Need Feedback on First Month of Autopap

Alisha · Post by **Alisha** » Tue Jan 02, 2007 10:48 pm

I would like to get some feedback of my first month on the auto, please. I hope to improve the averages, but this morning I was ecstatic to see my OAI for last night was only 0.5 with an AHI of 3.

The first 8 nights averaged 3.7 AHI which were mostly hypopneas. During the first 3 days of auto therapy, I felt my body come to life again with energy I had not felt in many years.

Then on the 9th night I was so curious to see how my numbers would read on cpap that I switched to cpap with my prescribed pressure. My OAI rose to 9.5 while my hypopnea index rose to 10, leaving me with an AHI of 19.5. I guess that explains why none of my symptoms improved during 4 years on straight cpap.

After spending night 9 on cpap, I had not been able to get my AHI on auto as low as the first 8 nights on auto.....until last night. That's why I got so excited when I saw last night's numbers. Of course part of the time since night 9 I was fighting a cold which could have influenced the numbers.

With that prelude, what follows are the averages of my first month on apap:

90% Pressure - 10.0
Average Pressure - 9.8
Avg Non-Responsive Apnea/Hypopnea Index - 0.0
Avg Obstructive Apnea Index - 3.0
Avg Hypopnea Index - 3.9
Average AHI - 6.9
Avg Flow Limitation Index - 1.6
Avg Vibratory Snore Index - 235.7
Average Leak - 51.2 (Bias flow for my ff mask is 39)
Average Usage - 7 hrs. 40 mins.
Avg Time in Apnea Per Day - 7 mins.
Compliance - 100%

As I said, there is room for improvement but I plan to slowly tweak for better results. The important thing is that I have more energy and am more mentally alert.

I do hope someone can help me figure out why my snore index is so high. The charts almost look like I have a continual snore most of the night. At my last sleep study in July of 2006 I asked about snoring. They said I snored a few times during the night. Could the auto think my shallow breathing is snoring? Also the charts look like the Flow Limitation only shows up when there is an occasional gap between what the apap is interpreting as snoring. Anyway, I do not believe this is snoring. What do you think it is?

I will welcome and appreciate any and all comments.

Alisha

Snoredog · Post by **Snoredog** » Wed Jan 03, 2007 3:00 am

how you feel is the most important factor to consider, I wouldn't worry too much about the snore indice, it is probably from using the full face mask, that machine is very sensitive to logging snores but limited on any response to them.

Some snores simply don't go away with increased pressure. The only thing you have to be concerned about with snores is if they trigger the machine into increased pressure which can increase other events as a by product. That is only a problem if CA/MA's were seen on your PSG, if not don't worry about it.

I would be noting when you feel refreshed and the 90% pressure found during that prior night.

-What was your prior titrated cpap pressure?
-Do you have MyEncore where you can run the Pressure vs. AHI report?
-What is your current Min. pressure set to?

your numbers don't look all that bad, but the OA could be lower, HI may drop as well. It would be interesting to see what the Pressure vs. AHI report says, don't know what your Min. pressure is currently set to, but from the AHI info, you could probably bump the Min. up a bit for a lower score.

Goofproof · Post by **Goofproof** » Wed Jan 03, 2007 9:20 pm

Avg Vibratory Snore Index - 235.7
Average Leak - 51.2 (Bias flow for my ff mask is 39)
Avg Time in Apnea Per Day - 7 mins.

#1, problem Mask Leak high (Snores are higher)

#2, 7 minutes a night you aren't breathing, my avg is 26 sec per night.

What pressure are you running, are you using 2 cm above and below your 90% pressure?

Leak rate control is the secret for me, along with the 4CM pressure spread. Jim

I used to use the F & P 431, and found it raised my AHI, double and triple, but it was the most comfortable FF.

jrfoster · Post by **jrfoster** » Tue Jan 09, 2007 10:07 pm

Goofproof wrote:
I used to use the F & P 431, and found it raised my AHI, double and triple, but it was the most comfortable FF.

Jim,

That is very interesting! My AHI averages 6.9 and I love my F & P 431. Is it possible that switching to another full face mask it might lower it? Is the Mirage Activa comfortable for you?

Jeff

Snoredog · Post by **Snoredog** » Wed Jan 10, 2007 2:03 am

Snores will always be higher with a FF mask. The machine is very sensitive to any vibratory noise, so they may not be actual snores. The machine would try and increase pressure to eliminate them.

Again, it all goes back to where you feel better, I would set the machine to autopap and the pressure you used before and just sleep with it, ignoring the snores.

The only way to really get rid of those snores is by using a nasal mask, but if you mouth breathe that would be counter productive.

oldgearhead · Post by **oldgearhead** » Wed Jan 10, 2007 6:37 am

Snores will always be higher with a FF mask

I concur. My FF mask scores twice as many snores as my CL2.
However, AHI is the same (goes up with congestion cold and down when clear).

tmaiberger · Post by **tmaiberger** » Wed Jan 10, 2007 6:40 am

With your machine and software, you should download James Skinner's Encore Pro Analyzer to get the Pressure vs. AHI report mentioned by above. MyEncore did not completely work with the new M machine and latest version of Encore Pro. The Encore Pro Analyzer has the same types of info that MyEncore pulled from the Encore Pro.
TM

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