Why is AHI getting worse?

[Rosefool]

Hello Everyone,

New member here. I apologize if this question has been asked; I have searched here and elsewhere and can't find the answer.

I've been using CPAP for almost two mos. I was diagnosed by sleep study with mild OSA (AHI), oxygen desaturation (78%), and severe periodic limb movements. I got a ResMed S9 Elite with Swift Bella nasal pillows. My first week my AHIs were in the 2-4 range and I felt great. Since then, my AHIs have been increasing. They are usually between 5&10, but I've had some as high as 15-18. Saw the Pulmonary doc after six weeks and my average AHI was 6.3. He was not concerned, but decided to increase my pressure from 9 to 10 when I told me I didn't feel as good. No evidence of leak issues, but I tried a chin strap anyway for a while, and it made no difference.

I definitely feel better when my AHI is well under 5. Am I crazy? Doc says there's really no evidence that an AHI of 5 vs 2, for example, should affect how I feel.

My AHI continues to vary quite a bit, and is rarely under 5. Why is that? Why did I do so much better in the beginning and then get worse? BTW, the AHI has improved some since pressure was increased--I've had no numbers over 10.

Thanks in advance.

Rosefool/Karen

[Rosefool]

Additional question: do the erratic AHI numbers mean my pressure needs are varying widely? Do you think I need an AutoPap?

Thanks.

[PaulaO2]

The Elite is data capable. Consider downloading either SleepyHead or ResScan (or both) to view the data. You can find information for downloading them here:

http://www.apneaboard.com/forums/Forum-P...-and-Links

The data can give you information like leaks, when the events happened, what kind of events they were, etc.

[trish6hundred]

Hi Rosefool and WELCOME! to the forum.!
Hang in there for more responses to your post.
Best of luck to you.

[zonk]

No evidence of leak issues, but I tried a chin strap anyway for a while, and it made no difference.
Rosefool/Karen

some leaks are acceptable but any leak large or small if disturb your sleep ... need to be addressed
mouth leak can be a concern as allows therapy air to escape thru the mouth
when air escape ... it decrease the delivered pressure required to maintain the airways open and might causes some events to be scored and compromise the therapy
give the chinstrap another chance and also try full face mask which did not works for me but lots people using full face mask quite successfully
full face mask allows you to breathe thru nose and mouth without compromising the therapy

[zimlich]

I wouldn't get ahead of yourself. We can have improvement and then hit a snag. The <10 numbers sounder better - sometimes it takes a few adjustments to get things right.
Good Luck, good post.
Mary

[Sleepster]

I definitely feel better when my AHI is well under 5. Am I crazy? Doc says there's really no evidence that an AHI of 5 vs 2, for example, should affect how I feel.

Well, that's just the pat clinical answer. Getting your AHI under 5 is essential, anything lower than that is frosting on the cake.

My AHI continues to vary quite a bit, and is rarely under 5. Why is that? Why did I do so much better in the beginning and then get worse? BTW, the AHI has improved some since pressure was increased--I've had no numbers over 10.

It could be that at first you weren't mouth-leaking, and now you are. Do you wake up with air hissing out of your mouth? Contact your equipment provider and tell them you need a chinstrap.

The first thing we have to do is make sure your leaks are under control. If you have large leaks the machine can't report your AHI reliably and the CPAP machine can't stop your apneas.

The next thing we need to look at is the components of your AHI. The AHI is the sum of your OA, CA, and hypopnea indices. If your AHI is dominated by CA's it could be because your pressure is too high. On the other hand if it's dominated by OA's and hypopneas that's a sign that your pressure is too low.

None of this matters, though, if you can't get your leaks under control.

[Rosefool]

I am posting SleepyHead graphs. I already know the data doesn't look "that bad" compared to some, but if my AHI is not <5 before 12/17, major surgery will be cancelled. So, I appreciate any and all comments, because the data is very confusing as a new user. Thanks in advance!

[Rosefool]

Shoot, sorry the graphs didn't show up. Can anyone tell me what I did wrong? I used the insert picture icon then pasted the URL you see above into the box that popped up.

Karen

[PaulaO2]

You are too "young" a user to be able to post links. Try using the attachment feature.