ejbpesca

I think I have the AHI concept correct:

The AHI (Apnea Hypopnea Index)score is measured and produced by most CPAP machines. AHI comes from the machine sensing apneas and hypopneas occurring per hour during a sleep session. A score of 5 and under is considered okay. The machine senses that breathing has stopped and if the stoppage lasts for enough seconds (I think 10) it is recorded as either CA (central apnea), OA (obstructive apnea), UA (unidentified apnea, or H (hypopnea). If my score is 5 or under a green smiley face will appear under Sleep Report on my ResMed AirSense. Over 5 and a red frown face appears.

To see the AHI numerical score I must remove the SD card from the CPAP machine, insert it into my laptop, launch the program OSCAR, and import data from the SD card. Daily reports will then be available for AHI scores and a large amount of other data concerning sleep sessions like machine settings, date, hours of sleep, air leaks, and number of apnea events.

Some feel AHI scores can be off due to the machine's falsely identifying apneas. My high AHI scores occur when a cluster of apneas are recorded during a 30-minute to hour period of large mask leaking. This happens when I roll from side to back during sleep. This action knocks the mask off its seal, therapy is not being delivered. How apneas can be registered when the mask has no seal, is something I do not understand. I eventually wake, adjust the mask, and therapy resumes. I feel that the large leak periods of lost mask seal skew the AHI. I would rather see an AHI of only the time I'm getting therapy, excluding the time spent with the mask seal lost.

Some may think my cluster of apneas that produce a >5 AHI score likely comes from my chin going towards my chest which causes restricted air flow, resulting in OAs. I think it is the mask losing its seal that causes these clusters to appear which can be 75 OAs registered in less than an hour. That's over 1 apnea per minute! Not breathing 10+ seconds out of every minute does not sound like an accurate sensing, but maybe it is possible.

Are there any opinions of the AHI being skewed by large leaks?

On its last year of use, year 4, my last AirSense 10 started blowing too much air. The mask was blowing out air at its sides. Turns out the water tank had lost its seal. I removed and installed the tank several times, made sure it was snug into the machine and the problem was solved. The water tank's lack of a seal to the water tank was causing the AutoSet to run up to 20 cm and stay there.

I have had my AirSense 10 auto on/off function fail intermittently, but once manually on it keeps pumping air.

I have experienced dents at the bridge of my nose for years from my full face masks. I have to strap them exceedingly tight to manage large leaks but with little success. Six months ago (after 17 years of CPAP) I got an Evora Full Face which is a hybrid nasal mask of sorts. It does not cover the top of the nose. It is an improvement for me. My AHI score is getting better and large leaks are more under control than ever even though I do not have to adjust the straps nearly as tight. My next mask to try will be a ResMed hybrid the AirFit 30.

I've had tinnitus since childhood starting about 64 years ago. It started when I had what was called, "the mumps." I have been on CPAP therapy for the last 17 years. My five CPAP machines have not caused an increase in the ringing. I have 3-4 fans running continuously to help get my mind off the ringing. Funny, when I read the title of your post, I heard the ringing. Think about it and there it is.

My experience with an increase in CAs came with increasing my minimum pressure from 8 to 10 over a few months. After a month at minium 10cm the CAs have gone back down. I was told a pressure increase can trigger CAs and EPR can raise CAs. I have EPR at 2 full time. My AHI is up and down continuously though so it is hard to figure out what settings are best. Of late I've been getting some pretty good AHI scores. About time after 17 years of CPAP therapy.

My AirSense 10 relieves my chronic allergy symptoms. I guess it filters out dust and mold spores.

My 4th machine was an AirSense 11. I had to return it due to it producing a smell like that of insulation burning on an electric wire. I replaced it with an AirSense 10. I had used AirSense 10 for five years without a recognized problem. The new AirSense 10 works similarly well and seems to be a more robust design than the AirSense 10.

My new ResMed AirSense 11 APAP had a strong smell to its output air. The odor was similar to burning insulation from a failing electrical connection. I returned it and got an AirSense 10 that does not produce a smell. My previous AirSense 10 did not have a smell either. One of my early machines did but it was not nearly as strong as what the AirSense 11 produced. This toxic smell issue is one others have also experienced causing them to also return an AirSense 11. Not sure if A11 is the same machine.

I had to fight off falling asleep at mid-day for most of my working life. It was not until after I retired that I was diagnosed with severe apnea. After sleep test number three I took a nap test. A nap test may produce a diagnosis of narcolepsy. Treatment for narcolepsy can be a prescription for a stimulant. I do not think narcolepsy is well understood and it has a spectrum of severity. Someone with narcolepsy may get 8 hours of good sleep, wake up, and then feel the urge to fall back to sleep soon after waking. Maybe something to consider...a nap test at a facility that does sleep tests.