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Varying AHI
#1
Varying AHI
        Hi all,

Recently my AHI (CA predominatley) has suddenly jumped from being well below 5 to well over 10. My machine (Resmed S9 auto) is currently set to CPAP with a pressure of 8 and has been working very well up until recently.

What areas do I need to look at to address this issue?

Interestingly, last night at around 3:30 am the AHI after about 5hrs was 5.1. At 7AM it was 17.8. Looking further into last night's readings, it seems as though when I am asleep, the CA's are almost non existant. When I wake up in the middle of the night for whatever reason, the CA's are very high when I am trying to get back to sleep. Once I am asleep, no CA'S! That is confusing. I have not kept a record of when I wake up in the middle of the night, but will do so for the next few nights.

As per the advice on many sites, I don't keep track of how long it takes me to get back to sleep and I don't look at the clock.

Perhaps my night time strategy needs to change but not sure how.

See attached screen shots of last night.

Regards,

Steve
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#2
RE: Varying AHI
Thanks for posting.  The large CA cluster in the morning before you wake up could be sleep wake junk where you are awake, but trying to fall asleep.  The machine can't tell if you are awake or asleep.  If a large cluster of CA's appears on your charts when you are 100% sure that you are asleep, then please post again.  I am sure you will find a way to tell if you are asleep or awake when these clusters are happening.
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#3
RE: Varying AHI
(09-10-2023, 11:04 AM)Jay51 Wrote: Thanks for posting.  The large CA cluster in the morning before you wake up could be sleep wake junk where you are awake, but trying to fall asleep.  The machine can't tell if you are awake or asleep.  If a large cluster of CA's appears on your charts when you are 100% sure that you are asleep, then please post again.  I am sure you will find a way to tell if you are asleep or awake when these clusters are happening.

Thanks,

Interestingly, last night showed a long period from about 2242 (when I probably drifted off, turning lights out at 2200) until about 0430 

with very few CA's. I know I woke up about 0430 then as usual struggled to get back to sleep. The graph shows high number of CA's from then on.

Regards,

Steve


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#4
RE: Varying AHI
Post deleted as anwered elswhere
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#5
RE: Varying AHI
Your flow limits (FL) are high
Enable EPR to Fulltime. Id start at 3 and see how that works.

I suspect the call of SWJ is accurate.
If you post 3-4 minute views covering the start of the CA clusters we might be able to confirm the SWJ.
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#6
RE: Varying AHI
(09-10-2023, 07:42 PM)Gideon Wrote: Your flow limits (FL) are high
Enable EPR to Fulltime.  Id start at 3 and see how that works.

I suspect the call of SWJ is accurate.  
If you post 3-4 minute views covering the start of the CA clusters we might be able to confirm the SWJ.

Thanks,

I have tried setting EPR on before, but it made things worse. I'll try again. to clarify, I am runing CPAP, not APAP.

Here is the requested 3 - 4 minute screen shot.

Regards,

Steve


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#7
RE: Varying AHI
Despite the lack of evidence on the FL chart I'm seeing significant flow limits on the breaths you captured. Your stats say 95% FL is 0.21 which is significantly higher than we like to see.

Two changes please
Mode: Auto with
Min=max=8 to keep your fixed pressure.

EPR=1, Fulltime. I think you need more but let's start with 1. Why because you said it made things worse, we will take it slow.
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#8
RE: Varying AHI
(09-11-2023, 09:50 AM)Gideon Wrote: Despite the lack of evidence on the FL chart I'm seeing significant flow limits on the breaths you captured.  Your stats say 95% FL is 0.21 which is significantly higher than we like to see.

Two changes please
Mode: Auto with
Min=max=8 to keep your fixed pressure.  

EPR=1, Fulltime. I think you need more but let's start with 1.  Why because you said it made things worse, we will take it slow.

OK,

Here are last night's results. Much better after setting epr to full and 3. 
95% flow limit was 0.14. More time needed though to evaluate and see if results hold, then I will try your suggestions. Spoke to Resmed today and that advise having anther home sleep study as it has been probalby 10 years since i had one. Here in Australia that won't cost me anything, so why  not?

Feeling reasobly refreshed this morning, time will tell.

One reason for pursuing this nowin detail  is that in Australia at age 75 I have to get doctor's approval that I have no health issues that would stop me from driving and sleep apnoea is a big reason. I will be 75 next June.

Regards,

Steve


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#9
RE: Varying AHI
(09-11-2023, 09:50 AM)Gideon Wrote: Two changes please
Mode: Auto with
Min=max=8 to keep your fixed pressure.  

EPR=1, Fulltime. I think you need more but let's start with 1.  Why because you said it made things worse, we will take it slow.

Hi Gideon,

A quick question while I wait to see how things settle down, what is the diff between CPAP fixed pressure and using APAP min and max equal?

Regards,

Steve
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