09-12-2018, 02:56 PM
How to tell if my CPAP is reporting correct AHIs?
The tech from *** ***, Butch, who delivered and set up my ICON+ two years ago left me with MINIMAL information about the device, supplies, or cleaning instructions. He gave zero information about user settings I could change by rotatiing the dial around the push button.
About two weeks ago my curiosity got the best of me and I searched for ICON+ videos on YouTube.
WOW! I now had a way to see the temperature setting, my average AHI over 7 & 30 nights, etc.
It showed an average AHI of 24 over 7 days and 26 over 30 days.
OOPS! In my experimentation I hit the push button too many times while looking at my AHI and accidentally cleared the history. SORRY.
WHOA! After clearing the history, my AHI reading showed 12 after a few nights. Over the last week I noticed it had dropped to an average of 10, and the 7-day average is now 8.5 ... a major difference from the former average AHI in the 24-26 range. Yes, I have experimented with the temp setting; NO, I have not changed the pressure: still 14 cm-H2O.
So, is a major change in reported AHI, ballpark of 25 a month ago down to 8.5 over the last 7 nights
(A) simply a coincidence that my Sleep Apnea changed about the same time I cleared the history, or
(B) did I [COULD I] totally screw up the machine? If so, how does one tell?
RE: How to tell if my CPAP is reporting correct AHIs?
Mike, you can get a copy of the clinician manual from Apnea Board here https://www.apneaboard.com/adjust-cpap-p...tup-manual
I think you can get basic efficacy information from your Fischer & Paykel Icon using #Sleepyhead. You should download a free copy and take a look at the data. Your AHI is unacceptably high. Did you ever have a titration study? It would be really nice if you could get some data on a Resmed or Philips Respironics machine that would tell you what type of events are responsible for this high AHI result.
RE: How to tell if my CPAP is reporting correct AHIs?
Hmmm, not sure what a "Titration Study" is! My Doctor scheduled me for a second "Sleep Study" two weeks ago ... just after I had cleared the AHI records. Don't see him until next Monday and expect him to be P**sed that I screwed up the ICON+'s history, but "it is what it is". (Hate the quote but it is our daughter's favorite.)
FYI, since the ICON+ CPAP 26 months ago, I have noticed major changes. Prior to that, I would be asleep in my recliner by 9 am. If driving, I could make 60-75 minutes before needing either a 30 minute nap or an alternate driver. Within a night of the ICON+ I no longer spent the morning in the recliner AND was able to drive 6-1/2 hours to our daughters in Atlanta WITHOUT A REST STOP FOR A NAP.
Since I started with an AHI in the 60's in my first sleep study 27 months ago, getting down to the last "real" AHI of 24/7-days, 26/30-days prior to my inadvertent destruction of that historic data about two weeks ago, seems phenomenal.
Getting down to a current "indicated" AHI of 8.5/7-days, 10/30-days seems borderline unbelievable. Is the current reading "real" ... did my sleep apnea really drop that much without major intervention (coincidence that I deleted historic info just as it drastically improved), ... or is it an artifact of a screwed up CPAP? How do I tell?
1. I'll try downloading the "SleepyHead" software.
2. I have an appointment with my doctor next Monday and I'll bring the machine with me.
When I have "SleepyHead" info or doctor /study info, I'll be back to you.
T H A N K S !!!
RE: How to tell if my CPAP is reporting correct AHIs?
There are two types of sleep study commonly used. A diagnostic study is done to diagnose apnea and determine its type and severity. This study hook a patient up to a polysomnograph and monitors untreated sleep. A titration study attempts to identify the CPAP pressure needed to resolve obstructive apnea and hypopnea. In some cases a bilevel study may look at the efficacy of using IPAP and EPAP pressures (inhale and exhale), but that is generally where CPAP has already failed. A more sophisticated titration study for bilevel with backup rate is done for people with central or complex apnea and other respiratory conditions that cannot be treated with CPAP, including severe COPD and hypoventilation. These studies assess the necessary pressure support needed to promote good ventilation, and to overcome central apnea (failure to spontaneously breathe). This advanced bilevel titration requires a higher level of training and knowledge to conduct.
RE: How to tell if my CPAP is reporting correct AHIs?
Sorry if this is a duplicate, but I discovered that "tabs" do funky things like dropping you from a post!
Got SleepyHead; downloaded data.
Odd that the best AHI was last night at 8.45; worst was 26 for 1 night. Average was 12.74 for time since pressure was adjusted to 14. Is it reasonably for the AHI to bounce around that much?
Second odd thing is that my average AHI INCREASED from 11.69 to 12.74 when the doctor adjusted pressure from 12 to 14, although it had dropped from 20.83 to 11.69 when he increased it from the initial 10 to 12. Untreated AHI was 46.
I.e., untreated was 46
Initial 300 nights at 10 it was 20.83
Next 170 nights at 12 it was 11.69
Last 46 nights at 14 it was 12.74 ... with variation between 8.45 and 26!
Obstructive Index was .95 last night, 1.97 last week, 2.23 last 30 nights.
Jypopnea Index was 7.50 last night, 9.91 last week, 9.86 last 30 nights.
A) Is this typical user data or is it possible my ICON+ is malfunctioning?
B) Based on your historical experience, how likely is insurance to cover a new DreamStation or comparable unit?
I see the doctor on Monday; will let you know his thoughts after that. THANKS FOR EVERYTHING!
RE: How to tell if my CPAP is reporting correct AHIs?
What is the break down of your AHI ?
Maybe post a typical daily graph so we can see what is going on. Details in my sig
09-15-2018, 03:58 PM
(This post was last modified: 09-15-2018, 04:00 PM by Sleeprider.)
RE: How to tell if my CPAP is reporting correct AHIs?
Mike, I'm not sure if your ICON reports CA (central apnea). With an event rate that high I think you need a clinical titration study. If changing machines for CPAP, I would recommend the Resmed Airsense 10 Autoset over Dreamstation, especially if hypopnea is predominate. If you actually have complex apnea, which seems possible, then a different therapy approach is in order. This is the problem with a machine that doesn't give good data, we are left guessing.
A minimum objective is to have AHI less than 5.0 every night, but most people on this forum have from zero to 2.0 AHI most of the time. Your event rate in inadequately or improperly treated.
RE: How to tell if my CPAP is reporting correct AHIs?
I thought this would be easy, but ...
OOPS! Sleepyhead claims to save screen shots to:
C:\Program Files (x86)\SleepHead\iconengines\Screenshots\screenshot-20180915-165230.png etc.
However, there is no subdirectory Screenshots under iconengines.
In fact, the ONLY file in SleepyHead/iconengines is a .dll titled Application extens
OK, I created one. From SleepHead: View--> Take a screen shot; Same issue; no screen shot.
Checked properties of the new subdirectory; UNchecked "Read Only". Took a new screen shot.
same issue, no screen shot in the subdirectory.
Went all the way back to Program Files and UNchecked the Read Only property, "Ignoring ALL cases of Permission denied."
Took another screen shot, same issue ... no shot in file where SleepyHead claims to have dropped the latest shot.
I'll try it via my iPhone photo, send to my PC, and from there to this site. To be continued!
RE: How to tell if my CPAP is reporting correct AHIs?
For windows computers look under My Documents/Sleepyhead/Screenshots It may also be under the profile there.
RE: How to tell if my CPAP is reporting correct AHIs?
Continuation: Printed the SleepyHead info, then photographed it on phone, emailed it to my PC, downloaded and then imported as attachments to this post.
THERE HAS TO BE AN EASIER WAY!
But, attached is the machine info. Most of it makes little sense to me, but makes me question whether my ICON+ is really doing what I need.
COMMENTS APPRECIATED.
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