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My AHI is going up unexpectedly?

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ericj +0 points · over 2 years ago Original Poster

My initial AHI was 6.8, with most of those Hypopneas (Hs), followed by CAs, then distantly by OAs (even though my diagnosis is OSA). I have some machine data from when it was good to great after adjusting my minimum pressure, then I forgot to stick the card back in so I don’t know what changed except for the last two nights. It started getting worse on Tuesday night before a visit to my doctor to get another mask to try out, giving me an embarrassing 1.8, which the tech said was great since most just aim for under 5 (which I can beat by just sleeping on my side without a CPAP).

  • Tuesday: 1.8 (unknown composition, worst I’ve seen since starting)
  • Wednesday: 0.6 (2 hours with a P10 mask that kept waking me before I removed it due to nostril pain and switched back to my Mirage FX)
  • Thursday: 3.4 (stuck the card back in before this one, it’s almost all CAs)
  • Friday: 1.9 (with nearly 10 hours asleep, similar to Thursday)

Looking through the data over time, at the original starting pressure I was seeing a fair number of my baseline types, but after turning the starting pressure up to just under the mean it was nothing but the occasional CA (roughly the number of centrals I had in my study); OAs were gone and Hs were rare (maybe a couple a night, but usually none). My CAs are now higher than they started and the other types remain low to nonexistent.

Are these bogus CAs? Is the CPAP teaching my brain to be lazier when asleep? What is going on here?

I can tell when I had a bad night like Thursday because CPAP seems to reduce my headaches, but it is doing absolutely nothing for my daytime fatigue/sleepiness. If anything, the original complaint that led to my diagnosis is getting worse...

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Sierra +0 points · over 2 years ago Sleep Patron

I see from your posts about a month ago that you are using the AirSense 10 AutoSet. Have you downloaded SleepyHead and are you tracking your results with the software? Apnea and treatment with an APAP is not always simple. It would be really helpful to see a few of your good nights and bad nights using a screenshot of your Daily Report. If you need help with SleepyHead post back and let me know. From what you say in your posts, about all I can say is that your main issue seems to be central apnea. Central apnea is not well treated with pressure from a CPAP. It can be aggravated by higher pressure, and also by EPR. In about 25% of cases of CPAP treatment central apnea can emerge from the treatment. About 75% of those go away after 8 weeks or so. Hypopnea can be obstructive or central in origin, and it is hard to tell them apart. It is possible that some of your hypopnea are central in nature. What is the history of pressures that you have used? Have you used a fixed CPAP mode, or the auto APAP mode?

In any case like I say, it would be much easier to discuss what is going on while looking at some SleepyHead daily reports if you can post some here.

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