Hello, new CPAP user here. My question: When you first start using a CPAP after having a sleep study, is it common for your "Events" number to be higher than what they got in the sleep lab? If so, why is that? My AHI was 8.5 untreated, and now for the first 4 nights, 23,14,11,and 6. At least it is trending down hopefully.
From your other post, I believe you are using a fixed pressure AirSense 10 CPAP. Not sure how you got to the point of using a CPAP but the normal way is that you get the sleep lab report which is the diagnosis of apnea. An AHI of 8.5 would be considered in the 5-15 mild category. The choice for treatment at that level is a CPAP or a dental appliance. The traditional next step if the CPAP route is chosen is to do a second overnight study (unless the first night was a split study). This second phase is a titration study where they increase the pressure of the CPAP over the night to see how much pressure is needed to stop the obstructive apnea. That becomes your treatment pressure and if you get a fixed pressure machine then it is set at that optimum pressure determined by the titration. Due to the extra cost of that second titration study the more recent practice promoted by insurance companies is to skip the titration study and just prescribe an automatic CPAP. It then adjusts the pressures.
So, I guess the question would be if you had a titration study? and what was the pressure selected? The second question would be the breakdown of your AHI of 8.5 at diagnosis. Do you know how much was central apnea and how much was obstructive? And does your machine report now report AHI and the portion of that is CA? The reason I ask all this is that there is a condition called treatment emergent central apnea. In other words the CPAP pressure can make the central apnea worse. In most this emergent apnea resolves itself over time.
With those numbers I can sure see why you would want to use SleepyHead. It would identify all the events and when they are happening and the type (OA, CA, hypopnea). One thing you could try if you are not currently getting a detailed sleep report from the machine is to enable the enhanced sleep report if your machine can do it. Here is a link to a technical manual for the AirSense series. What you want to do is change the Essentials setting, which is under Options, from On to Plus. That should give you the most detailed reporting that you can see on page 19 of this manual. The manual explains how to get into the clinical settings, but it basically is hold the Home and Round setting button in at the same time for 5 seconds or so. This will bring up a clinical menu that works basically like the user menu. Scroll down to Essentials, push the round set button and then select Plus. Then Home key out to the User Menu. If this works on your machine, you can then set the reporting period in the Sleep Report section and it will give you the more detailed numbers for the selected time interval.
Since you have only had your machine for 4 days, is there any option to return it and exchange it for an AutoSet? That might work much better for you.
Thankyou for the info so much, Sierra. Yes, I did have the titration study later in the month, which resulted in a setting of 5 and an EPR of 2. The tech didn't try any other pressures on me, but my ending AHI that night of titration study was 3.5. On titration I had No OA at all, I had 7 centrals, and 9 hyponea I do plan call and try to exchange for the elite model which would have the detailed data. But not sure if medicare will pay the higher rental fee .My reading on the web concurred with yours, that the Airsense 10 that I have ,does not have detailed data, but the elite does. Yea! I was able to complete the essentials to the plus setting. We Will see tonight what I get. Thankyou again
With the Essentials set to Plus, I would have thought the summary level detail from your 4 nights so far would have showed up, based on the thought that this summary data is stored in the machine. Perhaps it stores it on the card. Don't know. You have to keep scrolling down past the basic sleep report data to see the more detailed data. The first line should be the interval period which you can set.
Based on the limited data you have, it would seem you have issues with central apnea. Your pressure of 5 cm is only 1 cm above the minimum the machine can produce - 4 cm. That means you have very limited opportunity to reduce pressure. If you can't get AHI under 5 with a CPAP, you may have to explore the dental appliance route, which uses no pressure. But on the other hand a dental appliance is really only effective in reducing obstructive apnea, so it may not work either.
I suffer from central apnea as well as obstructive apnea. What I have observed is that hypopnea can be either an indication of partial obstruction, or it can be a central apnea (reduced breathing effort) that has not fully developed to a full central apnea breathing stoppage. What I am getting to is that your hypopnea events may be related to central apnea, not obstructive apnea. About the only way to determine that is to zoom in on the flow rate graph and see what it looks like. Most often you can determine what type is it likely to be by the visual appearance in SleepyHead.
This all should give you a good case to get a better machine. I would try to get the AutoSet if you can, and if not that then the Elite. The AutoSet can be set to use a fixed CPAP pressure mode, as well as operate in Auto mode.
With the machine set at 5 cm and EPR of 2, it will be delivering a steady 5 cm on inhale. In theory the EPR set at 2, will reduce the exhale pressure by 2 cm from that. However, the machine will not go to less than 4 cm, so it will only reduce pressure on exhale to 4 cm. Bottom line, is that you have very limited opportunity to reduce pressure. You could turn the EPR off, and that may help a little bit, and is worth a try. And pressure could also be reduced to 4 cm for a try. However, that may start to feel uncomfortably low.
Hope that helps some. Here is an article about central sleep apnea to read, if you have not already. Central sleep apnea may have underlying causes which are treatable without CPAP.
And here is another good article from another location at this website.
Thankyou so much. I did scroll down, and the only data I get is average AHI for the 4 nights of use and total sleep hours. I need an upgraded machine. My spouse doesn't think Medicare will cover more than a basic CPAP machine. I'll call my provider in the AM.
I'm from Canada and don't fully understand how the doctor, sleep doctor, DME provider system works. I do know from forums that others do get full Auto data capable machines out of the DME. Your main problem right now is that the CPAP has potentially made your apnea worse, not better, and you have no access to the data to figure out what is going on. Seems like that is a pretty good argument to get a better machine. Perhaps you have to go back to your medical doctor for help/support. If you can establish that your apnea is all central, then make sure to follow the other potential causes, such as medications which may be causing it, or heart and lung issues.
