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Ater two+ years AHI and AI still in mild range, 20/6.2
Afer two + years, the last 8 months on BiPap, my average for 6 months is AHI 20 and my AI is 6.2. That is better than the last month averages which are 21.1 and 10.9. This is with routine pressure increases, presently 24/20 with 0.22- 0.0 leakage with a total face mask.
I see the sleep doc August 24 and if numbers haven't improved ask for a manometer check on the machine pressure (should have thought of that a long time ago). Although I just called the DME and he said it's highly unlikely if the machine reports the right pressures that it's malfunctioning. Although I've heard on this forum of this very problem.
I guess my next step, depending on what the doctor says, but I'd like to have an idea of a plan, is an ENT workup (long overdue), and perhaps a cardiac workup.
I missed 19 days of machine use 3 months ago waiting for my badly broken down nose to heal before I discovered the total face mask, but otherwise have been totally compliant. .I plan on trying the cervical collar idea- nothing ventured, nothing gained and it's cheap.
I have gained weight since starting CPAP, but am steadily losing. Plan at the present rate at being at my ideal wight in three months (really motivated). I'm 5'4", 157 lbs.
My AI and AHI are slightly worse than when first diagnosed, but I have gained weight. I still take Nuvigil for EDS.
Do y'all think I'm missing anything? Any thoughts appreciated.
Thanks,
Mary Z.
Views: 442
Replies to This Discussion
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Permalink Reply by Melinda Hertel on
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Hi Mary. It is very possible that your machine needs to be re-calibrated. We see that problem all the time. We even have a form that we fill out for the patient's chart that shows what the machine reads compared to what the manometer reads. It's usually not a huge difference--only 0.5 to 1 cm off most of the time. But, it can make a difference for the patient. I even brought my machine into my office to check it and it was 1cm off. No big deal, but at least I know so I can keep an eye on it and make adjustments as necessary. Since you are on the highest pressure that most machines can go, if the pressure is running lower than 24, I would want that adjusted--I'm not sure if it can be adjusted higher if that is the highest setting.
Are you planning to use the cervical collar with your bilevel, or just on it's own?
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Permalink Reply by Mary Z on
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I take cymbalta, geodon, lamictal, klonipin (0.5- 1 mg tid), synthroid, and fosamax, and small dose of darvon at night. Decreasing the klonipin doesn't seem to help, though that may take longer than the amount of time I can reduce it without problems. No c entral on PSG. Would use the cervical collar with the BiPap.
I have hypothyroid, appropriately treated, bipolar disorder and Essential Tremor (with a Deep Brain Stimulater for about 4 months). I've never found any link between ET or Parkinsons and OSA. None of the other conditions seem a culprit unless it's the psych meds, but that would really mean a tradeoff either way to find out. I mean if they are causing it, and I've been on them long term and they're a lifesaver, but the OSA, well at least it's not severe. It's just disappointing not to get those good numbers.
Thanks for your help, both of you. I will get the machine calibrated.
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Well, j n k , that's a good place to start. I'll talk to my doctors about this. My sleep Docs father is also my neurologist and a psychiatrist, so he may be willing to consult on the matter (he may also be a sleep specialist himself). I also see my psych doctor next month and will discuss this with her. She does not know my BiPAP therapy has not been going well. She's pretty savvy and may have some ideas in the meantime. I just might have to bite some bullets, hopefully not so hard they fire. LOL!
j n k said:If I were taking those seven medications (well, 6, not counting the Synthroid) and had an AHI of 20 made up of
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This might be putting the cart before the horse, but I am failing BiPAP. I plan to have the machine calibrated to be sure I am getting the correct pressure and review all meds that I am on to see if any of these could be the cause. Maybe an ENT consult. If we cannot find a cause, is there a step up from a Bilevel machine? I have heard people say they are on a pressure of 30- I did not even know there was a machine that could go that high and I cannot imagine a mask that could work with that kind of pressure.
Thanks,
Mary Z.
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Permalink Reply by Mark Douglas on
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Mary I don't even know what all your initials mean -- Im just getting clear the AHI stuff!
But I do know, from experience, that CPAPS malfunction. That happened to my machine, which never seemed to help me, and was 17 months old. I took my unit in twice before they actually tested it. I think she said it was 25 or 40% off, I forget which, but it was a lot. The respiratory therapist seemed genuinely stunned, and deeply apologetic. The doctor said "well no wonder you didn't use it'
They gave me a loaner, then arranged for a new one in a week. . And these units both HELPED, they made a difference.
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Permalink Reply by Amy on
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Hi Mary - We both have the same height and weight. I have also been slim 115 lbs until my sleep apnea started. I was hoping to lose weight with the CPAP. I have been hungrier, probably due to feeling better but I'm going to try to eat better and exercise more. It's upsetting to weigh so much and I've got to get thinner. I have a closet full of clothes waiting for me from when I was thinner. We'll get there.
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Thanks Mark and Amy. Yes I definitely am going to get the machine checked out- I genuinely hope that is the problem- A malfunctioning machine.
And I've got my weight loss in progress. I gained another 10 lbs after I started watching my eating habits last time- just junk food. Now I'm two lbs under where I started in the first place. LOL.
I can already tell a difference, but unfortunately outgrew my clothes a long time ago, so to fit back into my old blue jeans- well- that will be the day. My sleep apnea was mild when I was normal weight so I have hopes this will help.
I guess this is a situation where no one thing is the culprit, but a combination of factors, each will have to be dealt with. I will be glad to tell the doc next month I am losing weight.
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Mary,
From the reaction of my RT, I assume malfunctioning machines (to that degree), are rare. She came into the examining room, interrupted the doctor, and was apologetic. It's just something to cross off your list.
Oh so weight can be impacted by sleep issues TOO? Well, of course! Makes sense, fatigue, slower metabolism, not to mention stressing your heart. I assume that for some anyway, their weight gain contributes to apnea, which contributes to weight gain, etc. Lovely process!
Mary Z said:Thanks Mark and Amy. Yes I definitely am going to get the machine checked out- I genuinely hope that is the problem- A malfunctioning machine.
And I've got my weight loss in progress. I gained another 10 lbs after I started watching my eating habits last time- just junk food. Now I'm two lbs under where I started in the first place. LOL.
I can already tell a difference, but unfortunately outgrew my clothes a long time ago, so to fit back into my old blue jeans- well- that will be the day. My sleep apnea was mild when I was normal weight so I have hopes this will help.
I guess this is a situation where no one thing is the culprit, but a combination of factors, each will have to be dealt with. I will be glad to tell the doc next month I am losing weight.
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Two days does not a trend make, but Sunday and today I woke up to an AHI of 4.8, and 7 and AI of 0.7 and 2.8. Maybe I'm finally on the downturn!
Will still check on the other things, psych meds, machine calibration, ENT visit?
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I continue to make progress, not every day, but more days with range of AHI below 5. I have change three things. Continue to diet and exercise, losing slowly but surely. My psych doc has gradully decreased my Cymbalta from 90 mg /am to 30mg. I have stopped taking benadryl 25- 50 mg daily for allergies. I am greatly heartened by this progress I have never had numbers this good after 2 1/2 years on cpap/bpap. I will report on the numbers when I consistently reach normal ranges,
Thanks for all the support. Especially the emphasis that there is a problem somewhere and I need to examine everything I am doing.
Mary Z.
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jeff , from 7/31 my AI numbers vary widely- 0.7, 2.8, 16.9 (yes), 9.2, 5.0, 1.3, 8.1, 2.0, 8.9. Some nights I don't sleep well and find myself finally getting off to sleep about the time my roommate gets up for work (3:00am). Those nights I know the numbers will be bad, perhaps because the AI is bad I don't sleep well (feel like I'm not sleeping, but it must be a very light sleep). I'll just wait and let the interventions I've done work, and keep losing weight until I see the doc on the 24th. Still I've never had any AI numbers as low as some of them so I am glad for even sporadic progress. Thanks for your insight. I'd be thrilled with and AHI consistenly below 5.
Mary Z.
j n k said:Benadryl messes with my numbers, too. I no longer take it. With PAP therapy, fortunately, I don't need it.
Mary, what is your AI? If you are consistently below one, your range may basically
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