AHI went higher to 38 on second night of usage

Hi Everyone!

Thanks, in advance, for any insight you can give me. I'm a new Cpap user. I was just diagnosed with severe OSA (AHI of 33 with severe desaturation drops). I got a Resmed Airsense 10. On my second night of usage, my AHI per hour was 38 (which is higher than my testing AHI). My mask seal was rated "good". I'm currently using the Resmed Airfit F20. I've also tried the Philips Respironics Dream mask with similar results. Leak was also rated as "good" on this mask as well.

My question is...does it take the machine a few days to develop algorithms to help my sleep apnea, or if the AHI doesn't improve in the first couple of things, does that mean it isn't working? Is it unusual for the AHI to be the same (or worse) at first, but then it improves in a few days?

Thanks!

Elizabeth

Exactly which model AirSense 10 machine are you using?
Look on the face of the machine lower right and see if it says
1. CPAP
2. Elite
3. AutoSet
4. AutoSet for Her

We need to know
1...what category of events the AHI is composed of
2...exactly what your settings are....including EPR (if using EPR).

If any model other than the CPAP number 1 model....
you can get all the information we need by using available software
OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

viewtopic/t158560/How-to-post-images-for-review.html

If you are using the "CPAP" model...it won't give you the information you need....call up the supplier and tell them you want a different machine.

No...the machine doesn't learn anything or change anything on how it works in response to your AHI.
Depending on the kind of events you are having there may be some things you can do though.

But we need much more information before we can hazard any guesses.

Thanks for your response. Forgive my ignorance. I'm a newbie, just getting started.

I have the Airsense 10 for Her Resmed machine. It is set to vary between levels 5 and 15.

Thanks!

The for Her machine is a full data machine....compatible with OSCAR.

We need more details to come up with ideas on what is needed to get your AHI numbers down.
What to do will depend on what is showing on the detailed report.

Post the detailed report in the format I showed in the "how to post images" thread.

You probably need to download and read the manual...I suspect you are going to need it.
https://www.respshop.com/manuals/ResMed ... %20her.pdf
This manual isn't the same manual as the user manual you probably got with the machine. It contains some more and very special information in it.

You need the "real" manual--get it.
I had the manual before I picked up my machine.
Downloaded it at work--sent it to the printer before I counted the pages.
Don't do that!
I nursed the printer until the incriminating pages could be snuck out of the office.

I tried to download Oscar onto my Mac but it is blocking it. Me not being super tech doesn't help this situation.

You have to tell the Mac that you know the software it is blocking and it is okay to install it.
I got a similar message on my Windows computer.
I am not familiar with Macs so I can't offer exact steps needed but a lot of Mac users are here and can tell you the exact steps.

In the meantime there is some limited data available on the machine's LCD screen where you are seeing the AHI.
You need to change the sleep report parameter to 1 day instead of the default 30 days and expand the sleep report to show
the AHI breakdown in its limited form.

You should be able to see not only the AHI but the AI index and the central index.
My main concern right now is the central index but if you give us the AHI and the AI index and the central index we can figure out the hyponea index and get the event categories at least.

The manual link I posted above...explains how to get the detailed sleep report information.

So...need to know

Which mode are you using on the machine?

Exactly what pressure settings are being used?

Is ramp being used...if so how long?

Is EPR being used? If so at what setting?

AHI

AI index

Central index

Hours used?

Actually, now my doctor put me on Bipap. I'm using the Resmed AirCurve 10 (valuto). Given the data below, what are your suggestions? My AHI is very high which is concerning to me. Settings as follows:

Ramp time: off
Humidity 4 leak alert off
smart start off
full face mask
tube slim line
mod auto
max pap 15
min pap 4
PS 5
TiMax 2.5sTiMin 1.0s
trigger med
cycle med
ramp time off
AB filter no
essentials plus
leak alert off
temp units (not set)

sleep report for first night:
9.42 hours
good mask seal
pressure 14.9
exp pressure 10.0
leak 0L/min
vt 380 ml
RR MV 3.9L/min
Ti 1.3s
I:E. 1:2:6
spont cyc. 65.5%
AHI 53.8
total AI. 51.1
Central AI. 1.6

You are going in the wrong direction very quickly.
Call up your doctor.
This

1speechpick wrote: ↑

Fri Jun 11, 2021 6:52 am

pressure 14.9
exp pressure 10.0

points to the machine essentially being at max pressure for a sizable chunk of the night most likely.
Hard to know for sure without seeing the software details.

Did you actually sleep soundly at these settings with this new machine?

No, I did not sleep well at all. Is it possible there was a leak that wasn't registered by the machine?

If you spent a lot of time awake with mask and machine on it is possible that the machine mistook awake breathing irregularities as some sort of apnea event and flagged some false positive events.
None of these machines can tell if we are awake or asleep because they only measuring air flow or breathing.
Awake breathing can be very irregular when compared to asleep breathing.

Highly unlikely that leaks are sneaking past the machine and you are having big leaks that the machine is missing. I don't see your issue being related to leaks unless tiny leaks are causing you to not be able to sleep.

The numbers (leak and pressure) on the LCD screen are what we call 95% numbers and that means you were at or below that number for 95% of the night. The "or below" part of the definition means we don't know just how much time might have been spent below that number which is why we need to see the detailed reports. These numbers are NOT averages though.

When I see a high obstructive number of events though and the 95% numbers for pressure being maxed....that usually means the person is very likely maxed out in terms of pressure pretty much all night.
Your CI (central index) number is 1.6....that's low and within normal limits but your AI number is 51.1 which is horribly high (obstructive apneas close to 50 per hour) and worse than your initial sleep study. I don't know if your initial sleep study didn't catch all your events or if you are having a lot of false positives from being awake with the machine on. If you know you spent a lot of time awake....greatly increases the chances that a good chunk of the flagged events are false positives. If you weren't asleep when something was flagged it doesn't count.
The machine doesn't know the difference though.....it will respond to awake flagged irregularities in breathing just like it would for asleep breathing irregularities.

How much time do you think you actually slept last night?

Second night?
Maybe we are freaking out too soon.
I would give it a few more days, and see how things shake out.
Not everything has a simple answer--if it's a one-off, it may not matter.
We talk about patterns; then turn around and forget about them.

1speechpick wrote: ↑

Thu Jun 10, 2021 6:40 am

I tried to download Oscar onto my Mac but it is blocking it. Me not being super tech doesn't help this situation.

Open Finder and go to Downloads. Don't double-click the file to open it. Instead right-click (or Command-click) and select Open. You'll get a nastygram dialog box but there will a button to open the file anyway.

Then follow the directions.

Thanks so much, everyone, for trying to help. I do think I spent likely 2.5-3 hours awake (in and out of sleep). My OSA seems to mostly affect my REM sleep, so I never really sleep of much significance. I am actually going tonight for a titration study.

Do you all find OSA made you pretty weak and tired until it was under control?