New guy - High AHI question

doxiedad · Post by **doxiedad** » Sun May 18, 2008 7:32 pm

I have been reading all the great info available on this forum, and hope you all will be able to offer advice. After 18 days of CPAP use I have some concerns. I do not go back to the Dr. for 2 more weeks for a compliance check. But by that time it will be over 30 days with the DME equipment. My current info off the M-Series is as follows

System Leak
7 Day Avg 29.7 L/min 30 Day Avg 29.2 L/min

Apn-Hyp Index
7 Day Avg AHI=33.5 30 Day Avg AHI=27.3

From what I have read the AHI is higher than what it should be. My pressure now is 8. I am wondering if I should try to get an M-Series Auto to replace my Pro to use to get what my pressure needs to be. I did not sleep well during the titration and they told me 8 was there best guess. My concern is if the Dr. does not want to change anything I will not be able to effectively monitor and set a new pressure with the M-Series Pro. Any thoughts and comment would be appreciated.

Goofproof · Post by **Goofproof** » Sun May 18, 2008 7:53 pm

You can get the software and card reader for the "M"series Pro, it has the same data as the APAP. The data from the LCD is less useful, but slightly better than none at all. Keep your leak rate low, if you leak rate is too high the numbers don't mean anything. Jim

Panhandler · Post by **Panhandler** » Sun May 18, 2008 8:08 pm

You've got to take responsibility for your own treatment. If your doctor is comfortable with this concept, you'll be in great shape (and probably be in the minority.) In some cases where the lab has had problem getting a good titration, users and their physicians have taken advantage of the APAP machine and it's data to focus in on a good pressure. To do that, you need the ability to record and read data from the machine.

There's actually a study that suggests use of an APAP to adjust pressure is as good as the results of a sleep test. I don't recall where I saw it, but someone here will know. If not, PM me and I'll search for it.

You need to be careful about challenging your doc, or questioning his expertise, so study up and get educated, but don't beat him over the head with it. If you can't work with him, folks here will help you, so don't worry. It's just easier of your doc is on the team.

Guest · Post by **Guest** » Mon May 19, 2008 12:19 am

dixiedad,

welcome to the forum and lucky you come to the great place for OSA.
the ahi is way too high for those that in the cpap treatment.
your doc seems to be in the wrong side?
you definatley need to get the right pressure.
8cm is a guessed fro your doc? something not right at all.

mckooi

Guest · Post by **Guest** » Mon May 19, 2008 12:32 am

Welcome to the forum, and congrats on your first 18 days. An AHI of 27 is way too high, almost like not being treated at all. Since your leak rate looks ok, and since your pressure of 8cm is just a "guess", I will take a shot and say that my guess is you need to adjust your pressure, probably upwards. I would also say that whatever machine you end up with, you definitely need software or some means to track your progress, along with the ability to make your own adjustments to your therapy. Even though I am not a doc it seems pretty obvious to me that someone guessed wrong about your treatment, and it will be up to you to get it right. Talk to your Dr tomorrow, and if he doesn't get busy and get you set up correctly fast, I would look for a new doc. Or just buy the software and reader, learn how to adjust your pressure, and figure it out yourself. IMHO.

ozij · Post by **ozij** » Mon May 19, 2008 1:33 am

I did not sleep well during the titration and they told me 8 was there best guess. My concern is if the Dr. does not want to change anything I will not be able to effectively monitor and set a new pressure with the M-Series Pro. Any thoughts and comment would be appreciated.

No need for that concern. I too would suggest you call the doctor immediately and tell him about you results - start with how you're feeling, not with the numbers, but make sure he's aware of both the AHI you have now, and of the little sleep you got in the study.

Play it by ear from there. Having a good doc whom you can treat as an ally, and who see you as an ally is a very good thing. Give him a chance. Ask him about an automatic titration machine for use at home if he doesn't bring it up - tell him you think you maybe sleeping very differently at home.

Getting a smart card and software to monitor you data is an excellent idea - and you can do that with Pro. You can also use a Pro for self-titration.

O.

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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, AHI, Smart Card

Snoredog · Post by **Snoredog** » Mon May 19, 2008 1:36 am

your leak rate is fine, but your AHI is way too high.

You need to bump up your pressure from 8.0 to 9.0 and compare new AHI. If the AHI drops you know you are heading in the right direction.

You can erase the LCD data and get a new reading the next day, instead of it being a 7-day average it is from the prior night.

you hold down the left and right arrows while plugging in the power on the back of the machine, wait for 2 beeps, press the minus (-) key, use arrows to navigate to Therapy screen, press the minus (-) key for 5 seconds, screen should go back to zero. This does NOT erase the data from the card, so when your doctor pulls a report from that they won't know you erased the screen data.

If you press the (+) key and go into setup, you can set the pressure from 8.0 to 9.0, then press the ON/Off key to exit programming.

doxiedad · Post by **doxiedad** » Tue May 20, 2008 8:55 am

Thanks everyone, I was able to get in this afternoon to see the Dr. so I will wait and see what she wants to do.

Thanks again!