AHI Higher With CPAP?!

Weezer · Post by **Weezer** » Fri Sep 28, 2007 12:57 pm

Can anyone help me? I'm a newbie hosehead, been on CPAP for about two weeks. I use a ResMed Vantage and the Swift II nasal pillows.

My original sleep study at Kaiser had me with an AHI of 10.2.

With my machine set "wide open" at 4-20, my AHI was consistently higher – over 11. I reset the parameters to 7-15. (My doctor titrated me at 11). Last night, I had it on for over 7 hrs. – and my AHI was 15.6!

My leak rate is low, under .1. And while my AI remains 5 or under, my HI is quite high – over 10.

How is this possible? CPAP does not seem to be treating me at all – and I don't feel any less sleepy during the day.

Any help would be greatly appreciated. Thank you.

Wulfman... · Post by **Wulfman...** » Fri Sep 28, 2007 1:26 pm

Weezer wrote:I reset the parameters to 7-15. (My doctor titrated me at 11).

If your titrated pressure is supposed to be 11 cm., why do you have the bottom pressure set to 7 cm.?

Try setting your bottom pressure up to either 10 or 11 and see what the numbers look like. Or......set it in CPAP mode (so you can use EPR) to 11.

Autos will frequently produce higher AHI numbers than straight CPAP.....especially if they're not configured correctly.

Den

Weezer · Post by **Weezer** » Fri Sep 28, 2007 1:57 pm

Thanks for your reply, Wulfman.

The reason I set it at 7-15 is because I'm not sure that I was properly titrated in the first place. At Kaiser, they send you home with an APAP for one night – but I couldn't fall asleep with it at all. I suspect my doctor pulled the number 11 out of the air.

Anyway, I will experiment with setting my bottom number higher or using it as straight CPAP and see if my results improve.

But with a pressure of 10, I still can't understand why my AHI would be higher than with no CPAP at all...

Wulfman... · Post by **Wulfman...** » Fri Sep 28, 2007 2:10 pm

Could very well be that that's what your doctor did.....I think mine did, too.
If you didn't sleep with the APAP during your titration study, it could be that the pressure changes during the night disturb your sleep. (again....Me, too.)

I'd suggest going to single pressure.....10 or 11....and see what happens. Maybe you need more than that. Make sure that the mask setting in the machine is correct for the one you use (for leak rates).

Let us know what happens.

Good luck.

Den

billbolton · Post by **billbolton** » Fri Sep 28, 2007 6:08 pm

Weezer wrote:My original sleep study at Kaiser had me with an AHI of 10.2.

Just to confirm something here.... have you had two sleep studies (that is a sleep study followed by a titration study) or just a single sleep study only?

If you haven't had a titration study you need to proceed with caution, because for some patients who may have a CSDB (Complex Sleep Disordered Breathing) condition that has not been fully disgnosed, an inappropriately set APAP can make things worse than no treatment.

Cheers,

Bill

Weezer · Post by **Weezer** » Fri Sep 28, 2007 8:02 pm

Gee. Maybe I didn't get a proper sleep study. Here's what Kaiser does:

They send you home to wear a monitor for one night – a band around your chest and a pulse meter on your finger.

The next night, they give you an APAP to take home for one night. I had a Vantage set wide open w/ no humidifier and a Breeze – which I hated and finally gave up on.

I don't think I slept at all that night – but they told me I did without knowing it and titrated me at 11.

Anyone else had this experience? Do you consider this a good sleep study? And what should I do now – go elsewhere and pay to go to another sleep lab?

Wulfman... · Post by **Wulfman...** » Fri Sep 28, 2007 8:38 pm

billbolton wrote:
Weezer wrote:My original sleep study at Kaiser had me with an AHI of 10.2.
Just to confirm something here.... have you had two sleep studies (that is a sleep study followed by a titration study) or just a single sleep study only?

If you haven't had a titration study you need to proceed with caution, because for some patients who may have a CSDB (Complex Sleep Disordered Breathing) condition that has not been fully disgnosed, an inappropriately set APAP can make things worse than no treatment.

Cheers,

Bill

That's precisely why I suggested that the machine initially be set at the prescribed pressure. You really shouldn't be making major adjustments until you know how the prescribed pressure works.....or doesn't.

Den

RosemaryB · Post by **RosemaryB** » Sat Sep 29, 2007 12:57 pm

[quote="Weezer"]Gee. Maybe I didn't get a proper sleep study. Here's what Kaiser does:

They send you home to wear a monitor for one night – a band around your chest and a pulse meter on your finger.

The next night, they give you an APAP to take home for one night. I had a Vantage set wide open w/ no humidifier and a Breeze – which I hated and finally gave up on.

I don't think I slept at all that night – but they told me I did without knowing it and titrated me at 11.

Anyone else had this experience? Do you consider this a good sleep study? And what should I do now – go elsewhere and pay to go to another sleep lab?

AHI Higher With CPAP?!

AHI Higher With CPAP?!

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Additional Comments: Airmini, Medistrom Pilot 24, CMS 60C Pulse Oximeter, ResScan 6