[CPAP] AHI suddenly high as well as PB and variable breathing

[tresero]

I'm trying to figure out why 3 years in, the last 3 months or so my AHI has been steadily climbing from around 2 to now near 10. Also, periodic breathing, is 27% (more or less), and variable breathing is around 60-70%.



The VA (Veterans Administration), only seems to care about the AHI, and just turned up the pressure to max 18. I wake up often to turn (lots of neck and back issues, and don't sleep on my back at all). I saw a post about positional apnea, and I do feel like I'm choking myself when I am on my side. My mouth is so dry I often can't swallow. Generally, everything went to hell the last few months and I can't even see the doctor until mid December, and that's telehealth.

Any ideas? I don't think the VA has any options for different machines, if that's an issue.


TIA

[Phaleronic]

Welcome to the forum tresero

First off please disable the ramp feature, you're not receiving your therapy pressure and it can cause mask leak issues. Then turn your minimum pressure up to 11.6cm and turn aflex up to 2. You are having reras and hypopneas, and some scattered CA events. Your leaks are spiking a bit too, what mask system are you using?

[tresero]

Welcome to the forum tresero  

First off please disable the ramp feature, you're not receiving your therapy pressure and it can cause mask leak issues.  Then turn your minimum pressure up to 11.6cm and turn aflex up to 2.  You are having reras and hypopneas, and some scattered CA events.   Your leaks are spiking a bit too, what mask system are you using?

Thanks for the welcome, I've lurked for a few years, but thought all was well

ResMed AirFit N30i


I have no ability to adjust anything, my machine doesn't even show AHI anymore. Not sure if the VA got P*ssed off and turned those features off, or it's just another crappy Respironics update.
I thought they disabled the ramp feature (see second image), at least they told me they did. She also told me that aflex makes no difference, even when I said S*&^ went downhill when they turned it off. I'm thoroughly confused, and unfortunately have to depend on the VA. I can take a photo of my machine that has no way to change anything now.

[Phaleronic]

You're welcome

So if you follow this guide you cannot get into the clinical menu?

https://www.apneaboard.com/dreamstation-...structions

Also, you likely need to tape your mouth closed or use a chinstrap to keep is shut as that's likely part of the reason why you're waking up with dry mouth (and why you're having leak spikes).

[tresero]

I appreciate it. I didn't see this about getting into the settings. I'll try it tonight.

They are sending a chin strap, but I tried on long ago (the first month of CPAP), and thought I was suffocating. When I get it, I'll try it again, since I'm very used to it now.

I'll keep you updated.

[tresero]

I heard back from the respiratory tech, and she sent this from the onsite doc. I also asked her to update the settings, just so it's official.


Vet has dx of severe OSA (AHI 37), he is compliant on PAP with significant
improvement on download data, although still mildly elevate residual AHI and
mild central component. He had subsequent oximetry which showed adequate
oxygenation and confirmed elevated residual AHI. Vet has appt scheduled with
sleep provider in Dec. He has seen cards and does not think that his PB and CAI
is from cardiac issues.

The only way to really assess this directly is with an updated titration study.
We can order that now or wait until sleep provider visit.