Alarming spike in AHI

[rohit261990]

I am a relatively new CPAP user here. I was diagnosed with OSA in March with an AHI 35.1( in lab sleep study). After the titration study I was prescribed a pressure of 13. Although it took me a couple of months I got used to it and averaged around 4-5 AHI most nights on N20 nasal mask. Most of the time these were due to central apnea events that hit just as crossed the sleep wake barrier I switched to an F30 full face mask earlier this month and although AHI went up slightly I was able to keep it on for longer than the N20 so I started using that regularly and my AHI ranged between 4-7 most nights with at least 4-5 hours of usage. 

A few days back I had to travel to my wife's home town and that night I couldn't sleep at all. I kept waking up just as I was falling asleep and sure enough there were a ton of central events but dramatically higher than normal. Surprisingly there were quite a few obstructive events too which is generally not the case as my CPAP takes care of most of the obstructive events. My overall AHI that night was 39.9. 

The next few nights were somewhat better and I was able to sleep and my AHI was around 6-9. But yesterday I experienced difficulty sleeping again. I tried everything- switching masks, changing pressure, propping myself up on a couple of pillows,  but every time I was about to doze of i would be awakened by an event. Finally when i checked the data the next morning my AHI was 20.21. I'm uncertain as to why my experience has drastically changed over the course of a couple of days.

I have had no change in weight. Im not on any medication. Couple of changes that have happened- last week i purchased a new resmed autoset 10 after returning the machine(same model) that i had been trialing for almost 3 months. The new machine comes with a climate line tube but apart from that no difference. 

Can the experts in the forum advise me on what i should be doing. Im attaching OSCAR screenshots from last night as well as from a few weeks ago.

[staceyburke]

On the night you had such a high AHI, you were having positional apnea. You can see positional apnea where either H or Oa events are clustered together. Getting rid of as many as you can will lower your AHI. Positional apnea can NOT be controlled by pressure changes. You have to find out what position you are getting into and cutting off your own airway. Have you changed your sleep position? Sleeping on your back? Using more (or new) pillows? These things can cause positional apnea by chin dropping to your sternum and cutting your airway. Think of it of a kinked hose – nothing can get through – you have to unkink the hose…

IF you can’t make a simple change like changing to a flatter pillow helps then you will need a collar. I have a link to collars in my signature at the bottom of the page. It shows people who are not wearing a collar and the SAME person wearing a collar. There is a huge difference between the two.

because of it only being one day it probably a one off and it will not become a problem. Again, maybe a new pillow was used.

[rohit261990]

Yes . that may be true. as i said i was staying away from home and the bed and pillows were not what I was used to. also I had a stuffy nose.i tried the collar once a while back but it was too uncomfortable for me. will give it another shot

[Deborah K.]

When I used soft cervical collars I tried quite a few.  The Caldera Releaf Collar was by far the most comfortable and worked as well as the others.  You can find it on Amazon if you are interested.