Results for the last 9 days - ugh!

What am I doing wrong? Any hints by these numbers? I could PM my entire report to someone here who is knowledgeable with reading these Encore Pro reports to help give me a clue as to what's going on. Last night I used a patch over the nose, taped my mouth shut, and the results were horrible.

Summary of results:

REMstar Auto Statistics

Auto-CPAP Mean Pressure 8.2 cm H2O
Auto-CPAP Peak Average Pressure 9.1 cm H2O Average Device Pressure <= 90% of Time 10.9 cm H2O Average Time in Apnea Per Day 32.2 mins.
Average Time in Large Leak Per Day 13.3 secs.
Average AHI 20.1

WARNING! TONGUE IN CHEEK HUMOR ALERT!

Clearly you need to turn your humidifier up...

I'm sorry. This is NOT in the least bit funny, and I'm stumped too, but that just burbled up to the surface!

I do think you should email your reports to someone. John Mudie has offered to read mine. You might PM a couple people like Wulfman (Den) or RestedGal (Laura) for advice. They seem very report-savvy to me.

GOOD LUCK AND BEST WISHES! (And too many laughs...)
Barbara

PS - any chance it's time to get a new mask? I keep thinking that today... I feel like the CarTalk guys - two answers - it's either the humidifier or the mask...

Auto-CPAP Mean Pressure 8.2 cm H2O
Auto-CPAP Peak Average Pressure 9.1 cm H2O Average Device Pressure <= 90% of Time 10.9 cm H2O Average Time in Apnea Per Day 32.2 mins.
Average Time in Large Leak Per Day 13.3 secs.
Average AHI 20.1

Large leaks too high. What about Average leaks?
I'll tell you what I was recently told. The leak problem has to be resolved before the other readings are relevant.

I'm probably going to have to change masks again.

Your AHI is also too high. I think under 5 is most desireable for AHI.
There are alot of more knowledgeable on this forum than me.
I'm just learning.

Victoria

Babette sneaking in on her work computer wrote:...two answers - it's either the humidifier or the mask...

Or......the pressure (or lack thereof).

What are the pressure settings on your machine?
If you're spending too much time at the lower pressures (8.2), and your 90% pressure is almost 11, I'd "guess" that you need to bump up your bottom pressure to about where your 90% number is.

Do you have a copy of your sleep study? What was your titrated pressure (if you had one) and were there any Central apneas?

The large leaks don't help, but I've also had some lately for somewhat longer durations and still have had few events. (I think my headgear is getting a little too loose because they stop as abruptly as they begin). The machines actually stop recording events during Large Leaks, so that MAY tend to lower your AHI.

Den

Humidifier is set on 2. Auto range is from 7-12. I was titrated and the level was at 6 but then I went into apneas and the tech did not increase the pressure. (Long story.) So the Dr. wanted the machine set at 6-10. I obviously expanded the perimeters. I have OSA, per report. Not sure what to make of the results. There are areas where when the pressure goes up, but so do the apneas. The numbers are all over the place and I just don't understand what is happening. There does not appear to be a trend. The report shows I had the machine on for 1 hour and the AHI was 4.4, then no more info for that night??? The following night, same thing.... 1 hour, but the AHI shows 50.7. Man, my sleep study was only 38/hour. Last night my AHI was 24.3 and I had a nasal strip on nose and taped my mouth shut to prevent leaks. Not so good, eh?

LB

Birdseed wrote:Humidifier is set on 2. Auto range is from 7-12. I was titrated and the level was at 6 but then I went into apneas and the tech did not increase the pressure. (Long story.) So the Dr. wanted the machine set at 6-10. I obviously expanded the perimeters. I have OSA, per report. Not sure what to make of the results. There are areas where when the pressure goes up, but so do the apneas. The numbers are all over the place and I just don't understand what is happening. There does not appear to be a trend. The report shows I had the machine on for 1 hour and the AHI was 4.4, then no more info for that night??? The following night, same thing.... 1 hour, but the AHI shows 50.7. Man, my sleep study was only 38/hour. Last night my AHI was 24.3 and I had a nasal strip on nose and taped my mouth shut to prevent leaks. Not so good, eh?

LB

Sounds more complicated than just OSA.

Do the events seem to be taking place at a certain pressure?

Depending on what your reports look like, I think I would switch to single pressure (CPAP mode) at about 6 for a few nights and see what that looks like. (also, since that's where your titration study stopped....apparently due to events)

Could you go into your machine and make a list of all of your settings? I'm curious to see what they are.

Den

[quote="Birdseed"]What am I doing wrong? Any hints by these numbers? I could PM my entire report to someone here who is knowledgeable with reading these Encore Pro reports to help give me a clue as to what's going on. Last night I used a patch over the nose, taped my mouth shut, and the results were horrible.

Summary of results:

REMstar Auto Statistics

Auto-CPAP Mean Pressure 8.2 cm H2O
Auto-CPAP Peak Average Pressure 9.1 cm H2O Average Device Pressure <= 90% of Time 10.9 cm H2O Average Time in Apnea Per Day 32.2 mins.
Average Time in Large Leak Per Day 13.3 secs.
Average AHI 20.1

current machine settings:

auto range min=6, max=12 (thought it was 7 - but it's really at 6 min)
A-flex setting @ 2
autoramp 15 min. @ 5cm

wee bit of extra info: I had the M Series Pro with straight CPAP (for 5 nights) and it was set at a max of 6cm. AHI with this setting was 15.4, obviously a far cry better than what I have currently with the Auto. Wouldn't it make sense that if it's set on auto, it should respond as needed?

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, AHI, auto

Birdseed wrote:current machine settings:

auto range min=6, max=12 (thought it was 7 - but it's really at 6 min)
A-flex setting @ 2
autoramp 15 min. @ 5cm

wee bit of extra info: I had the M Series Pro with straight CPAP (for 5 nights) and it was set at a max of 6cm. AHI with this setting was 15.4, obviously a far cry better than what I have currently with the Auto. Wouldn't it make sense that if it's set on auto, it should respond as needed?

Ahhhhhh......wrong machine in your profile?......If you have "A-Flex", that means you have the M Series Auto w/A-Flex....right?

An Auto will respond to events......just depends on if you WANT them to do that.....especially if the higher pressures are causing the events.

Part of the Auto report should show what all pressures it went to.....how much time in was there and what your AHI was at each pressure. If you can find that, does it help determining where you were having higher AHI numbers?

If your events are going up as your pressure increases, then you will want to limit your top pressure.

Den

Yes, I am having more apneas at the 10cm through 12cm range. The apneas are lowest in the 6-8cm range. However, the hypopneas are somewhat higher when the pressure is lower. Wierd results? I am thinking of setting my machine in a much more narrow range of 7-8 for at least 2-3 days and see how that goes.

Thanks much, everyone for your input.

LB

Birdseed wrote:Yes, I am having more apneas at the 10cm through 12cm range. The apneas are lowest in the 6-8cm range. However, the hypopneas are somewhat higher when the pressure is lower. Wierd results? I am thinking of setting my machine in a much more narrow range of 7-8 for at least 2-3 days and see how that goes.

Thanks much, everyone for your input.

LB

That kind of information would lead me to think you're having Central apneas.
These machines can't tell the difference and will increase pressure to SOME degree.

Yeah, I would limit the upper pressure to no more than 10....and maybe lower. It's possible that a range of 7 - 9 might work and might be worth a try for a few nights.

After some nights of the lower, smaller ranges, you might be able to see if there's a single pressure that looks good.

Autos will work for some......single pressure (CPAP) will work better for others. You've got a multi-mode machine and you need to determine what helps you treat your condition in the BEST manner possible. Could be a very narrow range or single pressure.
I have three machines, two of which are Autos, but run them all in single-pressure mode.

Please keep us informed.

Den

Absolutely, will keep y'all apprised of my trials and tribulations. (When I went to select my equipment, it seemed that the one I chose was the best of the available choices. Hmmmmm will check it out again.)
LB

Birdseed wrote:Absolutely, will keep y'all apprised of my trials and tribulations. (When I went to select my equipment, it seemed that the one I chose was the best of the available choices. Hmmmmm will check it out again.)
LB

I see you changed your machine in your profile.
The Auto with A-Flex is the "latest and greatest".....has more options than the other CPAP/APAP machines. Haven't used one, but those that have them are praising them highly.

Good luck.

Den

[quote="Anonymous"]WARNING! TONGUE IN CHEEK HUMOR ALERT!

Clearly you need to turn your humidifier up...

I'm sorry. This is NOT in the least bit funny, and I'm stumped too, but that just burbled up to the surface!

I do think you should email your reports to someone. John Mudie has offered to read mine. You might PM a couple people like Wulfman (Den) or RestedGal (Laura) for advice. They seem very report-savvy to me.

GOOD LUCK AND BEST WISHES! (And too many laughs...)
Barbara

PS - any chance it's time to get a new mask? I keep thinking that today... I feel like the CarTalk guys - two answers - it's either the humidifier or the mask...