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Suddenly high AHI!
#1
Suddenly high AHI!
I'm using a Resmed 10 with a F30i mask. I have used it for about 10 years with low AHI's. Over the past 10 days my AHI's have shot up. I started using my heated hose several days ago, hoping it would help. My hose is set at manual, 80 degrees and humidity set to 5. No change. Looking at Oscar it seemed like my leak rate was high. I made sure my mask was very snug last night. I see my OA's and UA's have gone way up, but I don't know why. Attached is my Oscar report. Can someone help me analyze it and figure out why my AHI's have gone up?


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#2
RE: Suddenly high AHI!
First, please read the link in my signature "Formatting OSCAR Charts" and post accordingly.

Second, too "snug" can cause leaks on its own. Watch some YouTube videos on mask fitting for the F30i, but understand they are notorious for leaks as one turns into the pillow they tend to dislodge. An F30 or F40 may prove to be a better mask if you prefer that kind of fit. Masks should just rest against the skin and be held in place by the headgear such that when the pressure is applied the silicone inflates and seals against the skin. 

Third, it looks to me like you do not have enough pressure nor pressure support based on the topping out on the high end and high flow limitations.

Try this for a few nights and we can tweak further from there. 

Mode APAP
Min pressure 8
Max pressure 15
EPR 3 full-time
No ramp

That should settle in and give a reasonable median and 95%. Once we have that we can try to find a small range or fixed pressure that will work for you.
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#3
RE: Suddenly high AHI!
You are 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.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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