AHI jumping to scary levels with new machine.

[SleepingBetterCPAP]

So, I made a thread in December 2017 viewtopic.php?f=1&t=157643&p=1211348when my AHI start jumping from it's usual <2 to 4 or 5. Felt like my old machine wasn't really doing its job and the humidifier was broken. I decided to finance a new machine and wound up getting the DreamStation Auto CPAP Machine. I don't have insurance coverage for my CPAP so I have to pay out of pocket for everything. The Dreamstation was a big expense but I was *hoping* the new machine + working humidifier would help get my numbers down. Instead, the numbers have gone from bad to horrible. I also switched masks in December from the Quatro to the Liberty Hybrid. I've had success in the past with the Hybrid although my nares got very sore so I switched to a full face. I saw a slight improvement with the Liberty but then it took a real hard turn for the worse. That, combined with the Dreamstation and I got an average AHI 7.94 (I had an AHI of 26.04 one day)

For the last few weeks I've been really congested and thought maybe there was an issue with that. I tried a cervical collar to see if that would help. It did a few times, with my obstructions going to 0 but my AHI jumping. Is there some sort of inverse-relationship between Obstructions and Hypopneas? The collar then seemed to stop working. I wasn't sure if it was because my nose was so congested that I wasn't getting enough air between the collar keeping my mouth closed and my sinuses being clogged. I went back to Quatro and the numbers have come down a little bit but not to where I'd like them. Any ideas? Is it possible my old machine wasn't reading data right and now that I have a new machine it's reading my numbers accurately? I did have an Oximeter on a few nights and I didn't really see any desats below 90--which gives me some relief mentally.

Here is a screenshot of my sleepyhead log:



Any ideas/suggestions?

[gwc2795]

Did you also change mask? I notice that your 90% leak rate has increased to 72. This leak rate could be causing the CPAP to misdiagnose the AHI's because of the pressure leaks.

[LSAT]

Did you also change mask? I notice that your 90% leak rate has increased to 72. This leak rate could be causing the CPAP to misdiagnose the AHI's because of the pressure leaks.

Read his post

[prodigyplace]

Did you also change mask? I notice that your 90% leak rate has increased to 72. This leak rate could be causing the CPAP to misdiagnose the AHI's because of the pressure leaks.

It's buried in the first post, but yes, they changed to a mask that worked well previously but caused soreness then.

I vote for trying the older mask, assuming it is still in decent shape. Too many changes at the same time to troubleshoot well, in my opinion.

[DavidY]

IMO, make a change and try it out for about a week if at all possible. Use SleepHead and adjust.

Dave

[Julie]

TO Sleepingbettercpap - It's possible your congestion's from using a high (or even low) humidifier setting when local conditions don't call for it - maybe at all. I don't use mine at all because the local climate's humid and I'd get cold symptoms if I did. It's an optional thing, so don't feel you have to use it, or at least try a lower setting for a couple of nights.

[Barb (Seattle)]

ever since I have been on DreamStation...my #'s have been horrible too.

coincidence? not sure. welcome to the club of evidently just 2 people now that aren't getting good results with the NightmareStation as I call it.

I find out Friday the results of my sleep study and why this machine is NOT dealing with my central apneas.

my AHI is consistently in the 20-30/hour range.

[Barb (Seattle)]

IMO, make a change and try it out for about a week if at all possible. Use SleepHead and adjust.

Dave

that is what I've been doing. So far??? nothing and no settings have worked to get my AHI down. I really think the machine is defective.

[Pugsy]

that is what I've been doing. So far??? nothing and no settings have worked to get my AHI down. I really think the machine is defective.

ever since I have been on DreamStation...my #'s have been horrible too.

I find out Friday the results of my sleep study and why this machine is NOT dealing with my central apneas.

Unless your current machine is the DreamStaton ASV machine I can tell you right now why it is NOT dealing with your central apneas.

It can't. It's the wrong machine to give to someone with central apnea.
It's not the machines's fault because it was never designed to treat centrals (unless you have the ASV model and I don't think you do).
If you are having a lot of central apneas....you need a machine designed to breathe for you and deal with those centrals.
Regular cpap/apap can't do it.

And IF your current machine is the ASV model...it's not doing its job because someone set it up incorrectly,

[Barb (Seattle)]

that is what I've been doing. So far??? nothing and no settings have worked to get my AHI down. I really think the machine is defective.

ever since I have been on DreamStation...my #'s have been horrible too.

I find out Friday the results of my sleep study and why this machine is NOT dealing with my central apneas.

Unless your current machine is the DreamStaton ASV machine I can tell you right now why it is NOT dealing with your central apneas.

It can't. It's the wrong machine to give to someone with central apnea.
It's not the machines's fault because it was never designed to treat centrals (unless you have the ASV model and I don't think you do).
If you are having a lot of central apneas....you need a machine designed to breathe for you and deal with those centrals.
Regular cpap/apap can't do it.

and, that's the reason I had 2 sleep studies recently (the 1st one I didn't sleep long enough to qualify for ASV) HOPEFULLY, I am told Friday that
I can get the ASV machine. Because if I can't...I am going to feel totally hopeless.

[Pugsy]

To OP here....Let's fix SleepyHead so it isn't incorrectly calculating your time over red line leak threshold.
Your leaks aren't nearly as bad as SH is saying..

Disregard any leak warning from SH. Your leaks are NOT excessive.
Instead the statistic reporting the % of time in large leak is based on a ResMed calculation number and that number won't work for your Respironics machine.
Open SH and go to Preferences and then the CPAP tab. SH Defaults to a red line leak threshold of 24 L/min which is a ResMed leak number...won't work with your machine. Your red line threshold number is more like 75...so change the 24 to 75 or just turn off that statistic by removing the check mark.

The nasal congestion may be a factor..might not be all of the AHI but it can be a factor.
Why the nasal congestion? Any idea?

[Ron AKA]

Unless your current machine is the DreamStaton ASV machine I can tell you right now why it is NOT dealing with your central apneas.

It can't. It's the wrong machine to give to someone with central apnea.
It's not the machines's fault because it was never designed to treat centrals (unless you have the ASV model and I don't think you do).
If you are having a lot of central apneas....you need a machine designed to breathe for you and deal with those centrals.
Regular cpap/apap can't do it.

And IF your current machine is the ASV model...it's not doing its job because someone set it up incorrectly,

Pugsy, did you actually look at the data sheet? The clear airway events (central apneas) are essentially zero, and have been for months. The problem is obstructive apneas and hypopneas, not centrals.

[Ron AKA]

Any ideas/suggestions?

Can you post a daily detail screenshot of the last result where the AHI was about 11 or so? April 10th? The good news is that your high AHI is being caused by obstructive events and hypopnea, and both can be addressed with your machine. If you post the daily detail screenshot I can give a more specific suggestion.

[Pugsy]

Pugsy, did you actually look at the data sheet? The clear airway events (central apneas) are essentially zero, and have been for months. The problem is obstructive apneas and hypopneas, not centrals.

Well...yes, as a matter of fact I did. That's why I talked about fixing the leak report because I know it is most likely wrong and he didn't adjust SH off the ResMed leak number. The leak and nasal congestion was the only thing I chose to address at this time. The obstructive stuff...I won't comment on unless I see a detailed report. I don't like guessing at settings unless I have no choice.
Once I got a reply about the nasal congestion the plan was to probably ask for a detailed report image and not the summary shown.

Did you happen to bother to look at who I was talking to?
In your haste to find me making an error and getting in a little "I told you so" you might want to slow down and read a bit first. I am not perfect but I rarely make mistakes and contrary to what you might want to think...I know this stuff frontwards and backwards.

I addressed the OP in one post and Barb(Seattle) in another post about the clear airways.. She's the one mentioning centrals.
All I mentioned to the OP was this below in case you missed it...
and when I was talking to Barb...I quoted her so there would be no mistake who I was talking to but I guess you made a mistake and missed that part. She's been interjecting her problems in several threads and when people do that...it does cause confusion ...just like you apparently had about what people respond to.

To OP here....Let's fix SleepyHead so it isn't incorrectly calculating your time over red line leak threshold.
Your leaks aren't nearly as bad as SH is saying..

Disregard any leak warning from SH. Your leaks are NOT excessive.
Instead the statistic reporting the % of time in large leak is based on a ResMed calculation number and that number won't work for your Respironics machine.
Open SH and go to Preferences and then the CPAP tab. SH Defaults to a red line leak threshold of 24 L/min which is a ResMed leak number...won't work with your machine. Your red line threshold number is more like 75...so change the 24 to 75 or just turn off that statistic by removing the check mark.

The nasal congestion may be a factor..might not be all of the AHI but it can be a factor.
Why the nasal congestion? Any idea?

[Pugsy]

and, that's the reason I had 2 sleep studies recently (the 1st one I didn't sleep long enough to qualify for ASV) HOPEFULLY, I am told Friday that
I can get the ASV machine. Because if I can't...I am going to feel totally hopeless.

I am so hoping they finally get you the proper machine to deal with your issues.
If you have had centrals as long as it appears to have been happening and in the numbers you are seeing on the reports it's the only logical solution

One of the NIV machines is likely the best option for you. ASV isn't the only NIV machine though....your doctor may opt for a different NIV machine with a back up rate to breathe for you when the centrals happen...that's up to him and your medical history and what he thinks is the best choice. I like ASV myself because it is pretty much automatic...and only kicks in when needed. The others kick in whether you need it or not and that can sometimes be harder to get used to.
But that's a decision for your doctor to be making.

I am just sorry it took them so long to get off their butts and at least try to get you some help.