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zaspan
  Unread post  Post subject: Same mask + different CPAP machine = higher AHI  |  Posted: Sat Dec 23, 2017 11:54 pm
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Joined: Sat Dec 23, 2017 11:10 pm
Posts: 3
PAP Mask: Phillips Dreamwear
PAP Machine: Fisher & Paykel Icon Premo+
Pressure Setting: 7

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It's my first post to this forum however I've been on and off CPAP machines for a few decades now. Having rejoined the plastic lung crowd, after getting help with a local hospital's sleep lab, I'm not getting the results I was hoping for. There are a number of considerations here and I'm hoping someone can advise/suggest something I could try.

To put the subject heading in context, said sleep labs gave me a CPAP machine to trial as I adjusted back into using CPAP. I tried a few masks but settled on the Phillips Dreamwear mask, which I have been using with the hospital-loaned machine and my recently purchased one. Personally I have mild OSA, which the lab determined I could treat using a fixed pressure CPAP set to 7. The results that came from the Resmed 10 CPAP (set to fixed pressure) showed AHI values consistently below 1. Lately with the (recently purchased) Fisher & Paykel Icon Premo I am getting AHI readings between 3 and 5. Although this is still acceptable I am wondering if the Icon is interpreting things differently or could the machine be performing 'less' than the Resmed 10 unit?

If the AHI readings were slightly higher the CPAP treatment would be pointless as this is what I was getting without treatment. Some may ask why I'd bother with CPAP with such a mild case of OSA. To answer, my doctor has recently diagnosed me with Chronic Fatigue Syndrome, and has suggested OSA may only be part of the problem, with other causes yet unknown.

As a side note, previously I had a weird reaction using the (previously purchased) Icon Premo, which I sold shortly after due to not finding a resolution to this reaction and receiving no proper medical assistance. After using it for the first night I experienced vertigo, to a point where I had to 'compose myself' before getting out of bed, ie dizzy to the point of almost throwing up. Any exertion during that day lead to a short dizzy spell where I'd need to grab hold of something as I felt I was going to drop. This time around (starting on the loaned Resmed 10) I had a brief recurrence of this vertigo problem but haven't experienced this issue for some time now.

Basically I'd need to know if this higher AHI reading is a 'non issue' or is this unit no good. I have heard good things about the F&P Icon Premo, and both the Resmed and Icon Premo were using a fixed pressure of 7 so it make it hard to believe it's due to the machine, ie if I was still tired after using an autoset I could consider it (possibly) an autoset algorithm issue, but fixed pressure is fixed pressure.

Hopefully I didn't rattle on too much. It would be great to hear suggestions or get advice as my next sleep lab appointment isn't til February. At the moment I'm having to prop myself up on Modafinil, which I'd rather not. This stuff has a 12 hr half life. :shock:


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Pugsy
Unread post  Post subject: Re: Same mask + different CPAP machine = higher AHI  |  Posted: Sun Dec 24, 2017 6:20 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 747
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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You aren't the first that I have seen with different AHI results using different brands of machines and even at fixed pressures.
I think it has more to do with the potential differences in sensing and recording than it does with supplying the fixed pressure.
If you were using auto adjusting pressures then we might say it is the auto adjusting algorithm in each brand that might be different but fixed pressure is fixed pressure.

Sounds a bit like BPPV ear issues and while not normally made worse with Cpap...if the little tubes to the ears from inside the nose don't close off real good it can maybe make things a little worse.
I have BPPV but fortunately cpap pressures (any pressure even high pressure) doesn't seem to make mine worse.

So that leaves maybe the sensing and recording and maybe event definition criteria that might be different.

If you are sleeping decently then I don't know that I would worry about it.
Now you could maybe try just a little more pressure to see if the "numbers" improve if the "numbers" bug you too much but I would be very careful with your history of potential ear issues.


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zaspan
Unread post  Post subject: Re: Same mask + different CPAP machine = higher AHI  |  Posted: Mon Dec 25, 2017 2:34 am
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Joined: Sat Dec 23, 2017 11:10 pm
Posts: 3
PAP Mask: Phillips Dreamwear
PAP Machine: Fisher & Paykel Icon Premo+
Pressure Setting: 7

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Thanks for the reply.

My main concern was if things got worse changing machine. I am sleeping 'better', ie nocturia has definitely reduced. From memory I think Resmed has settings to accommodate for particular mask types whereas the Premo doesn't. Maybe this explains the AHI difference?

Can't say I've ever heard of BPPV, but seems the likely issue. No recurrence to date so I think it was a new-starter issue, although I never had this when previously starting with CPAP years ago.

I'll give your suggestion of increasing the pressure slightly a go and see what happens with the numbers.


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cindyY
Unread post  Post subject: Re: Same mask + different CPAP machine = higher AHI  |  Posted: Fri Dec 29, 2017 1:42 pm

Joined: Sun Apr 23, 2017 8:34 pm
Posts: 439
Location: Southern California
PAP Mask: AirFit P10, Swift FX, Swift FX Nano, Eson2
PAP Machine: Resmed AirCurve 10 VAuto in S mode
Humidifier: Integrated set to 5 @ 81F; ClimateLineAir heated hose
Pressure Setting: IPAP 19 EPAP 15

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Maybe you can check out your readings with SleepyHead and get an idea if your F&P is flagging non-events as events.


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zaspan
Unread post  Post subject: Re: Same mask + different CPAP machine = higher AHI  |  Posted: Mon Jan 01, 2018 12:27 am
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Joined: Sat Dec 23, 2017 11:10 pm
Posts: 3
PAP Mask: Phillips Dreamwear
PAP Machine: Fisher & Paykel Icon Premo+
Pressure Setting: 7

Offline
cindyY wrote:
Maybe you can check out your readings with SleepyHead and get an idea if your F&P is flagging non-events as events.


I've been doing that after some hacking to make sleepyhead work in Linux.

I tried a slightly higher pressure but my AHI readings went up, but I can't conclude the higher pressure was to blame, ie it doesn't make sense that it would. I think I need to fix the mouth leak problem which has become more common since restarting CPAP, ie earlier I didn't notice it as much and the readings didn't reflect these higher AHI readings. Recently I have been using my chin strap as a partial mouth blocker with limited success.

I may need to go full face mask as 2 chin straps I've used to-date haven't worked too well.

Having heard suggestions of such, I tried taping my mouth closed. That went badly as I had an apnea event, which had me almost leap out of bed tearing the tape off and gasping for air. This was at the prescribed fixed pressure of 7, ie I dropped it back from the slightly higher 7.5. I'm slightly tempted to re-try this on the higher pressure, ie no leaping out of bed to tear the tape off means no apnea, right? :lol: :o

A follow-up at the sleep lab isn't til Feb but will call them as soon as their sleep labs people return to see if I can try an Amara hybrid full face for a while. Unfortunately it's a little bit of history repeating here with all these issues surfacing and no help available except to throw money at the problem (again), which really isn't an option I want to entertain. :(


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cindyY
Unread post  Post subject: Re: Same mask + different CPAP machine = higher AHI  |  Posted: Mon Jan 01, 2018 10:51 am

Joined: Sun Apr 23, 2017 8:34 pm
Posts: 439
Location: Southern California
PAP Mask: AirFit P10, Swift FX, Swift FX Nano, Eson2
PAP Machine: Resmed AirCurve 10 VAuto in S mode
Humidifier: Integrated set to 5 @ 81F; ClimateLineAir heated hose
Pressure Setting: IPAP 19 EPAP 15

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Have you tried a mouth guard? I couldn't do the double sided kind, my mouth is too small, but I found a thin kind from the market helped to train my mouth to mostly stay closed. It's just another tool for your toolbox.


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