Well, to say I am discouraged is putting it mildly. I had a sleep study in 2009 where my AHI was 29. I have been using a CPAP faithfully since then.
I had a sleep study 2 weeks ago and after losing 50 pounds my AHI is 35. WTF? Of all the things I expected in this second study it was not having my sleep apnea be worse.
Any thoughts would be greatly appreciated.
Well, my doctor isn't saying anything. I just got a 3 page report in the mail. I am going to call tomorrow to talk directly to the sleep doc. Yes, I do look at my daily figures. I have a really low leak rate and my AI is below 5 on average.
I can't really go by how I feel, unusual as it sounds I had no symptoms of sleep apnea but a little snoring. I always felt great, no different with my CPAP at all.
My SpO2 readings were a low of 87% using the CPAP during the split night study. How can my oxygen be so low with a setting of 11?
When I read the report this time next to the report last time from 3 years ago it looked like something really bad had happened, like I gained 100 pounds or something. Very confusing.
Yes, I think a good long discussion is in order. thanks for your input. I appreciate it. :>D
BeeAsleep, sorry for the unexpected news. I am a normal weight person and my AHI has steadily gone up in the time I've been on the machine. It was 5 my first study- I barely qualified for the machine. Now for the month (on AUTO) the average was 30 and I switched to ASV. Maybe the talk with the doc will yield some answers. It's good to see you posting, just wish it had been great news.
Hi Mary! I have missed being on SG, hope you are all doing well.
Yes, I had hoped for better news. The first call I make today is to make an appt with the sleep doc. It is good to know that someone else has had this sort of thing happen..the bottom line is that I need the CPAP and I need to stay up on my treatment regardless of the direction it takes me.
Thanks for the support. :>D smiles. b
One thing you would want to look at first is the previous report. Was your study conducted in supine, right/left side or prone. In my experience alot of labs are conducting studies and "titrating" pts on their sides, then when the pt is at home undergoing treatment they sleep in supine and now they dont have enough pressure. If that isnt it you would want to turn to haw long your apneas were. Your ahi might have increased due to the length of the apneas decreasing. Dont look at it as a negative. Also, auto-sets are the worst thing out there. Patinets should always have a titration done by a competent lab to correctly determine proper titration pressure. ASV should only be used in cases that are CSA and Cheyne-Stokes when deemed necessary.
Thanks so much for your response. I did have my study with supine, right and left side and prone. The sleep study was done by the Boulder Community Sleep Disorders Center, my last sleep study was done through National Jewish Hospital in Denver. I just made an appt with my sleep doc, a pulmonologist. The sleep lab is a good one, the tech was very thorough. I convinced the doctor to see me before MAY! I told them my oxygen was low, WITH my CPAP, and I wanted to get in asap. So I have an appt for the 23rd. I hope my questions will be answered.
Thanks for telling me that the numbers don't mean that I am sliding down hill as fast as I can go! lol I was beginning to wonder since I am very compliant in the use of my CPAP. bee
That's really odd. Maybe something medical is going on with you not related to sleep. I just found out that my vocal cords close when I inhale; that can't be helping my sleep either so it could be something odd like that going on with you.
The difference between an AHI of 29 and an AHI of 35 is statistically insignificant. There are many variations in the way we sleep and breathe from one night to the next.
You should have that discussion with the doc on the 23rd.
But most importantly, do you have a card reader and software for your S8 and are you using it to track the performance of your CPAP therapy?
If not I highly recommend upgrading to the ResMed S9 AutoSet machine and downloading the free software to monitor AHI, pressure, mask leak, etc. The S9 AutoSet uses a standard SD card and you probably already have a SD card reader.
Without the data capability you do not know whether CPAP is working at an acceptable level of effectiveness for you. Once you have the software, understand the therapy, and monitor the results regularly, you will never want to be without it again.
If your weight changes again you can see the effect on your therapy and know when adjustments must be made.
Congratulation on the weight loss!
Reply by jeremy gober
In my experience alot of labs are conducting studies and "titrating" pts on their sides, then when the pt is at home undergoing treatment they sleep in supine and now they dont have enough pressure.
Where did you get this experience? I have the opposite complaint - labs titrate in the supine position and the patient ends up with an intolerably high pressure that could be reduced if the patient agrees to avoid backsleeping.
Reply by jeremy gober
Also, auto-sets are the worst thing out there. Patinets should always have a titration done by a competent lab to correctly determine proper titration pressure.
If you are saying that some labs use data from an APAP machine to titrate the pressure that is strange news to me. Every lab I am familiar with has a technician adjusting the pressure to an optimal level during the titration process.
If, on the other hand, you are suggesting a patient home titrate using an APAP (AutoSet is the trade name of certain ResMed machines) set at 4 - 20 cm, I would agree that this is not the correct way to titrate. Titration can be done at home by an OSA patient with a little knowledge, a data-capable CPAP or APAP machine, and the machine software. But I do recommend the patient have an in-lab study and fully understand his diagnosis and comorbidities if any.
I do have the software to read my data, and I guess that is why I am so surprised. My AI reading is low and my leak rate is low....so I thought things looked great from my end. I will print out my home data and take to the appointment with me.
I have to say that when I was first diagnosed with SA 3 different doctors, including one from National Jewish Hospital (my asthma doc) told me that if I lost 50 pounds I would not need the CPAP machine. Hummm. I knew that was not absolutely the case because I was on this forum...so I wasn't surprised with my continuing need for the CPAP. It is good to know that 29-35 is not statistically significant. I will bring this up on the 23rd as well.
I think I am most concerned with my low oxygen rate WITH my machine. My rate was 78% without the CPAP and 89% with the CPAP. I live in Boulder, Colorado, so we are at a pretty high altitude..but I still think 89% is low with a CPAP.
Yes, having lost weight has given me many other wonderful health benefits, as well as being able to fit into my skinny jeans again. lol