Variable AHI's any idea??

[morph]

Evening all,

I have been using my cpap machine over the last 7 years, but lately I have been getting wildly varying figures. One night my AHI is 1.9, the next it might be 8 or higher. I have no idea why the results are so different. I try and sleep on my side, with my mouth shut, as I only have a nasal mask. I was diagnosed in the UK, but I have emigrated to Australia and brought my machine with me, I have no support here at present and wondered if someone might explain what's going on. You can have a look at the last 7 years worth of data if you are interested.

I tried re-seating my mask again last night, but it was a bad nights sleep! All I was told to be compliant is, minimum of 4hrs usage a night, and an AHI of under 5. I would really like to understand the data more and understand why the data is so variable. My weight has stayed fairly steady, so I don't think it's that. I don't smoke and have the occasional beer, but that's about it. I have a fairly physical job and walk approx 10,000 steps a day.

I have attached a report of this, I can make all 7 years worth of data available for the "bigger picture" but I need 3 posts before I can link to a file in my dropbox account. I'm struggling to post the data due to the file size limitations. If you drop me a pm I can send you the sleepyhead reports for AHi's of  1.38, 3.38 & 6.43 for the last 3 nights.

Thanks for your help

Alan

[Sleeprider]

Hi morph. Once you have over 4 posts you can post images, and preferably link to images hosted offsite. My signature has links on how to best organize charts and post them on Imgur so that they work over here. Take a look, at that information, and keep posting, event just to say hi or thanks, and you will soon be able to post links.

Your chart shows you are using a PRS1 CPAP Pro set to a pressure of 10. Your events appear obstructive with abundant snores, hypopnea and occasional obstructive apnea. The solution is pretty straight-forward, and will involve higher pressure. To do this manually you will need to enter the clinical settings by turning the control knob to Settings, and pressing the control knob and ramp button at the same time. Once the machine beeps, turn to settings, and scroll to CPAP pressure. You need to change from 10 to 11. You will need to increase pressure 1-cm until the hypopnea are at an acceptable level. Don't worry about snores on the chart as VS2, but you don't want to see many on the VS line. If you start to see more CA than OA, you may have to reduce pressure by 0.5 cm, then hold steady for a while and see how things look. We can help as you work through this. In addition, I recommend you either increase the starting pressure of ramp to 6 or as high as you can comfortably tolerate, or turn off ramp altogether. That setting is further down in the settings.

Your machine may have an Auto-Trial mode which will let you use your machine as an auto CPAP to help with automatic titration. While you are in settings, look at Mode options. If they are present the information below describes your alternatives:

SMART TECHNOLOGY MODES
The REMstar PRO 460 offers three operational modes -- Auto-Trial, CPAP-Check, and straight CPAP -- to help optimize your sleep therapy settings.

Auto-Trial Mode (Close) delivers breath-by-breath Auto-CPAP therapy for up to a total of 30-days. At the end of the Auto-Trial period, the device will automatically transition into the CPAP-Check mode at the pressure the patient was at or below 90% of the trial period time. (Note that Auto-Trial mode is for temporary use only and must be used for a minimum of 3 nights to be effective. The REMstar PRO is NOT an Auto-CPAP Machine.)

CPAP-Check Mode (Close) checks on the user every 30-hours to determine if therapy pressure is optimal. If not, it automatically adjusts the nightly fixed CPAP pressure by 1 cm H2O (with maximum upper and lower limits of 3 cm) to obtain an ideal pressure.

Straight CPAP Mode (Close) is for use when therapy with no changes or checks is preferred. In straight CPAP mode the REMstar PRO will not make pressure checks or adjust therapy levels although normal therapy data will still be tracked.

Take a look at your setting options and post back. We can help you get this dialed in. Also, download the clinician manual using instruction in the CPAP Setup manual link at the top of this page.

[trish6hundred]

Hi morph,
WELCOME! to the forum.!
Good luck to you as you continue your CPAP therapy, and also with getting it fine-tuned to better help you.
Hang in there for more responses to your post.

[morph]

Hi Sleeprider,

Thanks for the information.  I looked in the settings and can change the pressure to 11 easily. However it states this in the menu

Cflex+ (set on this)
Cflex
None

Then Cflex+ 1 2 3 (it's set on 3)
Cflex+ lock off

Thanks

Alan