Bogus HI?

[RLSdss]

See attachment

[Sleeprider]

It would be extremely helpful if you would keep your therapy threads together so the continuity is not lost. This will help you and anyone trying to help. Here is your last thread http://www.apneaboard.com/forums/Thread-Improve-AHI

When we left off, the following settings were recommended, and resulted an your best AHI of 4.5. In response to this trial, we suggested increasing the PSmin to 2.0 to target the hypopnea, and leaving the rest alone. You apparently reverted to the old settings with Pmax of 14 instead. Once again, my recommendations are unchanged.
EPAP min 9.0
EPAP max 11.0
PS min 2.0
PS max 10
IPAP max (Pmax) 21.0

[Mogy]

In some definitions of hypopneas you need a 3percent desat.
I don't believe that Dreamstations score it that way. I am not sure exactly, but it is something like a 50percent flow reduction for at least 10 secs.
That doesn't necessarily mean your SpO2 will go below 90.

[RLSdss]

With these settings my Oximeter recorder showed only 18% O2 below 95%. That sees pretty low. That's why I asked how the ASV determined HI. Will try to keep posts organized.

[Sleeprider]

All Philips Respironics machines score hypopnea as follows:

An episode of overly shallow breathing or an abnormally low respiratory rate. Our auto algorithm establishes a baseline of patient flow based on a moving flow signal window. When your device detects a hypopnea as a 40% reduction in flow lasting at least 10 seconds, followed by a recovery breath, then a Hypopnea event is recorded.

This FAQ has other event definitions. https://www.mydreammapper.com/Help/Faq#

Normally a CPAP or ASV is not equipped with a sensor for determining SpO2, but during polysomnography, a hypopnea is scored when flow is decreased more than 30% and an oxygen desaturation greater than 3% occurs, or an arousal. It's important to realize that oxygen saturation is not the endpoint for success in PAP therapy. Ensuring better sleep quality with fewer arousals is equally important. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459210/

[RLSdss]

With settings as on side bar I consistently get an AHI below 5. But the HI is high. My oximiter  recordings at the same time show above 90% O2 sat. I also sleep well and wake rested. You suggested that I set PSmin at 2 to improve HI. I did this last night and once before with the same results both times. My AHI after the first hour and a half skyrockets to as last night 29 or more. I then reset PSmin to 0 and things improve. I sleep in 1.5 to 3 hr. segments as I have nocturia due to Benign Prostatic Hyperplasia and have to get up to relieve myself 3 or 4 times a night. This is the reason they were unable to titrate my ASV. I figured out how to get my AHI down to 6 or better  so the MD gave me an Rx saying I could adjust the ASV myself for best results and finalize my Medicare requirements so in 8 months the machine is mine. My original all night Oximeter  study resulted in  an AHI of 40 with nearly an hour of O2 sat below 88. My diagnosis is severe Complex Sleep Apnea. I am happy with my results with my current settings and my plan is to stay with them until I meet with my Respiraitory theripist next  week and he can go over my data and make any recommendations necessary. I appreciate all the help I have received here it has been very helpful. I, otherwise would have had to rely solely on my go to diagnostic technique that I used in my dental practice for 40 years. It's called the SWAG method or Scientific Wild Ass Guess. You may need a magnifying glass to read the attached data.