions about what to do.
About a week ago I started seeing the AHi jump to 29-33 - and the hours used off as well as mask on off events.
The machine's LCD give better AHI data than MyAir does because the machine's LCD breaks the AHI down into component parts: The AI (total apnea index) and the CAI (central apnea index). With those numbers, it is easy to compute the HI (hypopnea index) and thus determine what kind of events are getting through the CPAP defenses. In your case we really need to know the breakdown of the AHI into its AI, CAI, and HI components.

In other words, we need to know more than just the increase in AHI from 5-10 to 29-30. We need to know if there has been a huge increase in central apneas or if the increase is being driven by a huge increase in obstructive apneas or hypopneas.

So can you tell us what the machine's LCD says you AHI, AI, and CAI are for a bad night?

I had an old wellue pulse ox sleep monitor so I put it on past two nights. As I thought it showed no drops below 91 in pulse ox. The graphs of it prior to cpap show drops to 82 and my heart rate spiking correlated to those drops. These graphs show no such activity. To me of I had 33 drops sn hour the wellue monitor would show that. The wellue reported. Last night I showed 33 drops an hour again but the wellue show 7 drops for the entire night which is 1 drop per hour.
Not all apnea events come with associated O2 desats.

It's also possible that if you are spending a lot of time tossing and turning while using the machine, your normal wake breathing could be irregular enough to cause the machine to score a bunch of things as apneas or hypopneas that are not real events simply because they occurred when you were not actually asleep. We can't tell whether this might be what's happening without a lot more information (and more data).
Did I break the tube or mask, I tried a different tube didn't make any difference. Haven't tried a different mask as I don't have a spare. However I wonder if I damaged that little valve thing at bottom of mask inlet that detaches and is on the elbow. Every so often I would exhale and I would hear a pop. Could this be the mask causing the machine to misinterprets?
That valve you are talking about appears to be the anti-asphyxiation valve, which is designed to pop open and allow you to breath (normally) if the machine loses power. I'll be honest: I don't use a full face mask and I don't know what would happen if someone tried to use a FFM with an anti-asphysxiation valve that won't close properly when the machine is turned on.
Screenshots can't upload they are too large.
Upload the Oscar screen shots to a photo sharing site like imgur.com and then link to the image inside your post.
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palerider
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Re: Wrong AHI, mask off, reported on Resmed

Post by palerider » Tue Feb 07, 2023 7:29 pm

ironman3 wrote:
Tue Feb 07, 2023 5:39 am
Screenshots can't upload they are too large.
Read the first post on the forum.
Alternatively: wiki/index.php/Oscar:organize

tl;dr: use imgur.com to post them, but *please* read the instructions on what we want before you post anything.

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ironman3
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Re: Wrong AHI, mask off, reported on Resmed

Post by ironman3 » Wed Feb 08, 2023 6:46 am

Thanks - I will upload later today. Last night the stats showed similar - 13 events per hour, mask leak of 3l per min , obstructive apneas were zero, Central apneas were 13.

I have to get a SD card as my machine has an empty SIM card slot.

I did change a setting in clinical to be "standard" from "soft" on how fast the machine tries to change pressure on apap - that made me feel better I thought and use it longer other day and dropped apneas a bit but could be placebo. I didn't realize the machine doesn't produce full data without that SD card.

Once I put in the SD card will I have the data from past few months or will it start new now?
Last edited by ironman3 on Wed Feb 08, 2023 10:49 am, edited 1 time in total.

ironman3
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Re: Wrong AHI, mask off, reported on Resmed

Post by ironman3 » Wed Feb 08, 2023 6:50 am

Also - once we get the data from the SD card will you be able do you think discern whether the supposed central apneas are real as compared to the wellue o2 stats? Again when I first started using machine I had central apneas below 2 and obstructive below 1 consistently with max of some days of 5 combined total. The recent spike to 33 and 13 and 8 etc is the main confusion point.

Really appreciate the insight here - so many to learn from.

Thanks!
Last edited by ironman3 on Wed Feb 08, 2023 10:48 am, edited 1 time in total.

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LSAT
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Re: Wrong AHI, mask off, reported on Resmed

Post by LSAT » Wed Feb 08, 2023 7:56 am

The machines use SD cards..not SIM cards

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robysue1
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Re: Wrong AHI, mask off, reported on Resmed

Post by robysue1 » Wed Feb 08, 2023 8:05 am

ironman3 wrote:
Wed Feb 08, 2023 6:46 am
Once I put in the SIM card will I have the data from past few months or will it start new now?
The machine uses a full size SD card---similar what many digital cameras use.

The summary data (the stuff you already have from MyAir, plus the events breakdown each night) will show up in Oscar for all the days you've used the machine.

The detailed data will only show up for the nights where you have an SD card in the slot.
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