Volatile AHI results under treatment

Folks might have seen some earlier posts of mine about mask leaks and then lots of volatility in my recent AHI results.

The recent thread is here: viewtopic.php?t=20058&start=30

Background: Newly dxed and been on the machine for about 6 weeks. Fairly low AHI of 11.5, titrated in a second study to 7cm H20. Got sent home with a M Series Pro, set at 7 cm H20. First couple of weeks, my AHI (off of the machine) was between 5 and 15. During the past 2-3 weeks, my AHI has been highly volatile, but tending between 15 - 25 events per hour at 7CM H20. Went to see my doc, who is concerned, and she has raised the pressure to 8 CM H20. Well, the firrst night at 8 ended me with 16 AHI at 8 CM H20. the instructions from my doc are to try 8 cm for two weeks and if no real improvement to go to an auto pap plus possibly some narcolepsy drug (provigil, or something like that??).

So. my question is with the volativility I'm experiencing with events/ahi is an auto pap the right solution? or am I just chasing a dragon's tail here? or am I perhaps one of those folks for whom xpap is not a good solution at all? I'm confused, but do have good insurance and want to do the right thing here. i'm exhausted right now, and having just started a new job, anxious to get my full energy back. I'm shot, the straight cpap isn't fixing things, and well feeling end-of-the-line here.

Thanks,

David

You are using a nasal mask, if you aren't taping well, you are probably loosing your treatment out of that big hole under your nose. If so your treatment won't work , it wouks by splinting your airway open with pressure. If the pressure comes out of your mouth, game over.

The solution is to tape you lips shut, or use a FF Mask, The FF Mask covers the big hole. Jim

The software is handy because it showes you whats happening.

Clarification: was originally on Swift II and moved to comfort gel. Mouth tapong tried on both, and made no difference. I'm keeping my mouth closed for once


David

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CPAPopedia Keywords Contained In This Post (Click For Definition): swift

Do you have Encore Pro? If so what is your avg leak rate, and over the night what is the leak range. Jim

I'd be looking into GERD (acid reflux.)

-SWS's thoughts on loonlvr's massive clusters of events and loonlvr's followup post:
Nov 05, 2005 subject: SUCCESS AT LAST-GERD,420E, PRILOSEC AND BENADRYL

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http://www.sciencedaily.com/releases/20 ... 080008.htm
"All patients with sleep apnea should be evaluated for gastroesophageal reflux," said J. Barry O'Connor, M.D., of Duke University Medical Center, one of the investigators.

http://www.medscape.com/viewarticle/516189

http://www.entnet.org/healthinfo/topics/GERD.cfm

http://www.grandtimes.com/GERD.html

thanks GP & RG:

The leaks with the new mask are a smidgen higher than they should be, but way better than before, when they were in the 50 l/m range when they should have been half of that.

The Gerd approach is interesting. I have previcid and could just take that for 4 days to see if any impact.

Letting the doc switch me to an auto isn't necessarily going to fix this, I gather?

oh well, thanks!
David

The Comfort Gel leak range should be between 30 to 38 cm to be effective, at 50 Treatment would be nill. That spells leaks, but acid will cause problems too. Jim

I have two Comfort Gel masks, and they have a 20 to 25 % difference in vent rate, I don't think quality control exists, at the factory. The result one mask works better than the other.

Agree on the Quality Control on the Comfort Gels... that's likely why (a) they're reasonably cheap and (b) why mine broke so easily.


Ugh. -David