Do you feel a noticeable difference on nights when your AHI is slightly higher ?

[vrapche031]

As an example :

My average stats are 2/h obstructive and 2/h central apneas each night. On some days like today they spike for some reason, today it was 4/h central and 4/h obstructive. I feel absolutely destroyed today. Cant wake up and its been a 5-6 hours since I woke up, tried having half a modafinil and that barely helped me at all today. I look like I got hit by truck, massive sang bags under my eyes.

I am curious if others also get this when they have a couple more events each hour ? The difference between how I feel today and on other days is absolutely massive and I am a bit surprised that the amount of events wasnt even higher

[OpalRose]

I sometimes have an opposite affect.  Example:  Woke up this morning with an .02 AHI and feel really tired after 7 hrs sleep.  Other days, I see an AHI of 1.7 and feel great.

I think it depends on the duration of the apnea's.  They are usually flagged at 10 sec, but if much longer, that could cause you to feel bad.  

Are you using any software that would give an indication of the length of Centrals and Obstructives you experience?  

Overall though, your total AHI is low, so there may be other reasons for not feeling that great.

There are so many other variables that make up AHI, sleep, and how we feel. Certain medications, eating and drinking too late, too little or too much sleep, stress, an uncomfortable bed, pillow or even the temperature of the room.

[vrapche031]

Are you using any software that would give an indication of the length of Centrals and Obstructives you experience?  

Overall though, your total AHI is low, so there may be other reasons for not feeling that great.

Is 8/h with CPAP considered low ? 

I unfortunately dont have the opportunity to use anything besides the crappy web based software which the manufacturer of my CPAP has. The model I have is not supported by Oscar and after trying for days I did not manage to install the Prisma TS software on my machine. So I only see if I get leaks and the amount of events, nothing else.

[OpalRose]

AHI of 8 is too high. It's hard to advise without knowing more about the breakdown of that number.

If it's mostly Obstructive, then raise the minimum pressure a bit.

If it's mostly clear airways and your using EPR(if your machine has that feature) then turn that feature off.

[jaswilliams]

Anything Over 5/hr total is considered untreated so room for improvement I think we like to see under 2/hr total events if we can but you need to remember a standar machine will not treat CA’s and you indicated that 50% of your events were CA’s maybe you need another type of machine such as an ASV or consider EERS

[vrapche031]

AHI of 8 is too high. It's hard to advise without knowing more about the breakdown of that number.

If it's mostly Obstructive, then raise the minimum pressure a bit.

If it's mostly clear airways and your using EPR(if your machine has that feature) then turn that feature off.

It was 4x central and 4x obstructive. Unfortunately no further details can be provided since I dont have access to the data. I do use EPR on max since I got the machine, at first I raised it from 1 to 2 because I was struggling with CPAP. But that was a long time ago so I might give it a try without EPR. Continue reading to the next quoted part please

Anything Over 5/hr total is considered untreated so room for improvement I think we like to see under 2/hr total events if we can but you need to remember a standar machine will not treat CA’s and you indicated that 50% of your events were CA’s maybe you need another type of machine such as an ASV or consider EERS

I did invest some time into reading about differences between machines that we can get, UARS etc. but I still dont completely understand all of that. What I did not know is that a standard machine wont treat CA's. I usually dont go over 4/h CA's ( most evenings it goes from 0 to 2 ).

A week ago I had another sleep study done and next Monday I am going to see the sleep doctor to go over the results and she will also go through the data from my CPAP for the last couple of months. I didnt get much info over the phone but she told me that I do not need BiPAP from what she saw in the sleep study results.

I will definitely push for a change to one of the recommended Resmed devices just so that I can get access to more data. Although when I mentioned the lack of data to my doctor I was basically told that I dont need access to more info and that I should keep coming back to them so they can analyze them and make changes...which is frustrating since that means at least a month or two between appointments. If that happens I might just buy my own device.

So since I already have the topic open, maybe you lovely people can help me with suggestions. What should I talk about with my sleep doctor when we go through the results ?

Besides the standard question of how many events I planned to ask them the following .

1. Proper explanation of what is causing the hypopnea's ( last sleep study I had a bunch of them and the doctors in the other clinic couldnt give me more info on them, besides just telling me that they happened )
2. What is causing the obstructive apneas
3. Was I tested for RERA's ?
4. Is there a chance that I have UARS ?

[Dormeo]

I would recommend asking about CAs, since they are about half of the events you are seeing now. If the doctor says centrals don't "count," I would push back. (Some doctors do say this. It baffles me.) You can say you understand that only an ASV machine can treat CAs, but why would they not count?

For hypopneas and obstructive events, I think some good questions are: do they occur primarily during REM sleep? Do they occur primarily when you sleep in a particular position (side, back)?

Yes, do ask whether RERAs were scored and if yes, what the results were. Same thing for periodic limb movements of sleep (PLMS) or any other form of restless legs. Same thing for spontaneous arousals (arousals that are not associated with respiratory effort).

I also recommend that you request a copy of your full sleep study. You can then redact it and post it here for further analysis and review.

Ignore the statements that you don't need data, shouldn't be adjusting your settings yourself, doctor knows best, etc. You absolutely should have data, and as I have seen countless time, you can optimize your treatment by fine-tuning your settings with the help of members of this forum.

I would recommend that you request the ResMed Airsense 10 Autoset, preferably the "For Her" version if it is available in Germany. (It has an extra setting mode you can try and is otherwise exactly like the regular Autoset. Please don't leave out any of the words in the name of the machine -- otherwise you could wind up with a machine that doesn't auto-adjust.