AHI help

stevemjc · Post by **stevemjc** » Mon Jul 01, 2019 1:21 pm

Hello all. I have been using a CPAP for about 2 years. Recently I have been having some issues. I do have an appointment scheduled to see my doctor. But I wanted to see if anyone had any insights.

Some days I will have 0,2-3.0 AHI events (which I was told is good). Other days I will have 10-20 AHI events. Per sleepyhead, the days of 10+ are a mixture of Clear Airway events and Obstructive events. This just started happening the last month plus.

How Can I have days of <3 to days of >10 in the same week and this pattern happens weekly.

Thanks for your help.

zonker · Post by **zonker** » Mon Jul 01, 2019 4:00 pm

stevemjc wrote: ↑
Mon Jul 01, 2019 1:21 pm
Hello all. I have been using a CPAP for about 2 years. Recently I have been having some issues. I do have an appointment scheduled to see my doctor. But I wanted to see if anyone had any insights.

Some days I will have 0,2-3.0 AHI events (which I was told is good). Other days I will have 10-20 AHI events. Per sleepyhead, the days of 10+ are a mixture of Clear Airway events and Obstructive events. This just started happening the last month plus.

How Can I have days of <3 to days of >10 in the same week and this pattern happens weekly.

Thanks for your help.

welcome to the zoo! glad that you have sleepyhead in hand and are monitoring your progress.

may i suggest your next step is to post screenshots here? then the experts can review your data and give you pertinent (and maybe even IMpertinent) advice.

see my sig and read the newbie post linked there if you have other questions.

good luck!

Julie · Post by **Julie** » Mon Jul 01, 2019 4:42 pm

Include full name and model of machine and mask please.

Pugsy · Post by **Pugsy** » Tue Jul 02, 2019 7:05 am

stevemjc wrote: ↑
Mon Jul 01, 2019 1:21 pm
How Can I have days of <3 to days of >10 in the same week and this pattern happens weekly.

We don't sleep the same each night. Lots of variables.
The one that I think of first is that some nights you are on your back more than other nights and when on your back you need more pressure.

JXG · Post by **JXG** » Tue Jul 02, 2019 3:45 pm

Two things to think about (are they correlated with your higher AHI days):
1. Medications you are taking occasionally
2. Variability in your alcohol consumption.

bjhunt01 · Post by **bjhunt01** » Tue Jul 02, 2019 8:32 pm

Pugsy wrote: ↑
Tue Jul 02, 2019 7:05 am

stevemjc wrote: ↑
Mon Jul 01, 2019 1:21 pm
How Can I have days of <3 to days of >10 in the same week and this pattern happens weekly.
We don't sleep the same each night. Lots of variables.
The one that I think of first is that some nights you are on your back more than other nights and when on your back you need more pressure.

When you sleep on your back - I do always - do you need more minimum pressure or more maximum pressure?

LSAT · Post by **LSAT** » Tue Jul 02, 2019 8:47 pm

bjhunt01 wrote: ↑
Tue Jul 02, 2019 8:32 pm

Pugsy wrote: ↑
Tue Jul 02, 2019 7:05 am

stevemjc wrote: ↑
Mon Jul 01, 2019 1:21 pm
How Can I have days of <3 to days of >10 in the same week and this pattern happens weekly.
We don't sleep the same each night. Lots of variables.
The one that I think of first is that some nights you are on your back more than other nights and when on your back you need more pressure.
When you sleep on your back - I do always - do you need more minimum pressure or more maximum pressure?

If you are using an Autoset the machine should compensate and increase your pressure. That's assuming your pressure settings are adequate.

bjhunt01 · Post by **bjhunt01** » Tue Jul 02, 2019 8:52 pm

LSAT wrote: ↑
Tue Jul 02, 2019 8:47 pm

bjhunt01 wrote: ↑
Tue Jul 02, 2019 8:32 pm

Pugsy wrote: ↑
Tue Jul 02, 2019 7:05 am

stevemjc wrote: ↑
Mon Jul 01, 2019 1:21 pm
How Can I have days of <3 to days of >10 in the same week and this pattern happens weekly.
We don't sleep the same each night. Lots of variables.
The one that I think of first is that some nights you are on your back more than other nights and when on your back you need more pressure.
When you sleep on your back - I do always - do you need more minimum pressure or more maximum pressure?
If you are using an Autoset the machine should compensate and increase your pressure. That's assuming your pressure settings are adequate.

Thanks! I just might still be trying to find those! They are greatly changed since I started here a few weeks ago thanks to people's input!

Pugsy · Post by **Pugsy** » Wed Jul 03, 2019 5:48 am

bjhunt01 wrote: ↑
Tue Jul 02, 2019 8:32 pm
When you sleep on your back - I do always - do you need more minimum pressure or more maximum pressure?

It depends...but often both minimum and maximum needs will be affected.
Same thing for people with OSA that is worse in REM....pressure needs can change significantly in REM for some people.
Some people get the doubly whammy....worse in REM and worse when supine combined.

I know a person who needs a pressure of 19 when on their back...that's not a minimum that's a full time pressure...when on their back but only 9 cm when on their side.

stevemjc · Post by **stevemjc** » Fri Jul 05, 2019 8:39 am

JXG wrote: ↑
Tue Jul 02, 2019 3:45 pm
Two things to think about (are they correlated with your higher AHI days):
1. Medications you are taking occasionally
2. Variability in your alcohol consumption.

Ok to meds.

No alcohol consumption.

stevemjc · Post by **stevemjc** » Fri Jul 05, 2019 8:42 am

Here is a screen shot.

Pugsy · Post by **Pugsy** » Fri Jul 05, 2019 9:02 am

You were probably on your back when that ugly cluster happened......either that or you were in REM stage sleep. Maybe a little of both.
It could be REM...that's about the same time frame as we normally have the greatest amount of REM.

You needed more pressure for whatever reason and with the current setup in cpap fixed mode the machine simply has to watch the events happen and get flagged until they quit happening.

Either switch over to apap mode and let the machine try to fight them or be prepared to use more pressure all night to prevent those ugly clusters from happening.

stevemjc · Post by **stevemjc** » Fri Jul 05, 2019 9:53 am

Pugsy wrote: ↑
Fri Jul 05, 2019 9:02 am
You were probably on your back when that ugly cluster happened......either that or you were in REM stage sleep. Maybe a little of both.
It could be REM...that's about the same time frame as we normally have the greatest amount of REM.

You needed more pressure for whatever reason and with the current setup in cpap fixed mode the machine simply has to watch the events happen and get flagged until they quit happening.

Either switch over to apap mode and let the machine try to fight them or be prepared to use more pressure all night to prevent those ugly clusters from happening.

Copy to the big cluster. I have changed to autoset and ranged up higher.

Do you think the events at the beginning events are also from being on my back?

The goal is to have the CPAP machine stop all events, right?

NoOnesPerfect · Post by **NoOnesPerfect** » Fri Jul 05, 2019 10:03 am

stevemjc wrote: ↑
Fri Jul 05, 2019 9:53 am

The goal is to have the CPAP machine stop all events, right?

As a goal, I suppose that would be correct. In reality, it is very unlikely. You will have good days and bad days. The machine reacts to apneas, it doesn’t typically anticipate them other than if you snore or have serious flow limitations. That means you will likely have at least a few events that are not prevented by the minimum pressure you have set.

Reducing events might also cause sleep disturbances because of your reaction to higher pressures or mask leaks, so you need to balance sleep quality and comfort against event reduction. In other words, the goal is to improve your sleep quality and time, not necessarily reduce events to zero.

zonker · Post by **zonker** » Fri Jul 05, 2019 10:08 am

NoOnesPerfect wrote: ↑
Fri Jul 05, 2019 10:03 am

stevemjc wrote: ↑
Fri Jul 05, 2019 9:53 am

The goal is to have the CPAP machine stop all events, right?
As a goal, I suppose that would be correct. In reality, it is very unlikely. You will have good days and bad days. The machine reacts to apneas, it doesn’t typically anticipate them other than if you snore or have serious flow limitations. That means you will likely have at least a few events that are not prevented by the minimum pressure you have set.

Reducing events might also cause sleep disturbances because of your reaction to higher pressures or mask leaks, so you need to balance sleep quality and comfort against event reduction. In other words, the goal is to improve your sleep quality and time, not necessarily reduce events to zero.

very well said.

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