Ye (very ) olde hoary AHI question

[CPAPreturnee]

I'm going somewhat agree with QAL, but get there in a bit different way.  First, this looks, feels and probably is Complex Apnea.  Something has changed in your health, and it's between you and your doctor to determine why you have abundant central apnea and hypopnea.   Any investigation will likely key in on cardiac issues.

Settings: Auto mode, minimum 6.0, maximum 6.0, Flex OFF.  The CPAP pressure with no EPAP relief is your best shot at better oxygenation by not dropping PEEP (positive end expiratory pressure).  If these results are typical, the optimum treatment may not be CPAP.   However you will need a complete cardiac workup if ASV is considered.  If you don't qualify for ASV, then CPAP will likely be superior to BiPAP, as you are likely to get better results with constant pressure, than with changing IPAP/EPAP.

Interesting analysis and something I will bring up with sleep doc in June.

The sleep nurse says that I have a case of restless leg syndrome and recommending dopamine regiment.  I went on line and read up on several respected medical websites not pushing cures.  NONE of the symptoms are present to indicate restless leg.  Probably found it because I kept moving legs in sleep study trying to get comfortable with all the wires and straps and way too tight headgear interfering with sleep.  So will skip that diagnosis plus dopamine has its own set of problems that I really don't care to have.

Being an engineer we are trained to troubleshoot down to the root cause of failure.  So it seems that looking over all the AHIs so far, 14-15 seems as good as it will get.  I have been advised to sleep on back/side, loosen/tighten straps, try different type masks (5 so far), sleep on wedge pillow, sleep in recliner in almost upright position, sleep in cooler/warmer room or bed as root cause problem solution.

But not gonna give up (yet), but is depressing to see not making positive headway just standing in place.

I reallly appreciate the help, and hope some day to be able to help others here.

[Marillion]

14-15 on an AHI score is not as good as it will get. You can get a much better result than that. I would follow Sleeprider's suggestions. He always has good advice.

I would also replace the AHI graph with the Flow Limit graph. Also I would uncheck VS2 (Vibratory Snore 2) tracking. You don't need that. Though it didn't factor in your current results. Best to remove it from the possible equation going forward.

[CPAPreturnee]

I'm going somewhat agree with QAL, but get there in a bit different way.  First, this looks, feels and probably is Complex Apnea.  Something has changed in your health, and it's between you and your doctor to determine why you have abundant central apnea and hypopnea.   Any investigation will likely key in on cardiac issues.

Settings: Auto mode, minimum 6.0, maximum 6.0, Flex OFF.  The CPAP pressure with no EPAP relief is your best shot at better oxygenation by not dropping PEEP (positive end expiratory pressure).  If these results are typical, the optimum treatment may not be CPAP.   However you will need a complete cardiac workup if ASV is considered.  If you don't qualify for ASV, then CPAP will likely be superior to BiPAP, as you are likely to get better results with constant pressure, than with changing IPAP/EPAP.

While looking for what cardiac ASV was found this from ResMed.
http://www.aasmnet.org/articles.aspx?id=5562
and later:
http://www.resmed.com/us/en/news-and-inf...comes.html

[TexasTiger]

So here is the cleaned up version but nothing changed except smiley is vanished.



If there are more/less graphs that would be helpful let me know as I really appreciate members help, as I am determined do or die to make this work.

Welcome to the forum CPAPreturnee - I'm also in the 70+ range and have problems similar to yours.  There are really good people here that can help.

I've been on CPAP since 2003 and only found I had problems when I got my Airsense 10 that allows me to see what's going on (only looked cause I was not happy with my quality of sleep).  I was on a fixed pressure of 9.0 cm with an EPR of 3.0 cm. (pressure from 6.0 to 9.0) and my charts looked a lot like yours.  With the board's help my average is under 5.0 AHI but still fighting the PB (CSR on my charts).  APAP mode with lowered max. pressure has helped me get better sleep along with better looking stats.  Minimizing the leakage also made a big difference along with using the soft cervical collar.  Good luck on your renewed PAPing adventure...

[CPAPreturnee]

I would also replace the AHI graph with the Flow Limit graph.  Also I would uncheck VS2 (Vibratory Snore 2) tracking.  You don't need that.  Though it didn't factor in your current results.  Best to remove it from the possible equation going forward.

Cannot locate Flow Limit graph.  Must be in a hidden menue I haven't come upon yet.

Will remove the VS2 tracking flag
Thanks!!

[pholynyk]

CPAPreturnee, I'm pretty sure you won't find a Flow Limit graph, because you have a Remstar machine. Only the Resmed machines report flow limitations as a continuous variable. You should find Flow Limitation as a flag - to replace the VS2 flag, for example.

[pholynyk]

You won't find a Flow Limitation graph because RemStar machines report it with a flag - the FL line in your flags chart (which has none, it looks like). Only Resmed machines report Flow Limitations as a continuous variable.

[Marillion]

You won't find a Flow Limitation graph because RemStar machines report it with a flag - the FL line in your flags chart (which has none, it looks like). Only Resmed machines report Flow Limitations as a continuous variable.

Thanks for that pholynyk.  For some reason I thought he had a Resmed machine!  I should look closer at his profile next time...   My apologies to you returnee!