What is happening?

Just this week I have had something happen that has not happened since I have had software. For 2 days, I knew that I had the terrible headaches, dizziness, sleepiness etc. as before cpap. After the 2nd day of this, I finally had time to read card and check what was going on. My AHI was 38 one night and 27 the next. I have my auto set 12 - 20 and both nights
I spent most of time at the 20 pressure. Had no centrals, quite a few snores, and leak rate was fine. What could be going on? Has anyone else ever had this happen to them. I get an AHI under 5 sometimes, but most often it is in the 8 - 12 range. I have tried pressures all different ways and I seem to get the lowest AHI and feel better with mine set 12 to 20. Last night was somewhat better but still not great and I am still feeling blah and sleepy. I cannot, for the life of me, figure out anything that was different about those 2 nights.

Help!!??

I've had that happen to me, but I kinda caused it myself. I tightened down my full face mask tight to stop leaks and it had the undesired effect of pulling my jaw back and inducing more apneas. Took me a couple of weeks to figure that out.

Since you're using the Swift though, that's obviously not your problem. Assuming that your physical condition hasn't changed all of a sudden, that kinda leaves either the machine or the mask. Have you noticed any difference in air pressure the past couple of nights?

The fact that the machine went up to 20 and stayed there kinda suggests to me that it is sensing a pressure constriction. My machine would react to water condensation in the tubing. Any chance your tube is kinked or crimped?

I also noticed that if there is a constant large air leak, that the Respironics algorithm does not recognize it as a leak. One night my machine blew a lot of air out at the humidifier (and I mean a lot!) which I didn't notice until morning, but when I checked the Encore Pro data, my leak rate for the night was very low! You might want to check to make sure no air is leaking at the humidifier and make sure that no air is leaking elsewhere.

That's all I can think of.

Regards,
Bill

Thanks, NightHawkeEye,

I will check that. But I did look at things and did not find any leaks. Maybe I need to check more closely.

You need to check your machine's programming again. Sounds to me you programmed a "Split-Night" timer by mistake.

What was your last known PSG titration pressure?

elliejose wrote:

I get an AHI under 5 sometimes, but most often it is in the 8 - 12 range.

If 12cm was your last known pressure range, you should set a high limit on the machine, if that value was 12cm pretty consistently, then you need to set the high pressure to 13cm or 14cm, you only increase that value if the reports show "flattening" and higher AHI scores.

Snores should NOT cause the Remstar to runaway to 20cm alone (Resmed Spirit yes, but not the Remstar).

I would go through the programming again and set the following (symbols represent the items below):

mode=AFLE or AUTO (other options are CPAP or CFLE)
CFLEX=2 (options are 1, 2 or 3).
low ramp=8cm (your minimum or starting pressure)
high ramp=12cm (your maximum pressure).
timer=00:00 (MUST be zero for auto modes).
Patient Alert=1 (1=On, 0=Off, On=beeps on large leak, disables autoOFF).
LED=1 (1=Lights On, 0=Lights Off).

Check for leaks (even though they don't show up on reports):
If the above is okay, then I would check your hose for any holes (from a Cat etc.), any leaks in the mask from cleaning etc. Also if using the Remstar Heated Humidifier check the silicone coupler between the tank and the machine, to make sure it is seated correctly, slide the tank off, pull out on the silicone coupler (it is hard to do), then only push the coupler on a little bit, then slide the tank back on using it to push the coupler on correctly.

If there was a leak at the coupler, the machine may have a harder time reading your events (mask could also cause it).

You may be leaking through your mouth,you might try taping or if you have it FF mask.

Another possibility -- what loonlvr dealt with when he had runaway high pressure and massive clusters of events causing a high AHI. Some conditions make the throat tissues and/or vocal cords unamenable to splinting open with air pressure.

Nov 05, 2005 subject: SUCCESS AT LAST-GERD,420E, PRILOSEC AND BENADRYL