baby dino's casa de los suenos, increasing ahi

When I had my tritation study it said:

"The patient had 161apeneas total. Of these, 12 were obstructive apeneas and 149 were central apeneas". It also said I had 149 hypopneas. A year later, I finally got a machine but I am living in a much lower elevation. Because I complained about the high pressure they set it to auto after a 2 week delay. Did I mention that my dme sucks ? "My air" reports a high of 7.6 events a night to a low of 1.9 events per night. Usually it is somewhere between those two numbers. (This is about 4 weeks with the machine) This seems high to me but seems acceptable to my dme company. My sleep study clinic was back where I used to live and my new doctor is hard to get ahold of. Is this acceptable? Obviously its better than my average of 141.33 events per hour but I am still quite tired and foggy.

Get SleepyHead software so you can see what kind of events you are having and when they occur.

Post a detailed report from both a good (low AHI) night and a not so good (higher AHI) night.
See this thread for how to post and in what format.
viewtopic/t158560/How-to-post-images-for-review.html

Link to download SleepyHead
https://sleepyhead.jedimark.net/

Also...what are all your settings on your machine?

Sleephead is a desktop software. I am posting from my phone. I don't have a desktop. I have the my air app. Will a screen shot help ?

I was not told what the settings were but following the links provide here I went to settings. It shows vauto. max ipap 24. min epap 8. Ps 4. ti max 2 sec. ti min .3 sec. trigger med. cycle med. ramp time 45 startepap 4.0 climate auto tube temp auto. The rest say accessories do you need that info also ?

Don't need the accessory information.

Need the breakdown into each event category that makes up the AHI.
How many centrals, obstructive apneas and hyponeas and how many hours used.

On the night's with the higher AHI are you sleeping soundly for the most part or having a lot of wake ups and maybe trouble falling asleep.

AHI of 1 to 2 ish....acceptable. AHI over 5 ish...not acceptable but if that happens to be a night where you didn't sleep well with a lot of wake ups then they might not be real events. These machines don't know if you are asleep or not. All they do is measure air flow/breathing and our awake/semi awake breathing is very irregular when compared to asleep breathing so it's very possible for the machine to give you false positive flags.

I had a night a
weeks ago with the AHI of 3 something which is unusually high for me so I went into SleepyHead and looked at each flagged event up close and every single flagged event was related to awake breathing....none were real as in I was asleep.
I had a crappy night's sleep due to back pain....I didn't sleep well...lots of tossing and turning and irregular breathing.
On the surface when just looking at the AHI it was much higher than normal but none of them were real.

If you have more nights with the AHI of 1 to 2 than you do over 5 and you are sleeping good and feeling decent then you are probably okay but without the ability to see the details of the night we are doing a lot of guessing.

On your machine go into the clinical menu find essentials and set it to plus. Then exit

Next bring up the sleep report it defaults to 30 days change it to one day by turning the knob to the days then press to select and select 1 day.


Finally scroll all of the way to the end of the report and you should get a breakdown of events post that information here

Used hours 6.1
Pressure 16.1
Exp Pressure 12.1
Leak 22L/m
Vt 420 ml
RR 21
Mv 9.3 l/m
Ti 1.2 s
I:E 1:1.5
Spont Cyc 97.5%
Ahi 5.2
Total AI 2.6
Cent AI 0

Here is the my air reports/graphs

No central apneas.
AHI 5.2
Apnea Index is 2.6
that means the hyponea index is also 2.6

Likely you need a little more minimum EPAP pressure to help reduce the airway collapses.
Your therapy isn't optimal and very well could still be an big factor in your unwanted daytime symptoms.

What are you exact settings as shown in the clinical setup menu? Do you know how to get into the setup menu to see those settings?
If not, go here and request the clinical/provider manual for your machine as it will explain how to get into that menu area.

https://www.apneaboard.com/adjust-cpap- ... tup-manual

The difference in AHI....some nights rather low and some nights above 5 could maybe be explained by sleep position changes.
It's possible that the nights with higher AHI you are maybe on your back more than the other nights.

Average of 5 per hour over 6 hours...that's 30 plus events over the night. Wouldn't be surprised if we could see the graphs to see some parts of the night with not much happening and other parts of the night with some clustering of events.
I am also betting that if we could see the flow limitation graph that it might be a bit ugly also.

Any chance you know anyone with a computer that you could put SleepyHead on?

I posted this earlier in the thread are these not the settings you are looking for?


I was not told what the settings were but following the links provide here I went to settings.

It shows vauto.
max ipap 24.
min epap 8.
Ps 4.
ti max 2 sec.
ti min .3 sec.
trigger med.
cycle med.

ramp time 45 startepap 4.0
climate auto
tube temp auto.

It could definitely be sleep position. I start on my right shoulder away from machine because that one is in the best shape then switch to my left shoulder (2 surgeries + rotator cuff) and usually wind up on my back when both shoulders are too painful. Then hubby wakes me up and says your mask is making tooting noises again roll over so the process starts again. Let me add that I havent slept good in years and to make sure I am getting enough time with the machine to count for my insurance I often read w mask on and machine running. Otherwise I wouldn't make my 5 hours 70% of the time that my friend who works for a different DME tells me I have to make.

Sorry....I missed the post with the settings.

Cynmatthes wrote: ↑

Wed Nov 07, 2018 6:36 pm

Pressure 16.1
Exp Pressure 12.1

These numbers off the machine are what we call 95% numbers and all that means is where you were at OR BELOW for 95% of the night.
Without seeing the pressure graph we can't really know how much time or how low you might have gone
EPAP 95% number is 12.1
IPAP 95% number is 16.1

I suspect all you need is a little more EPAP to better hold the airway open during those times you need more pressure. The machine probably just can't get up to where it needs to be quickly enough to do a good job and yes, probably you are on your back because you can no longer be comfortable on your shoulder.
Maybe as little as EPAP increased to 9 instead of 8 would be enough for you. It's guess since I can't see what the pressure did through the night. We don't even have a median average number to guide us.

I will try and see if my daughter or someone can get the sleepytime program. How do I get the data from my machine to her ? Is it online somewhere ?

If I change that lower setting how mad will my dme and my doctor and insurance provider be. I am supposed to be locked out of all that stuff.

Data storage is done with a SD card in your machine.
Explained in the manual...did you see it and does your machine have a SD card in the slot?
If no SD card in the slot then go to WalMart and get a generic SD card or maybe you have one already laying around the house.

Would your doctor be mad....that I don't know because some doctors are real control freaks and some aren't.

There is nothing in the slots so I guess I need to go buy an SD card for it. In the meanrime here are todays numbers.

Events per hour 3.5
use hours 6.4 hours
Pressure 14.9
Exp Pressure 10.8
Leak 25l/m
Vt 400 ml
Rr 21
Mv 9lm
Ti 1.1 s
I:e 1/1.5
Spot cyc 97.5
Ahi 3.5
Total ai 1.8
Central ai 0