AHI problem

[RLSdss]

I have had AHIs of 5 or less using the settings shown or similar ons one night and then on the next night with the same settings I get an AHI of 8 or 10. What is up with this? I have complex sleep apnea. I can't show charts as Sleepyhead has not yet been updated for this machine. I have Encore Pro 2.20 but it does not download my data.

[dmeRT]

AHI's will vary from night to night, a number of variables can play a roll in this. With the added difficulty of managing complex apnea, I would imagine a more widely range of results. Unfortunately, without seeing a detailed download, no one can offer any advice.

Question for you is how are you feeling since starting therapy? Has there been any improvement in how you are feeling? The main goal is to improve how you are feeling, not lower AHI's.

p.s. I would anticipate you needing a wider window of therapy pressures....

[RLSdss]

I feel much better. What might a wider range of pressures look like? Thanks for your reply?

[dmeRT]

without getting into too much detail. i'd increase the pmax. without changing any other settings the most pressure you can get (epap + ps) is 15. pmax just limits how high your epap+ps can go. I don't use pmax to limit pressure so i'll normally leave it at the default setting of 25.

I'd also increase your ps max to 10. This is to give the machine the freedom/range to work. If you change your ps max to 10, then the maximum amount of pressure the machine will give is 21(if needed). this would be if your epap titrated up to 11 and your ps titrated up to 10. in this case pmax does'nt come into play.

[Walla Walla]

I disagree. The last thing you want to do is increase your Pressure support. If anything you might want to drop the PS to 3cm. Increasing pressure support will lead to more clear airway events.

[dmeRT]

In my defense, in setting the ps max at 10 you're just increasing the range the machine can use... 0-10, instead of 0-4. i'll agree that you don't want 10 ps with every breath...

[Walla Walla]

My mistake I didn't see he was using an ASV.

[RLSdss]

Thanks to both of you. Do either of you have any idea why I can't get Encore Pro 2 to download my data? I know they are working on an upgrade  for Sleepyhead but that may be awhile. I do get some idea of what is going on with the print out of my pulse oximeter.

[dmeRT]

Call respironics support. Encore was having issues last week but they seem to be resolved now.

[Sleeprider]

One last note on your ASV results. You have BPM set to off, so you don't get any backup at all when you don't take a spontaneous breath. We have a member experimenting with BPM and he has gone as low as 7 or 8. The default for most people is 15, or normal respiration rate minus 2. I think if you want protection against central apnea, the minimum number you should use in BPM is 8. That would allow you the maximum opportunity to control your own breathing, but this would initiate a breath after 7.5 seconds if you're having a central. I think you would find that unobtrusive, and should help your inconsistent AHI.

I have tried a number of times to encourage you to implement a higher PS max and maximum pressure, so I'll just say I support dmeRT's suggestions on pressure, but without a backup rate in the settings, it won't make much difference.