Cannot get control of my AHI!

HoseCrusher wrote:You are caught between a rock and a hard spot.

The data from your xPAP machine is to be used for trending. It doesn't necessarily correspond to what is scored during a sleep study. The S8 scoring came into question and was changed with the S9.

I have a similar machine and was instructed to minimize the AI and ignore the rest. I confirm my treatment using a pulse oximeter checking to make sure I have no desaturations below 90% and no spikes in pulse rate.

I was told to cut the HI's in half, nothing was mentioned about the AI's. I do not expect it to be the same as my titration, but an AHI of 13.5 is a just a bit high. The position change from right side to left sent my readings up to an AHI of 29.2. That is really high, even for a machine that scores higher then it should.

I cannot get another titration for quite some time. I do plan on purchasing one of those Nonin wrist pulse/oximeters & the software so I can compare them with resscan. I have so little trust in my sleep Doctor. I never had a RERA until my last titration & that was scored at an index of 9.1 and a central apnea index of 5.1 which my sleep doctor did not even bring up after the titration. So in my last titration I have centrals & RERA's for the first time & I am not even told about it. I have to read it in the report myself.

I would like to be able to sleep with the peace of mind knowing that a direction change in my sleep is not going to shoot everything up & I am unsure what to do about the centrals from the last titration. IS the straight CPAP machine what I really need, or do I need one of the other ones. I would think the machine that monitors my breathing & makes appropriate changes would be a better choice. A machine that can compensate for the rises when I move to another position in my sleep & one that could possably chart centrals and RERA's.

Thank you HoseCrusher for taking the time to help me here. I really do appreciate your suggestions. You confirmed my thoughts on getting a wrist/pulse oximeter. I really like the nonin 3150 wirst meter, but unable to get them in Canada or buy them online in the US.

I contacted my supplier in Canada & ordered one of the resmed hoses 2 meter for my s8 elite ii & he was out of stock. He tried to replace it with the new resmed slimline hose. I happened to look it up on the net & called resmed. They told me it was only compatible with the s9 series. These people should know that. If I had been someone who knew little about cpap machines & was told that, I may hve taken it & would never have know the difference. Thats kind of wrong of them. IT is a nice lite hose though. To bad I cannot use it on the S8, especially the heated one.

RIck

red1 wrote: I never had a RERA until my last titration & that was scored at an index of 9.1 and a central apnea index of 5.1 which my sleep doctor did not even bring up after the titration. So in my last titration I have centrals & RERA's for the first time & I am not even told about it. I have to read it in the report myself.

red1 wrote:IS the straight CPAP machine what I really need, or do I need one of the other ones. I would think the machine that monitors my breathing & makes appropriate changes would be a better choice. A machine that can compensate for the rises when I move to another position in my sleep & one that could possably chart centrals and RERA's.

S9 AutoSet would give you the flexibility that you may need with different position pressure requirements.
It will also score centrals. Sometimes APAPs aren't the best choice if someone does have centrals if they happen to be related to pressure increases. You don't know if your centrals are or not. The S9 Autoset could be used in straight CPAP mode if pressure changes make a huge impact on centrals or even used in a limited APAP range to lessen the chance of pressure creating centrals. Plus you don't know if your centrals would be there regardless of the pressure.
And if so, in a number that might even require a more advanced machine.
I don't think ResMed machine's will score RERAs though. My Respironics machine does though. Now how accurate or just how import that little piece of data really is, I don't know.

It's obvious that you need to do something. If you could get your hands on either a S9 Autoset or PR S1 Auto...you could at least see if some of those Hyponeas would be called central and or have the pressure variations you might need. Now if you have a truck load of centrals that would of course open up a whole new can of worms.
Ideally a new sleep study but if that is out of the question your options at this point are pretty limited.

Pugsy wrote:

red1 wrote: I never had a RERA until my last titration & that was scored at an index of 9.1 and a central apnea index of 5.1 which my sleep doctor did not even bring up after the titration. So in my last titration I have centrals & RERA's for the first time & I am not even told about it. I have to read it in the report myself.

red1 wrote:IS the straight CPAP machine what I really need, or do I need one of the other ones. I would think the machine that monitors my breathing & makes appropriate changes would be a better choice. A machine that can compensate for the rises when I move to another position in my sleep & one that could possably chart centrals and RERA's.

S9 AutoSet would give you the flexibility that you may need with different position pressure requirements.
It will also score centrals. Sometimes APAPs aren't the best choice if someone does have centrals if they happen to be related to pressure increases. You don't know if your centrals are or not. The S9 Autoset could be used in straight CPAP mode if pressure changes make a huge impact on centrals or even used in a limited APAP range to lessen the chance of pressure creating centrals. Plus you don't know if your centrals would be there regardless of the pressure.
And if so, in a number that might even require a more advanced machine.
I don't think ResMed machine's will score RERAs though. My Respironics machine does though. Now how accurate or just how import that little piece of data really is, I don't know.

It's obvious that you need to do something. If you could get your hands on either a S9 Autoset or PR S1 Auto...you could at least see if some of those Hyponeas would be called central and or have the pressure variations you might need. Now if you have a truck load of centrals that would of course open up a whole new can of worms.
Ideally a new sleep study but if that is out of the question your options at this point are pretty limited.

I am unsure if the centrals are caused by pressure or something else. I think I need to get myself a new sleep doctor. Someone who will listen to me & someone who shows an interest in my sleep apnea. The doctor I have now spends more time staring at what ever is on her desk, then she does looking at me or my results. She hates it when I ask questions. She would rather I sit there mute & just shake my head in agreement. She makes me feel like I'm distracting her from something more important, like a book she is reading on her desk.

I cannot spend my life just sleeping on my right side. I also enjoy sleeping on my left side. Rarely do I sleep on my back & the reason for that is, I find I have a lot of abrupt awakenings on my back. One right after the other & on the odd ocassion, I wake up gasping for air. It's like my airway is still partially closed. There are also other times, where I wake up, not moving & not breathing & I have to shake myself hard from within to breath & move again. This happens rarely, but does happen none the less.

My S8 Elite ii is about 3 years old. But, I certainly am willing to fork out for the proper machine, once I am able to establish what that is. I am unsure we can rent xpap's in Ontario, Canada.The S9 Autoset sounds like a good machine. I just do not want to buy it & then later find out I need the VPAP machine.

Thanks Pugsy for your comment & suggestions. I really appreciate it

red1 wrote:I just do not want to buy it & then later find out I need the VPAP machine.

Certainly understandable and I would be thinking the same thing in your shoes. We just don't know for sure what you might need. There just is no way to know from what information is available now.
If you were here in the US with some careful shopping on craigslist you could probably find something that would work to at least give you a start on the data ( centrals) and wouldn't cost a lot and you could resell it if it worked out that you needed a different type of machine.

red1 wrote: I cannot spend my life just sleeping on my right side. I also enjoy sleeping on my left side. Rarely do I sleep on my back & the reason for that is, I find I have a lot of abrupt awakenings on my back. One right after the other & on the odd ocassion, I wake up gasping for air. It's like my airway is still partially closed. There are also other times, where I wake up, not moving & not breathing & I have to shake myself hard from within to breath & move again. This happens rarely, but does happen none the less.
Thanks Pugsy for your comment & suggestions. I really appreciate it

I know nothing about it, but regarding sleeping on whatever side, an experimental option might be but on a tilted bed or plank, so your head is more above the feet, but you still need to get data from a capable machine to have any idea.

Im pretty sure there was a thread at this forum on tilted sleeping , or whatever it's called.

[quote="peterg

I know nothing about it, but regarding sleeping on whatever side, an experimental option might be but on a tilted bed or plank, so your head is more above the feet, but you still need to get data from a capable machine to have any idea.

Im pretty sure there was a thread at this forum on tilted sleeping , or whatever it's called.[/quote]


Yes, I am going to half to get hold of a machine somehow, that can read centrals, as my s8 elite ii cannot read them. If I had just obstructive sleep apnea, I would be able to find a pressure that would keep my numbers somewhat at bay, no matter what direction I slept in. I think my best bet, as pointed out, would be to get hold of a S9 Autoset. That way I can see what centrals I am having & the pressure would be adjusted to compensate for any direction I sleep in.

I see no other options. What if's mean nothing. I need data, which my present machine will not give me.

Thanks peterg

Hi everyone,

Last night I used an extra thin pillow & it actually droped my numbers a few points.

What is the best kind of pillow to get, soft, medium or hard? I do have a cpap pillow I have not even used, because I find it does not raise my head abouve my legs at all. IT does not seem like the kind of pillow you can put another one underneath.

Thanks