Your CPAP AHI is WRONG. (Bilevel, APAP, ASV AHI too)

[@Freecpapadvice]

Any of you notice you still feel horrible even with a low AHI? Thank you for watching! All comments welcome. Links: 1. Have a PAP Analysis with me at: axgsleepdiagnostics.com 2. As an Amazon Associate, I earn on Qualified Purchases: amzn.to/3drPax1 Check out my latest VIRAL Use my CPAPSupplies.com (affiliate link): bit.ly/38yPlXk Use Discount Code: LEFTYSUMMER for the month of June for 25% off. Past June? You can always used LEFTY20 for 20% off. 😂 cat channel video. Really got some people heated: kzbin.info/www/bejne/rZnNgoV7hKdqd7csi=orH4N9_vkwKxiPdC Check out my new Amazon Store: www.amazon.com/shop/thelankylefty27 (or....use my Amazon affiliate link every time you shop Amazon. I earn on all qualifying Amazon Purchases using the link. Thanks!) Join this channel to get access to perks: kzbin.info/door/g_Rj5qrxlCo4OX6MMq08gQjoin

[@FullAttach]

I have severe sleep apnea. I’ve been struggling with this condition for decades. I’ve had numerous sleep studies and doctor visits. I am still struggling to this day with CPAP/ASV therapy. The lack of innovation in this area and the lack of any sense of urgency by doctors I find astounding. I know my life is being shortened by years.

[@smokingtarheel3003]

If you can, have a PAP analysis by Jason at the link above. Who knows, he might be able to help. He certainly helped me. Doctors can be frustrating. Don't give up.

[@calengr1]

@@smokingtarheel3003 how specifically did he assist ?

[@andrewpersaud4144]

Take up running and then run at least 5 times a week. It will at least decrease it from severe to mild. You'll still feel like crap but relatively you will feel better

[@CounselorsinChrist]

This is random, but if you haven't tried it yet, consider a memory foam mask, like the airtouch f20. Had lots of issues, but for me the mask changed made a world of difference. In my case, many of my issues came from the mask.

[@Septeemberpain]

The lack of innovation is astounding

[@cris_miko]

I would love to see an analysis like this with an "after" version where adjustments to pressure have dramatically improved sleep.

[@flowsy5294]

thats what i want to see too since im in the same boat. Low AHI under 1, still tired.

[@cebruthius]

3:17 Real doctors response: "I didn't, and you're a crazy health anxiety hypochondriac for even bringing this up"

[@CPAPReviews]

I hope you got lucky after that shave and haircut

[@mrunknown6842]

I love your videos, big fan of yours, your tips are so useful

[@georgesantiago45]

Thank you...don't ever change. You're a great funny resource, and the wealth of information is awesome.

[@stevecrim4557]

YES - my sleep has been a train wreck for about a year which correlates with starting V-Com. Not blaming V-Com but this video made me go back and look at my Sleepy Head data. From that point on those little bumps you just talked about started showing up in my charts. I also started getting RERAs which were new to me. My pressure was normally 7 but raised it to 8 after starting the V-Com. I'm going to remove the V-Com and see if there is an improvement. I read that a lot of people love that gadget so I may just be the odd guy out. Regardless, my sleep is worse right now than before even starting CPAP so I am looking at everything. Thank you for this video and the charts...

[@nikkismom857]

@stevecrim4557 - did it improve after raising your pressure?

[@stevecrim4557]

@@nikkismom857 It probably works great for some people but I had to remove it.

[@ASpectacular3777]

Glad you brought this up; this needs to be discussed and known by all who rely on the MyAir app.

[@jamierick79]

My husband has an ASV and will have nights where he has high events but feels well and then he has nights where his events are low and he feels like complete crap. Is there a reason for this and how can he get more quality sleep?

[@Septeemberpain]

So the solution is to learn how to read the whole data (aka the wave of the study) and adjust your own pressure accordingly? Thank you for this information I’m tired all the time and use my CPAP religiously

[@maryrollins607]

Nice to see ya Ja-son. I totally get the perspective on the ring. I have one, used it for a while, it was a stop gap of sorts when I had a harder time reading the data and still felt like poooo. I’m doing better overall, not as good as I want but trending the right way. Took my brain, with some excellent help, a while to “get it”.

[@OBD01]

Love the data videos! Just went to new pulmonologist and that is exactly what she said. "Your AHI is great, anything under 5" I responded "That is not what LeftLanky27 told me!" But she was able to get my 15 year old AirCurve 10 replaced with a new one with insurance so not all bad.

[@MichaelMulholland1]

I'm new to a CPAP. I have the ResMed 11. The software you show on the screen with more details than what's showing on the MyAir app. What is that and how does data get from the rosemead 11 to that app?

[@cebruthius]

10:50 The sleep medicine industry needs more, much more angry energy :D

[@FullAttach]

Thank you. I have the N20 with memory foam, and it has helped.

[@jimihendrix1998]

Hope you see this Jason, would love some help. Getting desperate now. I use the tape you suggested in another video, but recently I'm waking up a lot with a dry mouth, it's like I'm forcing air out of the tape while sleeping. It isn't just a leaking a bit, it's gushing out and I'm waking up so tired it's like I'm not even using cpap. I can't do my job properly like this. I'm exhausted

[@OneIdeaTooMany]

THIS IS 1000% spot on! Fantastic video! I have an average AHI of less than 1. 0 leaks thanks to my LENA full face mask. My o2 ring and watch say my spo2 never drops below 94% yet I still don't feel fully rested. Using your videos I see I'm still seeing hypopnia's that are less 10 seconds and not being picked up. I see lots of arousals and position changes and this is happening even at pressure levels of 20 or very close to it... I filmed myself while sleeping so I could align the footage with my sleep data and it's clear the higher pressures are required while on my back but 20 doesn't seem like it's enough. I think I've gone as far as I can on my own and probably need professional assistance to move forward but this video at least aligns with what I've been seeing using my own ring, galaxy watch 4, airsense 10 and o2 ring...

[@Sneaky-stab]

Look at his video on bipap or mandibular advancement device +cpap

[@af1966]

Try to not sleep on your back. Sleep on your sides.

[@jamesbruzgis9476]

This is me again. The BRUZA needs another review fm the Cpap goat!

[@eddiememphis1]

So how do you stop the arousals? Just keep increasing the pressure until they stop?

[@scowell]

Lab titration is the gold standard... someone watches your EEG, O2, etc etc and adjusts the pressures. I'm on bi-level now, 21/17... herculean pressures... but few arousals.

[@ryansherwood7136]

@@scowell Do you feel significantly better at these higher pressures?

[@ryansherwood7136]

I'm wondering the same thing. Wouldn't central apneas start to occur at higher pressures?

[@scowell]

@@ryansherwood7136 Yes... my sleep efficiency went way up, according to the lab report. Above 95% O2 all night... hitting 99% sometimes. Popping zeros just about every night.

[@Freecpapadvice]

It all depends on what is causing them. Leak? Obstructive events (OSA, OSH, RERAs)? Mode of therapy? Can be one, two, or all. 9 times out of 10 increasing the pressure is a step in the right direction.

[@Dan-dg9pi]

Great video. As always.

[@Curiousgeorge47]

Although the o2 ring doesn’t detect what sleep position you are in, you can compare the movements to the flow rate and that how you can certainly know that you are sleeping on your back.

[@JosephBolen]

I’ve been getting low AHI results (

[@rickperoni250]

If you don’t use wearables, how are you supposed to know if a oral appliance is working and where to titrate it?

[@andrewpersaud4144]

Do the algorithms change per machine or do they update with the same software like different cell phone generations? My air sense 10 gives me an AHI of 5-7 and my air sense 11 ranges between 0-1.5. Energy wise I feel like the 5-7 is more correct. My eyes are closing while typing this.

[@why-r7g]

Some thing is wrong my averg AHI has been under 7 last night it showes it being 51 I use Dreamstation 2.

[@Ndersso]

Is there any device I can buy for at home self analysis of how my dental device setting is working for me? I have big trouble getting adequate help from the healthcare system in my country.

[@jorisbonson386]

Hi Jason, are you saying that RERAs are typically caused by positional changes then? Because my AHI is fine but I'm absolutely wiped out every day and my Zeo is showing only 30 mins of deep sleep each night... when correlated with flow rate data in OSCAR it does look like RERAs are responsible.

[@robertbillings8869]

what happens if you stop using your bi level machine (resmed)

[@harold3184]

Maybe I missed it or misunderstood, but can this arousal pattern of spikes be read as easily using SleepHQ?

[@SilentServiceCode]

I mean those flat tops WOULD trigger flow limit-driven pressure increases, but it's set on CPAP.

[@NicK-gw6go]

How do we reach out to you these days after paying for a consultation session?

[@fracman55]

I’m sleeping well but still waking up in the morn,average. 7 hours a nite ,and still feel tired on CPAP using nasal mask and I use mouth tape .i dont agree with her my sleep doctor said my numbers were awesome but sleep doctor is not willing too turn up- my pressure a little more . max on set pressure is only 10 .my AHI numbers have been under 5 for a long time now .on my resmed 10 .i know how to change the settings did it once and she lost it .

[@devnull1313]

I annoyed my slleep doc for reducing my max ramp pressure down from 15 to 5. (So it's basically a constant 5.) But when the algorithm as originally set reached 6.6, it was blowing my mouth tape solutions wide open. Morning dry Mouth isn't just a minor inconvenence for me. Just ask my dentist. If I have to choose between dentistry and voodoo, I'm going with science.

[@mrunknown6842]

Do what you need to for your own survival, change your pressure if you need to and screw these doctors

[@itzMeWilly]

Lanky I hate to ask but is there a way to contact you about possible pro bono cpap review via OSCAR. I’m just suffering trying to find the right settings, everything should be working but I still wake up choking and ripping my mask off, thanks!

[@matthewaustin796]

What about transferring a machine to another person? When I was diagnosed, my sister had an AirSense 11 that she didn’t need because she liked her AirSense 10 better. She mailed it to me. Are we criminals now? I did have a prescription but didn’t get it through official channels. She owned the machine free and clear.

[@af1966]

no you are not criminls. Use it and set your correct pressure.

[@debbiebridygham9230]

So are the detection algorithms in the BiLevel units better at detecting hypopneas, and how does the FDA and other regulatory agencies let these manufacturers get away with this?

[@rexwine]

Sorry, can't quite figure out what is ironic or satire here. I've been wearing a fitbit to bed for about a year and half, and now that I've started cpap it has finally done an analysis of the bare minimum of 3 hours sleep which it has never done up to this point because it never detected that i have had 3 hours. First time ever it is showing some REM sleep. But still waking up tired, so there's that. Since the cpap isn't at all connected to the fitbit, I assume there has been a change for the better though.

[@greggleswong]

Thank f*ck KZbin recommended this video to me! I wonder if ResMed will try to cover its *ss with the next machine or some firmware update...

[@Dogsallday14]

How do I get Oscar? I have an iPhone and iPad. Do I need a real computer with windows? I’m new to Cpap 17 days. Swallowing so much air and I’m sooooo sleepy help

[@en2oh]

Do you have a sleep doctor monitoring your settings? I’m amazed at how much energy I’ve got with even only a few days on APAP. My doctor looked at the initial data and adjusted the minimum pressure upward and I have to say, even as a trained MD, I value the expertise of a good respiratory tech and sleep doctor guiding my therapy. These forums are great for improving my understanding of the therapy but it more provides me with the knowledge to ask more relevant questions with appointments (typically now by phone). If my doctor wasn’t interested in discussing my concerns, I’d find a different doctor.

[@CowboyTrucking61]

I was subscribe am ASV machine 5 years ago, I quit using it a week ago. I can't stand the darn thing with the mask and the air blowing. I've tried several mask over the years, could not get used to any of them. This last week without using the machine I get better sleep each night then I ever have been, sleep 8 to 9 hours per night without waking up. I still think its a scam for Doctors to make money from insurance companies.

[@johnhancock8267]

Solution?

[@ahn0x]

A bit tired of messaging that goes "don't trust anyone" & then still no solution...

[@flowsy5294]

@@ahn0x Same tbh.

[@Freecpapadvice]

I do have recent videos where I show just that: kzbin.info/www/bejne/g33TXpSjobmUaNksi=hPGpBfsiTWsISQgk at the 1415 minute mark. The problem with saying ONE solution is that everyone is different. People respond to pressures differently (stiff airway vs slack airway), Aerophagia thresholds, Central Apnea thresholds, interface (mask) problems and of course leaking. There isn't one simple fix that works for everyone. So I hear your criticism....it's fair. I'm just letting you know that I've made some videos that I feel are very straightforward and they are interpreted the opposite of what I intended. The video is that AHI reported by the machine is bull$hit.....it is. Sometimes it over estimates.....sometimes underestimates. The fix can be anything if you're still tired. More often than not it's a pressure increase of some variety.....or leak fix. Not just one solution, but many that would result in a 30 minute video.

[@Thatsmessedupman]

Why do I get high Central and AHI an hour in when I was not asleep? if not asleep yet why does it say there are events?

[@BigWingUK]

The machine doesn't know when you are asleep. Hold your breath for 10s while turning over to get comfortable, for example - which is quite common - and your machine will register an event!

[@catallergiccat]

Thanks Jason! I need a higher pressure and I wish I could. My problem is the aerophagia would kick my stomach even harder if I do. Even now when I am on low pressure, I got chipmunk cheeks all night long if I tape my mouth completely, otherwise leaks would destroy everything. Ive also got UARS, bilevel doesn’t seem to help but gives me a lot more centrals. VCom helps but not too much.

[@Freecpapadvice]

Sometimes it's higher pressure needed to get rid of aerophagia.....that and eliminating leak. Bilevel really needs to be titrated carefully, so it really might work for you.

[@catallergiccat]

@@FreecpapadviceThank you Jason! I understand that insufficient pressure can also cause air swallow, and it might be my case. Or rather it is my loose LES, air is forced into my stomach (as some research suggests). I definitely need extra pressure support to push away the meat, as I found flow limitation looks better when PS is activated (2 to 3). I can eliminate leaking by firm mouth taping, but it doesn’t get rid of chipmunk cheeks, that phenomenon can occur all night long and keep waking me up. I even attach the vcom when using BiLevel, I know they are conflicting, but it does make the therapy a little more tolerable to me.

[@arnoldoliphant8680]

Algorithms to find and reach optima are well known in many industries. I’ve helped develop some of them, but I’ve been laughing and cursing at my 11 auto data now for several weeks. Frequent overshoot and undershoot. How does our FDA accept this crap. I think first grade kids could develop better code than these ResMed algorithms. I’ve been trying all the ResMed variants. So far, they all suck. Auto is a great idea but so poorly implemented that it’s killing Americans. ResMed fire your algorithm coders and get some good ones. I’ll join the cult.

[@FFOGHORN]

I have a shitty attitude just like you, but I lack your charisma, so life is hard.

[@Freecpapadvice]

🤣 .......thank you?????

[@BigWingUK]

I try to watch all your videos, as I am fairly new to sleep apnea and am learning a lot from you and similar experts in the field. Mind you, I strongly believe that you would be taken more seriously - and look far more professional - without the numerous annoying breaks to 'Legoman' and gimmicky video effects. I think they just detract from your message. Anyway, this video had me confused about a couple of things. 1. Throughout the video, you talk about arousals and awakenings interchangeably. For example, at 1m35s you introduce the spikes as representing awakenings. Then at 1m46s you start calling them arousals - and then switch again. But isn't it well known that not all arousals cause an awakening? I believe that an arousal can be a shift from deep to light sleep, or from sleep to a state of being awake. At 2m35s, in the expanded waveform you show, you call the change in shape an awakening - and yet the breaths *immediately* following it look to me exactly like sleeping breaths and not at all like awake breaths (or even "sleep wake junk"). Don't you agree? 2. You show concern for there being ~36 of these 'occurences' per hour, but I understand that normal young and middle aged adults average around 15 arousals per hour anyway - and older people maybe double that. I don't know the age of your subject but surely it may not be too much over the norm? Unless of course you really do think these are awakenings....once every 2 minutes?!

[@jamesf8783]

Not horrible but definitely sub optimal like i need to try bipap or asv. It appears my emails or your replies are lost in the abyss lol. Id like to do another analysis/speak zoom.

[@Freecpapadvice]

Our last correspondence it looked like your questions were answered. Just double checked.

[@anneg8319]

Dumb question. With resmed 11 I've set my pressure from 8 to 15 but in the "my view" it says pressure is 10.4? Not sure what that means? Should I set my minimum pressure to 10.4? Or maybe 11? Thank you in advance. Also, I've been told sometimes position awakening can be from pain/discomfort and pain med of some kind can help?

[@flowsy5294]

So the way to fix Low AHI but still tired, is to raise pressure?

[@catallergiccat]

Yes, and deal with the complications. Good luck

[@Freecpapadvice]

Or there is high leak, or it's an inappropriate mode of therapy. There are a lot of "simple" things that greatly effect the outcome.

[@Dogsallday14]

I all these cases isn’t auto the best mine is set at 6-20 I turned it down to 15 oops 😊

[@droptozro]

I get AHI between 1-3 most nights. Still dont feel best cause I see issues in the data too from morwle waking events. Yeah i wake up way less on APAP vs none, but still tired, puffy eyes, mostly CA events all night. At least my sleep doc is going to put me thru a study with BiPaP to see if theres any difference.

[@gilrose12345]

O2 ring is NOT accurate at all! Nonin Wrist ox with nvision software is the only solution.

[@jamesbruzgis9476]

YOUR WELCOME