AHI 14 not going down

So I'm still on my trial,I call in to check my results,I'm at 87% compliance!mask leaks aren't bad but my AHI is stating on 14 roughly. How do they get that lower,I'm on a boat right now so it's not like I can just go and have it adjusted,I'm more curious to what they'll do to lower it. I have a apap dream machine,it was set up from 4-14 but at 14 it would blow the mask off at night,I was using the wisp,switched to nasel pillows and it did the same on both.
They turned it down to 4-12 and it doesn't blow the mask off,I've now switched to the dreamware mask and I love that mask. I'm here till mid December then I'll see my sleep Dr for adjustments.
So back to main question,what do they do to lower AHI??

Well it depends - you would have to get some data off the machine and into a program that show's if you are having central event's / obstructive etc...

I myself have no experience with that machine, unsure if it works with sleepyhead or shows the data itself etc...

Someone will reply soon that will be of better assistance for sure. I myself, my AHI was real high on Cpap - I ended up needing an ASV.

But in your case, I am sure some tweaking of things you can control you could prob get it down to normal (5ish and below) AHI's

Welcome to the Forum, You will find it very helpful.

When you get a chance, fill out your equip in the control panel it will help other know exactly what your using etc.....

KDB wrote:So I'm still on my trial,I call in to check my results,I'm at 87% compliance!mask leaks aren't bad but my AHI is stating on 14 roughly. How do they get that lower,I'm on a boat right now so it's not like I can just go and have it adjusted,I'm more curious to what they'll do to lower it. I have a apap dream machine,it was set up from 4-14 but at 14 it would blow the mask off at night,I was using the wisp,switched to nasel pillows and it did the same on both.
They turned it down to 4-12 and it doesn't blow the mask off,I've now switched to the dreamware mask and I love that mask. I'm here till mid December then I'll see my sleep Dr for adjustments.
So back to main question,what do they do to lower AHI??

Most likely, they (or you) would need to increase the minimum pressure. With it being so low (4 cm.), you're likely having many events before the pressure can rise to prevent them.
You DO know, that the pressures don't rise WHILE you're having apneas, don't you? Pressures mainly increase on Flow Limitations and Snores.......because that's what they THINK precede apneas. However, some people don't have them and the apneas happen without precursor events. Which means the events are going to happen without any attempt from the machine to prevent them. And, pressures usually increase SLOWLY.......checking while increasing to see if the pressure is correct. If, after some time with no other events, the pressure drops back down.

So, the best minimum pressure when using an APAP is where it eliminates almost all of the events........sort of like using single pressure in CPAP mode.

And, if you're going to use a range of pressures, you're going to need to adjust your mask headgear to handle the highest pressures it will go to.


Den

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Wulfman... wrote:

KDB wrote:So I'm still on my trial,I call in to check my results,I'm at 87% compliance!mask leaks aren't bad but my AHI is stating on 14 roughly. How do they get that lower,I'm on a boat right now so it's not like I can just go and have it adjusted,I'm more curious to what they'll do to lower it. I have a apap dream machine,it was set up from 4-14 but at 14 it would blow the mask off at night,I was using the wisp,switched to nasel pillows and it did the same on both.
They turned it down to 4-12 and it doesn't blow the mask off,I've now switched to the dreamware mask and I love that mask. I'm here till mid December then I'll see my sleep Dr for adjustments.
So back to main question,what do they do to lower AHI??

Most likely, they (or you) would need to increase the minimum pressure. With it being so low (4 cm.), you're likely having many events before the pressure can rise to prevent them.
You DO know, that the pressures don't rise WHILE you're having apneas, don't you? Pressures mainly increase on Flow Limitations and Snores.......because that's what they THINK precede apneas. However, some people don't have them and the apneas happen without precursor events. Which means the events are going to happen without any attempt from the machine to prevent them. And, pressures usually increase SLOWLY.......checking while increasing to see if the pressure is correct. If, after some time with no other events, the pressure drops back down.

So, the best minimum pressure when using an APAP is where it eliminates almost all of the events........sort of like using single pressure in CPAP mode.

And, if you're going to use a range of pressures, you're going to need to adjust your mask headgear to handle the highest pressures it will go to.


Den

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Den, thanks for your reply,I'm so new to this I have a lot to learn. Right now they have the adjustments locked out so I can't do anything,hopefully after my 90 days are up they'll unlock that. As far as the masks and more pressure,I tried tightening the wisp mask I had,I would take it off at night cause it was bothering me,I know when it was at 14 and blowing,it kept the mask off my face,I tried tightening it and it still would leak by,I think with the new dreamware mask I have it could probably be raised back up.. I guess I'll just see what they want to do when I get home mid Dec...

KDB wrote:Den, thanks for your reply,I'm so new to this I have a lot to learn. Right now they have the adjustments locked out so I can't do anything,hopefully after my 90 days are up they'll unlock that. As far as the masks and more pressure,I tried tightening the wisp mask I had,I would take it off at night cause it was bothering me,I know when it was at 14 and blowing,it kept the mask off my face,I tried tightening it and it still would leak by,I think with the new dreamware mask I have it could probably be raised back up.. I guess I'll just see what they want to do when I get home mid Dec...

If all they know is to adjust the maximum pressure, you COULD be dealing with idiots.
It's YOUR therapy and YOU should have some input to what they're doing, too.

I'm not familiar with nasal masks at all, so I can't advise much on those. But, the principle is still pretty much the same with adjusting the tension to be able to handle pressures.

Just sayin'.......


Den

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Do you have a Windows computer?

Are you able to use SleepMapper to see what that AHI is made up of?

SleepyHead software won't work with the new Dream machines from Respironics but if you have Windows we could maybe get you Encore Pro to see what the AHI is made up of and I think SleepMapper also breaks down the AHI into each category.

Go here and request the clinical manual for your machine
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
It explains how to "unlock" the machine.

If your AHI is primarily OA and hyponea you probably need a little more minimum pressure (how much more we don't know without seeing some reports) but if the AHI is primarily made up of Clear Airway apneas/Centrals then more pressure won't help and could make things worse.
So before you go fixing something...make sure it is fixable with what you want to do.

Pugsy wrote:Do you have a Windows computer?

Are you able to use SleepMapper to see what that AHI is made up of?

SleepyHead software won't work with the new Dream machines from Respironics but if you have Windows we could maybe get you Encore Pro to see what the AHI is made up of and I think SleepMapper also breaks down the AHI into each category.

Go here and request the clinical manual for your machine
http://www.apneaboard.com/adjust-cpap-p ... tup-manual
It explains how to "unlock" the machine.

If your AHI is primarily OA and hyponea you probably need a little more minimum pressure (how much more we don't know without seeing some reports) but if the AHI is primarily made up of Clear Airway apneas/Centrals then more pressure won't help and could make things worse.
So before you go fixing something...make sure it is fixable with what you want to do.

So all the data on my machine gets sent in,I just called and they're going to send me the report,when I get it,I'll be hitting you guys up with lots of questions...hope you don't mind...

u can access this data yourself - in great detail, somtimes more then the dr knows even lol

metsfan302 wrote:u can access this data yourself - in great detail, somtimes more then the dr knows even lol

How??? I already have sleepMapper,that's pretty much useless...SleepyHead doesn't support the new dreamMachine..

I think that the latest version of Encore Pro from Respironics will work with the new DreamStation machines but I don't have confirmation of that yet.
This last version was released after the DreamStation release so I assume that is why they did it but I haven't been able to install it and test it out.
If you want to be a guinea pig...send me a private message and I will point you to the beast...Encore Pro...or the bitch as I call it. Not nearly as easy to get along with as SleepyHead but SH won't work yet with your machine so it's either that or nothing.

EncoreGuide link this will show you examples of what you will see. For a different machine than yours but the basics are the same.
http://www.healthcare.philips.com/pwc_h ... _Guide.pdf

Though I thought I saw where SleepMapper with the DreamStation machines was at least showing AHI breakdown into each category...Clear Airway...Obstructive Apnea...Hyponea..
which would at least give you an idea what the AHI is made up of.

Pugsy wrote:I think that the latest version of Encore Pro from Respironics will work with the new DreamStation machines but I don't have confirmation of that yet.
This last version was released after the DreamStation release so I assume that is why they did it but I haven't been able to install it and test it out.
If you want to be a guinea pig...send me a private message and I will point you to the beast...Encore Pro...or the bitch as I call it. Not nearly as easy to get along with as SleepyHead but SH won't work yet with your machine so it's either that or nothing.

EncoreGuide link this will show you examples of what you will see. For a different machine than yours but the basics are the same.
http://www.healthcare.philips.com/pwc_h ... _Guide.pdf

Though I thought I saw where SleepMapper with the DreamStation machines was at least showing AHI breakdown into each category...Clear Airway...Obstructive Apnea...Hyponea..
which would at least give you an idea what the AHI is made up of.

The version of sleepmapper I have is pretty basic,shows no breakdown whatso ever...shows that I have 100% zero mask leak!no way!!!! I'll get the copy and then ask questions.. I did try to unlock per someone's instructions,didn't work on my machine..

I had someone tell me that they had to hold the buttons down longer and more carefully on the Dream Station to get it unlocked...it will unlock because there's nothing special that DMEs do or can do other than the little code thing to lock it..

KDB wrote:shows that I have 100% zero mask leak!no way!!!!

Actually it isn't saying no mask leak at all...what it is saying is that there is no leak large enough to earn a large leak flag...no time spent in large leak is what it means.
Doesn't mean there is no leak at all going on.
Respironics machines have quite a general leak allowance where it can compensate for leaks before it flags large leak territory leak.
I never get a large leak flag with my Respironics machines and I rarely go without at least a short large leak on my ResMed machine. Respironics has more wiggle room before it flags a large leak.