AHI Increasing after Minimum Pressure Change

[clinedj50]

I have been using my DeVilbiss Intellipap Auto for several months and my doctor suggested that I increase my Minimum Pressure as my AHI was running around 8-10. So now my setting are Min Pressure =10, Max Pressure = 18 and my AHI is now running around 12-15. My reports says that Pressure Plateua Time is 17-18. My NOI is 3.2, Leak is 0, and Exhale Puff Index is between 10-17.

I don't understand why my AHI has increased nor what I should do to get it lowered again -- go back to a lower minimum pressure?

Any help would be appreciated.

[Snoregone Conclusion]

There will be someone along that’ll almost certainly ask you to put up the standard array of Sleepyhead charts.

You didn’t break out if there was an increase of centrals as part of that.

Even outside of that, how airflow and our airway anatomy interacts isn’t always “raise pressure to remove all flow limitations” as I found out in my case from experience.

After over time adjusting upward based on data and not seeing the flow limitations go away (they actually went up) I got frustrated and decided if the pressure at and above the sleep study prescription wasn’t getting the hoped-for results, time to try something different, so I set the machine with max range from low to high, then analyzed the waveforms and flow limitations, I found I had the best results at a lower pressure than prescribed.

[nicholasjh1]

There could be quite a few reasons we can't say for sure. It may be you're getting more centrals in which case the pressure increase may be a problem, one solution may be changing the EPR, or it may be the increased pressure is allowing you to get into a deeper more relaxed sleep which increases apneas meaning it the minimum may not be high enough yet. That definitely happens to me. 16 can have 1 - 6 AHI, but 18 has .2 ahi. however if I were to set it to 9 it would only be .2 ahi, but may sleep graphs show me constantly waking up at 9, those rousing out of an apnea state, but there's no way for us to tell you what's going on with you without some charts.

[clinedj50]

It doesnt appear that I can do the charts with the machine that I have without purchasing an add-0n SD Card. So all I have is what Ive given you. Unless someone can tell me how to download the data without an SDCard.

[Pugsy]

You can't do the SD card to get the detailed data from the software without the module which is a separate purchase.
I don't think Devilbiss separates centrals and OAs though....I can't remember.

It's possible that the apnea events you are seeing flagged are central apneas and more pressure won't fix them and in fact for some people it can cause central apneas to increase.

Without seeing whatever detailed data might be available if you had the SD card and module....all we can do is guess.

You might try reducing the pressure and see if the events reduce...if it does then that may be a clue to what is going on.

[Jas_williams]

Can you generate the intellipap smart codes and put in the intellipap website and decode the basic info ?

[Pugsy]

Can you generate the intellipap smart codes and put in the intellipap website and decode the basic info ?

That's what he did to get the above data that he mentioned. That's all you get with the smart codes.

[Jas_williams]

Can you generate the intellipap smart codes and put in the intellipap website and decode the basic info ?

That's what he did to get the above data that he mentioned. That's all you get with the smart codes.

Bummer

[williamwu1107]

I upgraded from Intellipap to Intellipap 2 and I had the same problem as you.
You can take a look at my post and it might help.

[mcs2015]

Just happened on this thread which hit home.

I was @ 6 pressure for the last couple years and just increased it to 6.5 4 days ago to see if it would improve when it actually worsened. Such a small adjustment, it's hard for me to believe this much difference.

Over time, AHI increase has progressed (<4 avg for the last couple years); I was good up until about June (4-5) and then AHI started staying stuck in July (avg 6).

Another observance which I know can be related but not certain is that around same time the jump in AHI, my PVCs started increasing. Ectopic beats can go hand-in-hand.

You can see from the data an increase in periodic breathing and AHI. From what I'm researching, an increase in periodic breathing is an indication of CSA.

My DreamStation settings: https://app.box.com/s/y66bdmdlv6rm4v4crb37ya4so1foapic

Thoughts?

[Miss Emerita]

Just happened on this thread which hit home.

I was @ 6 pressure for the last couple years and just increased it to 6.5 4 days ago to see if it would improve when it actually worsened. Such a small adjustment, it's hard for me to believe this much difference.

Over time, AHI increase has progressed (<4 avg for the last couple years); I was good up until about June (4-5) and then AHI started staying stuck in July (avg 6).

Another observance which I know can be related but not certain is that around same time the jump in AHI, my PVCs started increasing. Ectopic beats can go hand-in-hand.

You can see from the data an increase in periodic breathing and AHI. From what I'm researching, an increase in periodic breathing is an indication of CSA.

My DreamStation settings: https://app.box.com/s/y66bdmdlv6rm4v4crb37ya4so1foapic

Thoughts?

MCS, if you'd like help with your own situation, it would be best if you started a new thread. The images you posted don't tell us what we'd need to know, though. Please download the Oscar software and post a screenshot. There's all the information you'll need linked here:

http://www.apneaboard.com/wiki/index.ph ... OSCAR_Help