Is my problem unique?

[Gary K]

I have been using my Philips Bipap machine since last August. I am still experiencing AHIs in the 20s. I live in SouthWest Florida and have used the machine here, in Hilton Head, and Atlanta. I am trying to determine what I need to do to get my AHI in line. I have been tested for allergies because I get stuffed up at night. I tested positive for whole wheat allergies so have been on a gluten free diet. My doctor told me to try different pressure levels on the machine and to try not putting water in the humidifier. My AHI jumps all over the map for no apparent reason. For about a week in Dec I had AHI readings below 5. Now they have jumped back up to 24. I have recently started to experience bloody mucus in the mornings when blowing my nose. I attributed this to low humidity and have started using the humidifier again, but this has not cleared up yet. I also started using scented oil (eucalyptus) and this seems to help my stuffiness but has not affected my AHI. Any suggestions.

[Terry]

My doctor told me to try different pressure levels on the machine and to try not putting water in the humidifier. My AHI jumps all over the map for no apparent reason.

Assuming you're in an air conditioned space, I can almost guarantee you'll need the humidifier.

My best two guesses for your high AHI are:

* You have mask leaks and the machine can't generate enough pressure to correct your apneas.
* You're having central apneas and may need a different machine.

The first one, you can fix.

The second one might require a sleep study.

In any case, it's all fixable. You just need a good doctor and a good sleep study and the right machine.

Terry

[Sleeprider]

Gary, it might be helpful if you listed your IPAP/EPAP pressure settings. Have you downloaded Sleepyhead software and taken a look at the apneas that are occurring?

You should be able to tell if they are related to certain pressures, and observe their type and duration. Posting data would be a plus. Do you know the distribution of your apneas between OA, CA and H? Are there flow limitations? Without that information, there is little we can say or advise.

[retired_guy]

1st, do as Sleeprider suggests and report back.

Beyond that I would add that it sounds like you may be sleeping on your back. Take steps to not do that, at least for now.

and yes, go back to the humidifier.

By the way, it's not a great idea to change too many things at a time. Because if you do and your results change, which of course they will for better or worse, then you don't really know what did or did not work. So one thing at a time. Except for now, if you're on your back, get off it, and turn the humidifier on to a nice comfy level.

[Gary K]

My doctor told me to try different pressure levels on the machine and to try not putting water in the humidifier. My AHI jumps all over the map for no apparent reason.

Assuming you're in an air conditioned space, I can almost guarantee you'll need the humidifier.

My best two guesses for your high AHI are:

* You have mask leaks and the machine can't generate enough pressure to correct your apneas.
* You're having central apneas and may need a different machine.

The first one, you can fix.

The second one might require a sleep study.

In any case, it's all fixable. You just need a good doctor and a good sleep study and the right machine.

Terry

Terry, thanks for your response.
Yes, I have come to the conclusion that I need the humidifier; even though at first it seemed to help the stuffiness. My pressure setting are at 15/10. The data from both Philips website and Sleepyhead indicate no significant mask leak. I do have central apnea and a bipap machine. The mix of OA and CA are about the same.

[Gary K]

Sleeprider, thanks for the response

Not sure of the best way to post data. I tried different ways of pasting in data, but this board did not like any of them.

My break down of events last night were
Hypopnea 1.93
OA 8.55
CA 12.31
Respiratory effort .2
Wibratory snore .61
Periodic Breathing .95

---

1st, do as Sleeprider suggests and report back.

Beyond that I would add that it sounds like you may be sleeping on your back. Take steps to not do that, at least for now.

and yes, go back to the humidifier.

By the way, it's not a great idea to change too many things at a time. Because if you do and your results change, which of course they will for better or worse, then you don't really know what did or did not work. So one thing at a time. Except for now, if you're on your back, get off it, and turn the humidifier on to a nice comfy level.

Retired Guy
Thank
Yes, I have been sleeping mostly on my back since I got the machine because now I can. I will try your advice.

[Terry]

Yes, I have come to the conclusion that I need the humidifier; even though at first it seemed to help the stuffiness. My pressure setting are at 15/10. The data from both Philips website and Sleepyhead indicate no significant mask leak. I do have central apnea and a bipap machine. The mix of OA and CA are about the same.

Respironics makes a number of different bipap machines, as far as I know, and not all of them can take care of CAs.

You might want to make sure that the machine you have is actually capable of handling CAs.

Terry

[Gary K]

Yes, I have come to the conclusion that I need the humidifier; even though at first it seemed to help the stuffiness. My pressure setting are at 15/10. The data from both Philips website and Sleepyhead indicate no significant mask leak. I do have central apnea and a bipap machine. The mix of OA and CA are about the same.

Respironics makes a number of different bipap machines, as far as I know, and not all of them can take care of CAs.

You might want to make sure that the machine you have is actually capable of handling CAs.

Terry

Terry

Yes, my machine does not support the flexible pressure adjustments, however, I also have a loaner machine that does and I used it for several weeks and the doctor told me to go back on my machine. My apnea was worse with the fluctuating pressure.

[justMongo]

Sometimes CA's are pressure induced. Your doc gave you permission to tweak the pressure... backing off just a bit on the IPAP (15 in your profile) might improve centrals. Some people with CA or mixed apnea can get adequate results on a bilevel PAP machine.

The machine for treating centrals is the ASV machine. It has 3 pressure settings -- one is used to inflate the lungs during a clear airway apnea to non-invasively ventilate the patient. Usually the insurance game works such that you must fail to achieve control on less complex ( translate to less expensive) machines before being given an ASV.

[me50]

it could be possible that your pressure is not what you need (the 15/10)

If you aren't using software, download SleepyHead and look at what happens when you are sleeping.

I don't know anything about the machine you are using so I will leave that to those who do.