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AHI climbing and need help - slushy - 09-30-2022
Hi all, have lurked for some time and read many of the newbie topics on wiki which I really appreciate thank you. Have been a user of CPAP for many years and usually things under control with periodic spikes in AHI. I was diagnosed with AHI at 30 and my most recent sleep study in 2019 put the maximum titration at 14cm.
For the past few weeks my AHI and leaks have been climbing. There has been a big increase in central apneas and unclassified apneas (likely also centrals). Cheyne stokes respiration phases have started to occur and hypopneas have increased moderately. Obstructive apneas seem to be fairly well controlled.
I tried lowering and tightening the range of titration of 7cm to 15cm to 9cm to 13cm and then down further to 8 and 12cm. I am back at teens with AHI. CSR for big sections of time. Most clusters occurring towards earlier morning when I am more restless, so may in some cases be false positives.
A further complication for me is that I experience Catathrenia which is a sleep groaning. This involves long continuous exhalations so this may also play around with the readings.
I have booked into see my sleep physician (early November), but I know there is also much wisdom on these boards so just wanted to check in.
[img]blob:http://www.apneaboard.com/695bb1bd-87b2-440f-89f6-d9994f3d0ba2[/img]
RE: AHI climbing and need help - slushy - 09-30-2022
[img]blob:http://www.apneaboard.com/fef83cf8-fbbc-47f0-893f-2800d79b3694[/img]
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RE: AHI climbing and need help - slushy - 09-30-2022
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RE: AHI climbing and need help - multicast - 09-30-2022
Actually, you're using your device as a leafblower. Hence the data provided by the machine don't correspond the sleeping reality. And the therapy literally blows out.
Use an FFM to get rid of the massive leakage.
RE: AHI climbing and need help - Psychotech - 09-30-2022
yes your problem are large leaks, get it under control with full face mask or hybrid mask, then you will know the real condition of your apnea
RE: AHI climbing and need help - slushy - 09-30-2022
Thanks for having a look and that suggestion.
I've got an ResMed Air Fit F20 which I tried for a few nights and got similar results. It may be though that my mask for this is the wrong size and I need slightly bigger, was still getting leaks. Also have a Phillips respironics dreamwear under the nose mask (Big leaks) and a Resmed Ait fit P30i (assuming big leaks). Nice to have a focus for what to solve first. Feel like I have been going in circles and nothing improving. Cheers!
RE: AHI climbing and need help - OpalRose - 09-30-2022
slushy,
Solving your leak issue is essential. Your machine cannot compensate with a leak rate that high. Pressure adjustments are not going to make much of a difference until that is solved.
It could be the way your sleeping too... Positional Sleep Apnea.
Here's a couple wiki articles to read.
http://www.apneaboard.com/wiki/index.php?title=Mask_Primer
http://www.apneaboard.com/wiki/index.php?title=Optimizing_therapy#Positional_Apnea
http://www.apneaboard.com/wiki/index.php?title=Soft_Cervical_Collar
RE: AHI climbing and need help - KeepSmiling - 09-30-2022
slushy,
If the 31 Aug 2022 scan was typical and not a fluke (there was no CSR), I would:
For Pressure - Your 31 Aug 2022 Chart, with Min 7.0 Max 15.0. I would use 8 - 15 and see how that goes.
For Leaks - I think it is the mask moving (maybe you moved). Time of the year, maybe allergies opening.
Other then adjusting Pressure were there other changes that may have happened to you?
[[I was diagnosed with AHI at 30 and my most recent sleep study in 2019 put the maximum titration at 14cm.]]
-What was happening that you switched to 15 cm?
Were you diagnosed with having Cheyne stokes respiration or central apnea?
RE: AHI climbing and need help - KeepSmiling - 09-30-2022
Forgot to add
I will assume that you being followed by a doctor in case you have other issues.
RE: AHI climbing and need help - slushy - 09-30-2022
Many thanks Opal Rose and Keep smiling. Those articles were really helpful to read. I'll definitely redouble my efforts with fitting mask each night. I have tendency to shift a lot in bed, particularly towards the end of the sleep cycle. I think this has a lot to do with it. At the moment I am losing some weight to bring me down to the middle-lower end of my BMI for height. I was hoping it might help a little with apneas
I have never had CSR in my diagnosis, so it is a recent phenomena. I thought maybe it was a new feature of the S10 model picking this up? In May this year I went from an S9 to an S10. Central apneas were present in the initial and subsequent sleep studies, but obstructive were the main feature. OSA's are now under pretty good control with therapy. My BMI is in the healthy range, however it has tended to be at the top of the healthy range. I have been losing weight (about 5 kilograms so far) to bring it lower. This means I suppose I am under a bit of calorific deficit each day. Not sure if this might affect my sleep.
Last night I slept with Air fit F20 till 1.30am and then changed to Swift FX with a chin strap for the rest of the night. Although the F20 mask is a little small and I will need to get next size up it is obviously doing the job in terms of leaks. I tend to sleep on my back for the start of the night and then become a side sleeper as the night goes on. The FFM seemed to handle this okay. So it would seem FFM is the way to go even though it is a bit cumbersome and will take a while to adjust sleeping with each night. Those fitting instructions were really helpful Opal Rose. I think I will be able to make it much more comfortable over time.
So 8cm to 15cm. That was more or less the recommended from previous sleep study in 2019 so probably safe to go back to that and see how it goes with leaks being handled better. I have an appointment with sleep doctor in November, so will see if there is anything else untoward going on.
Thanks again everyone for weighing in and the information. Very much appreciated.