AHI JUMPS from 5 to 25!

[Pedrx]

My AHI readings have increased, for a week or so now, from under 5 to about 25.
It may have been a slow increase over the previous 2 weeks, this period being the last time I checked the readings; and found them to be under 5.
These results were using a  RESMED AIRSENSE 10 AUTOSET.
For 2 of the seven nights I switched machines to use a BMC Resmart G2 which produced similar results.
I have tried a Pillow mask, a full facial mask and a mask in conjunction with a  Mandibular Advancement Advice (now failing due to permanent jaw advancement over 10 years). Have just acquired the full facial mask hence am not used to it.
Have reset the RESMED to factory condition to compensate for any changes made by me. Still reading about 25.
This suggests that it is not the machinery but me that is the cause. 
My medication and state of mind (poor) has not altered.
The NHS department who supplied the RESMED have no suggestions though they say 25 AHI is nothing to worry about till it is safe to see me after the Covid lockdown.
Any ideas? Please?

[Sleeprider]

Chances are your apnea are central, not obstructive. Put a SD card into the Resmed Airsense 10 and download the free OSCAR software. Use the tutorials linked in my signature to post some charts. This is fairly common, but you will have a long road ahead of you to convince the NHS to dispense the ASV machine that is needed to treat central or complex apnea. First step is to determine what is going on, and the OSCAR charts are the key.

[Pedrx]

Thank you for the swift response.

[Sleeprider]

Using the Resmed at default values is probably not ideal. I know we can help, but without knowing the types of events, and the circumstances underwhich they occur, it's only a guess how to guide you. On your Resmed Airsense 10 Autoset, the clinical settings include an Essentials setting. The default is on, but I want you to put that to Plus which will give you a more detailed sleep report on-screen. I'd prefer OSCAR, but I'll take what we can get. Need to know pressures, AHI, CAI and OAI.

[Pedrx]

Thanks. Will supply these details and also work on this OSCAR thing which is new to me.

[Pedrx]

These are the only results showing on clinical menu:
 
Essentials                   Plus
Hours used                  9
Days used                   1/1
Pressure                     10 cmH2O
Leak                           16 L/min
AHI                             33
Total AI                       32
Central AI                     31

[Sleeprider]

That shows us your apnea is central events, and that is what we needed to know to get started. Let's start by dropping pressure to 8.0 and if EPR is on, turn it off. CPAP does not treat central apnea. You may need an Adaptive Servo Ventilator (ASV) which provides pressure support to keep you breathing when you don't make spontaneous effort. If you had a sleep study, it would help to see results from that. Once you are able to contact your consultant at NHS, tell them that you have a very high incidence of central apnea and no obstructive events. They will want to confirm this and hopefully take appropriate therapeutic action.

[jaswilliams]

I agree with Sleeprider. When are you due you next appointment with your Sleep Dept ? Or do they run a drop in clinic. Get in touch with the clinic as it would be good to move this forward as the majority of your events are CA’s and you are not adequately treated any more.

[Pedrx]

Excellent! Thank you very much. Will adjust as requested.
I take it that the pressure of 10, as above, is the maximum pressure reached during the period the statistics cover? The maximum pressure setting, which is presently at 16, is to be halved to 8?
Have sent a copy of my opening comment and your initial response to it to the appropriate NHS department.
Will send a copy of your final comment but first:
I inadvertently misled you in saying ‘medication has not changed’.
It occurred to me this morning that to relieve the inconvenience of a fistula of the bum I have recently been taking, for the first time in my life, 30mg co-codamol tablets.
Research tells me that this is a morphine based drug AND that morphine ‘can cause or lead to central sleep apnea.’
Surely this could account for the sudden onset of Central Apnea after at least 12 years of only the Obstructive version.