AHI Reading with SleepyHead

[PaulaO2]

Occasional odd readings are normal. It is when the spikes are every night (or every other night) that anything is worth being concerned about. No two nights are the same. There's just too many factors that go into getting a good night's sleep.

[zonk]

I use the same machine and don,t get any pressure induced central apnea
The S9 AutoSet differentiates between obstructive and central sleep apnea
http://www.s9morecomfort.com/s9morecomfo...toset.html

The machine cannot tell if you,re awake or sleep ....Look at the ResScan, you want to discard those events are flagged as you start the machine or staying in bed awake . Whats your leak and do you get up during the night?

[Sleepster]

Sleeptster, can you help me understand what you just said about CA readings being caused by pressure too high (perhaps you were saying simply that they are associated)?

The thinking is that the CPAP pressure raises the oxygen level in your blood making the brain think that you don't need to breathe.

I am using a Resmed S9 set at pressures 6.8-14. After about six months of AHI readings shown on the rescan software under 5, lately, I have been getting the occasional readings in excess of 5 (about every 3 or 4 days). When the readings are in excess of 5, they are composed of unusually high CA readings, plus OA readings of less than 4.

Check for clusters of CA's. If there are clusters of CA's on the nights when the CA index is high, see if they are accompanied by high pressure. You can try lowering the upper range of the pressure, set it to maybe 6.8-13.5, or 6.8-13 and see if that lowers your AHI. If it causes your OA index to rise, then you're getting nowhere. Discuss this with your doctor and DME and see if they have any ideas about what might be done.

[dragonflyoh]

The readings are:

While Set at 11, Set to Auto (5 - 17)
obstructive apnea (OA) index 4.5 9.4
central apnea (CA) index 13.3 11.2
hypopnea index 1.0 1.6

Hi dragonflyoh,

Welcome to the Forum!

You didn't say whether the results you posted are for two separate days, or whether the results for CPAP are a long term average of many days and the results for APAP are a short term average of a couple days.

It is really too early to properly conclude anything from just the few days on Auto mode, but if the short term trend turns into a long term trend, then it may be that because your pressure using Auto mode is sometimes lower than 11, you have more obstructive events in Auto mode. And if your Central Apnea Index is lower using Auto mode, that may be a side effect of the times the pressure is lower while in Auto mode, since most sleep therapists seem to be of the opinion that (at least for some patients) higher pressure can increase a patient's number of Central events.

With your present treatment for OSA, your CA index is above 5.0, and I think this should qualify you for a different type of machine.

Your doctor may need to prescribe an Adaptive Servo Ventilator machine, such as the new ResMed S9 Adapt SV, which may be able to treat both your obstructive events and your central events, by raising the pressure to treat obstructive events and by effectively breathing for you when your Central Nervous System takes a little holiday from breathing.

I suggest you work closely with a doctor on this, if you continue to feel not much better with CPAP or APAP treatment modes.

Or, you may need to find a new sleep doctor who has experience with ASV treatment mode, if you find out your present doctor is unwilling to try something new. Unfortunately, it seems that happens some times.

Take care,
--- Vaughn

The machine was set to 11 for 44 days and on auto (5-17) for 5 days. I have an appointment with the doctor and am taking in the comments I have received. Will see what happens. Thank you for you insights.

[dragonflyoh]

Vaughn,
It was over five years ago that you wrote me about the ASV machine. I was on a CPAP and BIPAP and neither helped. Had daily recurring headaches and went through more drugs than you can imagine with no improvement. Medicare would not approve a ASV machine. I went to the VA three months ago, three weeks later I received a ASV machine. The results are wonderful. My AHI readings are steadily going down and are now between 2.1 and 3, the headaches occurrences are going down and I am feeling better than I have in years. You were correct back then and I just could not get anyone to listen. Two doctors, six sleep studies and many drugs later. I am putting together a total of the costs for the the sleep studies, Dr. appointments and drugs. The ASV machine is pricey, however the total for just the sleep studies would cover the cost of the ASV machine. My Senator is going to get a letter about my experience with Medicare.
Thanks for your help!!!!
Jim