Cannot get control of my AHI!

Hello everyone,

I do not understand what is happening with my AI's Hi's & the AHI.

I normally sleep on my right side. Over so many months, I have tried to get a pressure that would get me down to an AHI of 5. I cannot do it. I have tried raising pressure .5 at a time & backing also backing off on the epr.

My lowest AHI of 13.4, which consisted of an AI of 2.7 and a HI of 10.7 was achieved at a pressure of 6.8 & an EPR of 1. The moment I raise the pressure even by .5, or drop the EPR to 0 thngs start to reverse themselves. I start getting higher

AI's & lower HI's with an AHI of almost 13.4. An example was when I raise it to 7.4, I get a AI of 7, an HI of 6.4, giving an AHI of 13.4. As I lower it, the numbers reverse always. I also get strange headaches once I get up to about 7.6.

Now, Today, I turned over on my left side after 12 noon for the first time which put the numbers on a new day, as the s8 elite ii is from noon until noon. I slept for 3 hours. At the pressure of 6.8 & the EPR set at one, as in the first example

, My AI was 7.9, my HI was 21.3, giving me a AHI of 29.2.


How can I get the numbers below an AHI of 13.4 & Do I need to find a pressure setting for every position I sleep in. IF I raise the setting to help lower the numbers when I sleep on my left side, and then turn on my right side, The numbers will be way off. There is the odd time I sleep on my back as well.

What I am seeing with cpap pressures, is there does not seem to be one pressure that gets me below 5 AHI and there does not seem to be 1 pressure that will take care of Apneas & Hypopneas no matter what sleeping position I am in. I certainly cannot sleep permanently on my right side. Even I could, I am still not getting to an AHI of 5.

Leaks were never an issue. I was at a median leak of 0 & at the most, a 95 percentile of 12, which is half of what resmed sets as their maximum leak.

I am really desperate for some suggestions. Please Help!

Thanks

Rick

How long have you been using this machine?
Have you discussed your findings with your physician?

I don't know much about your machine, but the only thing that comes to mind is the possibility of complex apnea where you are having central apneas as a result of your cpap therapy? I think that may require another machine.

I'm sure some more knowledgable folks with chime in, good luck!

The S8 machines historically seemed to score Hyponeas pretty aggressively for some people and not others.
Some S8 users switching to the S9 machines reported Hypnoneas not scored nearly so aggressively. S9 uses a different algorithm.

I am seeing my sleep doc again on Nov. 15th. I have been using since 2008, but stopped for quite some time in between 2008 & 2011 for just the reasons I mentioned.

In past discussions with my sleep Doc, it did not go to well. I find her top be uninterested in what I had to say. She kept sluffing off the concerns I have. She is the one I will be seeing again.

I noticed on my last titration there were 18 centrals in a short sleep-awake period which had an index of 5.6. There was also 20 RERA's at an index of 9.1.I never had RERA's before. She never talked about any of this with me. I have no faith in her.

I am really concerned about all this, especially due to the fact that I have surgery, with general anasthetic (mis-spelled ) coming up in a couple of months. They want me to bring in my cpap machine. Whats the use if the pressures to not help me.

Thanks

Rick

Rick, I also can't find a most effective pressure.

But as long as the AHI is below 20 I don't give a d-mn

By the way if I show any data from my APAP to my sleep doc, then he does not want to look at it saying that CPAPs are not diagnostic equipment. Only air blowers.

p.s. Please don't copy my own graphs

Is there any way to get your hands on a ResMed S9 full data machine?

S8 machines didn't score centrals. S9 machines do.

Not saying that your hyponeas are centrals but it would be a concern until ruled out.

If your sleep doctor was aware of this in the past and did not attempt to investigate things.. doesn't bode well for the upcoming visit.

Ignore Avi...

Pugsy wrote:Is there any way to get your hands on a ResMed S9 full data machine?

S8 machines didn't score centrals. S9 machines do.

Not saying that your hyponeas are centrals but it would be a concern until ruled out.

If your sleep doctor was aware of this in the past and did not attempt to investigate things.. doesn't bode well for the upcoming visit.

Ignore Avi...

I have no problem purchasing a s9 on my own, if it will make a difference for me. I just do not know which one to get, the vpap or the autoset? This Sleep doctor I have, is very hard to talk to.

I do know that when I am at the very beginning of sleep, a lot of times I realize I am not breathing. As so as I realize I am not I breath. Almost as though I have forgotten to. I do not recall it feelig like an inability to breath, just that I was not.

Sounds like you may want a new Doctor. If you can change. Doctors do so. ( insuracne or another factor may limit this). Find one who will listen to you. It appears something has to be done to get your readings in a more normal range. I'm only speaking from a standpoint of your Doctor may need to be changed. A new Doctor who will listen and address this so you can get it under control. I'm new here. And i can tell you my Doctor is great but his staff is horrible. Never aanswer the phone. Wont call you back. When you do get them its like " what do you need".

I'm the patient, you need to address ny needs/ concerns. I will tell The Doctor my feelings when i see him next. If this doesn't change a new Doctor will be sought out. This forum is great not doubt to gain information, but your Doctor should be concerned as you are about you not being able to get your AHI under control.

avi123 wrote:Rick, I also can't find a most effective pressure:







But as long as the AHI is below 20 I don't give a d-mn

By the way if I show any data from my APAP (such as above for example) to my sleep doc, then he does not want to look at it saying that CPAPs are not diagnostic equipment. Only air blowers.

Is it not the point to have this info. so we are able to take it into our sleep doctor, to help them in making the best discisons for us. I think its good to have a point to start from, & these results give them that. ITs much easier to show them on paper, when we reach a wall, in our therapy, then to try & explain it to them.

red1 wrote:I have no problem purchasing a s9 on my own, if it will make a difference for me. I just do not know which one to get, the vpap or the autoset?

Problem is we don't know too many things and know too little.
We don't know if those Hyponeas are centrals or not. They could just be over scored run of the mill hyponeas..
If they are centrals...just a few that we would ignore or number enough to warrant special bilevel?

A trial with an S9 would be ideal. Rent one for a week? Autoset can be used in straight cpap mode if needed.

Your pressure needs don't point to VPAP but if true centrals then the VPAP ASV (I forget the exact name) machine might be needed and you don't won't to buy that yourself. But that is thinking way out there and we have nothing to base it on.

sorry to joke, but
do you sleep with the snake? they have been known to have an effect on many a creatures breathing.

consider also purchasing an O2 meter to give you more info.

http://www.door2doorshop.com/wholesale/ ... 0F-36.html

peterg wrote:sorry to joke, but
do you sleep with the snake? they have been known to have an effect on many a creatures breathing.

consider also purchasing an O2 meter to give you more info.

http://www.door2doorshop.com/wholesale/ ... 0F-36.html

No, but he bit me just after the photo. He now is a nice leather belt in my closet. (JUst kidding)

I may purchase one of those Nonin 02 meters that records & works well with movement. I could compare the graphs of the nonin readings with the rescan readings.

Thank you all for your help, I really appreciate it.

Rick

You are caught between a rock and a hard spot.

The data from your xPAP machine is to be used for trending. It doesn't necessarily correspond to what is scored during a sleep study. The S8 scoring came into question and was changed with the S9.

I have a similar machine and was instructed to minimize the AI and ignore the rest. I confirm my treatment using a pulse oximeter checking to make sure I have no desaturations below 90% and no spikes in pulse rate.

Del