AHI events while awake???

cindjo717 wrote:I have a question! I get itchy sometimes and have to take my mask off for a quick scratch. Should I shut the machine off before I take off my mask? Sometimes I just unclip one side and then just scratch my nose a bit and put it back on with the machine running. I wonder if this would cause the machine to read that as an ahi?

No, it won't show up as an AHI, but it may show up as a spike in the leak. So, as long as you know which leak it is, it's really no issue at all.

My AHI is usually between 6 and 10, so naturally I am wondering if I should be concerned about that, if I should be striving for an AHI < 5
, if my equipment can be trusted to accurately report what's going on, etc. One thing that bugs me is that it's supposed to have an "auto off" function. When you remove the mask, it is supposed to be able to detect that and turn itself off. It doesn't. So that makes me wonder why and what else it is not detecting properly. Maybe there is a sensor that isn't working. I'm just skeptical by nature and probably overly-analytical (former computer professional). I know that to err is human, but to really f*** up you need a computer. Please bear with me.

Yes, you should be striving to get your AHI under 5. Under 5 is considered apnea controlled by CPAP therapy. Three items or indicators (added together) make up the total AHI.THey are hypopneas, obstructive apneas, & central apneas. Sometimes your obstructive apneas will be under 1 while the CA and Hypopneas will be 4-5, hence the total you may have at the AHI6-10 reading. I see you are using the SleepHead so those are the results you see in the left hand column. Wearing the mask w/ machine turned on for an hour will certainly skew the results. If you remove your mask during the night for some reason, the pressure leak column average will adjust accordinly, the flow graph will show a blank space, but nothing else will be skewed.

In order for the mask to turn itself off, after a period, the "Auto Off".. which says ON or OFF in the setup screen must be selected to ON. Your DME probably selected off during the original setup. Most of them turn this feature off because there is no harm in letting it run during a bathroom break during the night, unless the sound is bothering a partner, spouse or the cat.

I sleep on the opposite side of a queen-sized bed from where the CPAP machine sits. It bother's ME to have to crawl over to that side of the bed just to turn the machine off. It's not a huge deal, just annoying, particularly at 3AM when I've had enough of the mask for one night and just want to rip it off, turn over and go back to sleep.

Oh, and BTW, I learned how to get into the DME settings, thanks to another post in this forum, and auto-off IS set to "ON".

Auto Off.... when it is On (which is a poorly named feature anyway) does not immediately turn itself off when it senses no respiration. I have not ever timed it but it is far from as immediate as the Auto On feature is. I read where someone says a minute. I thought it was longer than that. If I think about it tonight I will time it.

cnew wrote: It's not a huge deal, just annoying, particularly at 3AM when I've had enough of the mask for one night and just want to rip it off, turn over and go back to sleep

This is bad, bad habit to start. I know it is tempting but it is a bad habit for the evil side of your brain to learn and a hard habit for the good side of your brain to break.

cnew wrote:I sleep on the opposite side of a queen-sized bed from where the CPAP machine sits. It bother's ME to have to crawl over to that side of the bed just to turn the machine off. It's not a huge deal, just annoying, particularly at 3AM when I've had enough of the mask for one night and just want to rip it off, turn over and go back to sleep.

the mask is your friend
the mask is your friend
the mask is your friend
the mask is your friend

Oh, and BTW, I learned how to get into the DME settings, thanks to another post in this forum, and auto-off IS set to "ON".

now that I have to put my machine under the bed, in the middle, to drown the annoying wheezing noise, I AM using the autooff feature, so it's handy that way, though I doubt that's why they put in the feature. (I think of old people in nursing homes who remove the masks then nodd off to sleep. then theres degrees of invalidity that would make it difficult to reach down (with humidifier) to the floor to push the button.

Okay, I tested time for Auto Off feature to turn off the machine when no breathing is detected.
Took mask off and let machine run.
approx 30 seconds the Mask Alert feature kicked in with its little beeps.
another approx 30 seconds and the machine turned off all by itself. So probably is a minute. It just seems a lot longer.
I didn't have a stop watch to measure exactly. I just counted seconds...one thousand and one.....thing.

So these 3 features.
Auto On... when set to ON the machine will start on its own after it senses a few deep breaths inhale and exhale.
For me about 5. It may vary depending on how forcefully one inhales and exhales. When set to Off... one simply pushes the round button to start the machine.

Auto Off... when it is set to ON, the machine will turn itself off after a minute of not sensing breathing. This short of time spine will probably not show up on report as large leak. I will check report tomorrow to see for sure.
If it is set to OFF...the machine will continue to run for however long it runs I suppose. I am guessing will record large leak if for a prolonged time until we either turn it off or put the mask back on.

Mask Alert...when set to ON after no breathing is detected for 30 seconds there is an audible beeping of the same volume as when we press the round button to stop therapy in the AM. In the past this beeping I have slept through.
I suppose it depends on just how deeply a person sleeps and how sensitive they are to noise. Obviously I am not particularly sensitive.

These features (for PR System One machines) are found in the clinical setup menu and are easily changed. If someone doesn't know how to get to clinical menu here are instructions with pictures. http://www.apneaboard.com/PR-System-One ... -Setup.htm
This information (and a lot more) is also in the ultra secret clinical/provider manual which if you don't have one and want one you can request one here. Make sure to follow directions and be specific about which machine you have. Instructions near the bottom of the page.
http://www.apneaboard.com/CPAP%20Adjustment.htm
The clinical menu is also where the pressures are set. If you want to go look I would suggest writing the initial settings down and keep it handy...just in case you accidentally change something and want to change back.

cnew wrote:Last night I "hooked up" early and watched a video for approximately one hour before going to sleep. I was interested to see what would register on my report this morning. My machine reported clear airway apneas, hypopneas and obstructive apneas during the
hour before I went to sleep. What's up with that?

We just plain breathe differently awake compared to asleep. My greatest difference is my respiration rate drops from about 16 bpm while asleep to about 12 or fewer bpm when awake. The flow graph shows my inhale/exhale pattern is quite a bit different also.

Pugsy wrote:
This is bad, bad habit to start. I know it is tempting but it is a bad habit for the evil side of your brain to learn and a hard habit for the good side of your brain to break.

I have been duly chastised. But, but, but . . . I don't seem to be sleeping all that well with the mask. I keep waking up. This morning, I caved in at 3:30 AM and fell back to sleep for 4 solid hours. It felt really good. Is this the evil side of my brain talking?

pap4life wrote:Yes, your machine doesn't know when you are asleep, you might get some CRS events or centrals , but why would you get obstructive apneas when you are awake.?

That's what I'd like to know!

HoseCrusher wrote: However, understanding all of these limitations, isn't it wonderful when you can strive to keep the flow events as low as possible, and feel much better in the process.

Yes, very good point.

peterg wrote: the mask is your friend
the mask is your friend
the mask is your friend
the mask is your friend

LOL!

cnew wrote:I have been duly chastised. But, but, but . . . I don't seem to be sleeping all that well with the mask. I keep waking up. This morning, I caved in at 3:30 AM and fell back to sleep for 4 solid hours. It felt really good. Is this the evil side of my brain talking?

You know it is. I don't have to tell you.

Instead, try to isolate what it is about the mask that means you either wake up or can't sleep well with it. Work on the cause instead of settling for half assed treatment.
One of our members here (Robysue) has had some awful trials with cpap induced insomnia, hopefully she will stop by and tell you more about that evil side of your brain. In the meantime she has written about it in her blog here.
http://adventures-in-hosehead-land.blog ... er_19.html

cnew wrote:

pap4life wrote:Yes, your machine doesn't know when you are asleep, you might get some CRS events or centrals , but why would you get obstructive apneas when you are awake.?

That's what I'd like to know!

case 1:

person assaulted, hit with stick in front of face, multiple sinus fractures, operations, obstructive (apnea?), anyway, cant breath whilst lying down while awake, uses xPAP whilst lying down so can breath again.
(real case. not me). Im not sure what their machine says about this situation.

Pugsy is right. The "Auto off" on my PR System One REMstar does work -- it just takes a while.