Pressure keeps going up but higher AHI?!

[Sleepygirl84]

I have noted that my sleep provider forgot to put my memory card back in last week when I saw her.
I ended up seeing another person and told them this and they put another memory card in (which i thought was mine) now looking at the data going back a few months im a bit unsure if they are all my results - I use a dream station.

What cord do i need to buy to relay the information from my cpap machine to sleepy head as i want to give the last few months readings not just the last weeks.

[C0mbe]

You will need to buy an SD card reader.  Do a search of amazon for one - they usually connect to your computer via USB. Do take a look to make sure your computer does NOT already have an SD slot.  A lot of them do - particularly if it's a windows machine, or a mac pre-current generation of laptops.  

The steps are:

1. Open hinged cover on the right side on the screen while facing the machine and remove the SD card.  
   
2. On the SD card, you'll see a small light colored tab on the left side of the card.  Flick that down into the locked position.  
   
3. Put the SD card into your SD card reader or directly into the computer SD card slot.  
   
4. Go into sleepyhead and click "import". It should recognize a "dreamstation" file for import.  
   
5. Once import is complete, I eject the card from the computer to avoid damaging it because it's a mounted external disk.  On windows:  go to the file explorer, right click on the drive letter for the SD card and click "eject."  On a mac:  open the finder window and click the eject icon next to the SD card name.  
   
6. Remove card from computer, flick the tab back to unlocked and place it back in your dreamstation.
   

When I first started, I did this once a day, but now I do it 3 times a week, or when I have a rough night.  

Good luck!

[Sleeprider]

Sleepygirl84, it appears your results are clearly getting worse with higher pressure. I suspect that your machine is not correctly classifying OA and CA. Before jumping to conclusions, I have a couple questions. When did you start using this machine? Your data appears to go back to at least June 8, 2016, is that your data? From September 30 to January 4 your settings were 5-16 with no Flex, and you recorded 0.00 AHI in 54 sessions. If this is your data, do that again, and lets see if your AHI returns to a better level.

Your machine may need a firmware update that helps to better classify apnea and fix some other problems. You may want to get updated firmware and carefully follow the directions here: http://www.apneaboard.com/forums/Thread-...r-OWN-RISK You will need a SD card to apply this firmware update.

I have repeatedly suggested in posts #5 and #17 that you reduce your pressure. So far, you've done pretty good at ignoring that suggestion, and your AHI is terrible. Why not give it a try?

[Sleepygirl84]

Hi,

So I went back to seem my sleep specialist as to why I was having inconsistent results with my nightly AHI.

One night I would have a total of 25 then down to 12 the following night.

I have been using a dreamstation machine for almost a year. However it took me 10 months until I found the correct mask for my face so it wasn't until the start of this year that we have been addressing my pressures as I was still tired.

After consultants playing around with it and putting it up was making me worse then too low wasn't capturing them.

He today looked at the results and said I will need to go in and have another sleep test down my machine and see what it happening.

He said it could be positional and that I am rolling onto my back and that's where my apneas are worse (even though i tend to wake up on my tummy or side)

He said if it isn't that it could be complex apnea?

I am wondering if anyone else here has had anything similar happen to them and how they got through it and what can they do to help complex apnea?

I really feel at the end of it all to be honest.

I was first initially diagnosed with this when i was 16, but being young and silly i thought i would just "go away" until i went on for years being so tired and finally started to do something about it last year. Then it took 8 different masks to try and now it's not as simple as being put on cpap.

He even mentioned i may need to have the surgery with my jaw which is the last resort.

I live in australia and nothing is covered by medibank so its not only costing me my health its costing me so much where ever i turn

To be honest how I feel right now is better off to end it all as I dont see any light at the end of this tunnel.

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Reply to sleeprider

I am sorry for the delay - I am very new to all of this and don't completely understand the technically terms and much about the machine i am using.

I am a bit unsure if that is my data from early last year as I never remember getting the low of AHI - the lowest I can remember getting was 6 AHI and that was a few weeks ago.

I also noted in my note above i have used 8 different masks so at the start i tried a nasal until we noticed i kept opening my mouth so i am now currently on a full face mask that doesn't leak.

[PoolQ]

Yep best to keep to one thread, so we can review the history.

First don't give up! Really. It took me the most of a year to get this right and now I sleep all night . You are in good hands here, some great people that helped me. After my last sleep study, my Doctor looked at the report and said "you didn't sleep at all last night" "welcome to my world" was my response.

Not that what I needed would have much to do with what you may need, but the length of the process may be close. You don't sound "typical" like me.
APAP
VPAP
increase Tmax to 4 seconds
increase sensitivity of trigger
decrease sensitivity of cycle
and finally increase starting pressure from 5 to 6.4 and bingo sleep was found.

Turns out I am very sensitive to aliens sitting on my face, blowing air up my nose. Go figure.
Hang in there and adjust what you can/need to

[ajack]

I live in australia and nothing is covered by medibank so its not only costing me my health its costing me so much where ever i turn

To be honest how I feel right now is better off to end it all as I dont see any light at the end of this tunnel.

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Ask your GP Dr. for a referral to a public hospital, it's all free except for the machine, unless you are health card, then the machine is free too. There will be a wait list though, it won't be as quick as private.

[Sleepygirl84]

Thank you Poolq!

It does become discouraging and also worrying though when your specialist doesn't seem to know what might be happening. I go straight into over thinking and worrying that they will be unable to help, but I think you are right I think its just about finding the right pressure for me.

I could need a machine like your one instead of the CPAP machine?

Should I create a new post to see if i get anymore help on here?

[PoolQ]

so maybe a couple basic questions:
1. are you comfortable changing your pressure? Would your Doctor have a problem with you changing your pressure?
2. looking at your data that you posted it seems like you were doing better around Jan 3rd and Mar 3, assuming that this is your data-which I am not convinced of yet. I am wondering if the replacement card had some old data on it from a RemStar machine and just added yours to that
3. I am more sure that the Mar 9th and Mar 13th data is yours and perhaps any entries that are for the same machine Auto CPAP (500X150).
4. did you have your machine changed over the past year?

There are two things that need to be done: 1. get your AHI into a reasonable range 2. get you comfortable with the settings so you sleep

I think I read in one of your earlier posts about apneas-depression-anxiety and yes they can all be connected and caused by sleep apnea.

SleepRider is the person that helped me so much, I trust him 100%

We will chat more when I hear back about your comfort with changing your pressure settings.

[Sleepygirl84]

Thanks for the reply PoolQ.

1. I have to be honest when it comes to changing my pressure I do not feel that comfortable as I feel like I have no idea what I am doing?
I dont understand all the terms everyone uses on here like auto set, flex, etc and so on.
I am not sure if my doctor would mind if I changed it myself.

2. See I don't believe it to be my data from earlier on also. When I very first started with cpap I did try the resmed and a fisher and paykeyl - to be honest there have been so many different ones and masks that I am so confused to which was which and on which dates I used them on etc.
I guess I can only really go on the data collected over the last few months to show you as I know that it's definable my data
Not sure if this makes a difference but the machine I purchased is a 2nd hand one as it was discounted - the consultant said when i put and SD card in it should automatically pick up all my data.

I trust everyone's input on here as they are in the same boat as me and I know i can get some great advice that sometimes specialists havent thought of.

I do feel that I haven't explained my whole situation from the start very well and my have annoyed a few people.

[PoolQ]

you have been fine (and they will read this , so no worries.
so what are some of the terms:
CPAP is used generically, but really means fixed pressure all the time, maybe some exhale relief (more on that later)

APAP is auto you give it a range like 4-16 and it will start at 4 and if it detects apneas the machine will increase the pressure trying to get the apneas to stop
. once they have stopped for a while the machine will back down the pressure. This goes on through out the night

flex is for philips machines and presents a different "feel' to breathing. you can try any of these settings and see if you like one better (comfort settings)

some people have a problem exhaling into pressure, so Resmed has EPR (Exhale Pressure Relief) that drops the pressure during exhale by 1,2, or 3 cm of water. the Philips flex does much the same thing. this is a comfort thing

if the low side pressure (the 4 of a range of 4-16) is too low it may cause problems. You may feel like you are not getting enough air or it will take longer to stop apneas once they start up. The pressure increases in steps, so the farther away you start the more steps it takes to get to the right pressure.

The apneas do not happen real fast. Things have physically move. So when the exhale pressure drops things only just barely start to move, before the pressure goes back up. In other words this is not a problem . again comfort

ramp- lots of talk about this, personally I use it. Others say it delays treatment. If I don't have any apneas during ramp, well then I don't need treatment right then. Ramp is a comfort thing, it starts the machine out at a lower pressure and over a selected amount of time will "ramp" the pressure up to you starting pressure (the 4 of the 4-20)

the name of the game. stop apneas and sleep. so sometimes having too high of a pressure (say 15 fixed) may be disruptive to your sleep, not letting you get "good" sleep. Some people find pressure changes disruptive and do better with a fixed pressure. This is all trial and error, try it and if you like it keep it, if not try something else. All the while watching you AHI numbers.

personally I would change it to auto, set it for 5 or 6 - 16 and see what happens. You will not cause damage. the low end number you can get a pretty good idea about if you put the mask on with pressure during the day. lay down and read a book or watch TV, are you breathing comfortably? getting enough air? can you relax? find your starting number.

If you can't sleep with this starting number, enable ramp and have that start at a lower number that helps you fall asleep

The machine will find you high number, most people like to set it at 2 cm higher than your max number from the reports.

Big things is to get some data and post the plots. look at sleepriders signature in his posts and you will find links to how to post good plots and what we need to see. the plots you posted are missing some important plots like pressure.

hang in there, keep posting, learn, get used to it, try one thing at a time, give yourself some time to get used to it (unless you know right away that you need to change it), nothing happens fast with sleep apnea-you will be fine while we work it out