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Can Even an AHI of 1 Be Deadly?
I heard back from Dr. Mack Jones that Dr. Barbara Phillips, former president on the NSF, is the physician who has advocated that even an AHI of 1 can be deadly. He included two of her references, below, in his book "Deadly Sleep" (a work in progress).
Here they are: Malcolm Kohler, et al, American Journal of Respiratory and Critical Care Medicine, November 1, 2008. (Even mild sleep apnea ups heart risk) and Shahar et al, Am J Respir Crit Care Med, 2001- (AHI’s of 1-10 are associated with increased cardiovascular risk).
Do you guys think that Dr. Phillips is right, that even "an AHI of one can be deadly"?
Here they are: Malcolm Kohler, et al, American Journal of Respiratory and Critical Care Medicine, November 1, 2008. (Even mild sleep apnea ups heart risk) and Shahar et al, Am J Respir Crit Care Med, 2001- (AHI’s of 1-10 are associated with increased cardiovascular risk).
Do you guys think that Dr. Phillips is right, that even "an AHI of one can be deadly"?
Views: 83
Replies to This Discussion
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Permalink Reply by Steven Y. Park, MD on
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In theory, having an AHI of 1 has been shown to increase your risk of cardiovascular and other various complications. It's a linear relationship. In children, the threshold for an abnormal result is 1, but with adults, it's 5. The danger in not addressing even very mild sleep apnea is that if left alone, it will most likely increase slowly, so that by the time you pick it up later in life, it's become 40 or 50. This is why there's a movement amongst dentists and orthodontists to address these issues in young children, BEFORE their permanent teeth come in.
In practice, however, it's unrealistic to test for and treat everyone that has an AHI of 1 or greater since the vast majority of the population will probably have it, especially if they have allergies or viruses that causes temporary inflammation. I think Dr. Jones is advocating for more awareness that even very slight amounts of breathing problems while sleeping can have potentially serious effects on your health.
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Permalink Reply by Mike on
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i think that if even an AHI of 1 puts a strain on a person's heart, that as a lifestyle choice, just like good exercise and nutrition, folks should have the option to get treated for Sleep Apnea, or at least buy the supplies over the counter. Right now, if you have an AHI of 4, say, it's impossible for you to get treated because the equipment is by order of a doctor's prescription only, and you can't get a diagnosis without an AHI of greater than or equal to 5.
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Permalink Reply by RockRpsgt on
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There is a difference between a a symptamatic AHI of 4 and non-symptimatic AHI of 4. A good doc would be able to tell the difference and hopefully give the right Dx.
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Permalink Reply by Daniel on
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Last week, I heard Dr. William Dement speak, and he talked about the origins of AHI of < 5 being normal. Turns out that he and Christian Guillemanault basically pulled the number out of their ass. They both felt that 1 event per hour was basically normal. One felt that 10 per hour represented problems and the other felt that 3 per hour was problematic, so they settled on 5 per hour. Done. No commitees, no journals, no standards. It has been accepted that an AHI of 5 or less per hour is normal respiration ever since.
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Good story Daniel. How was Seattle? My boss went and had a blast. I have already put my request in for San Antonio.
Daniel said:Last week, I heard Dr. William Dement speak, and he talked about the origins of AHI of < 5 being normal. Turns out that he and Christian Guillemanault basically pulled the number out of their ass. They both felt that 1 event per hour was basically normal. One felt that 10 per hour represented problems and the other felt that 3 per hour was problematic, so they settled on 5 per hour. Done. No commitees, no journals, no standards. It has been accepted that an AHI of 5 or less per hour is normal respiration ever since.
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Hilarious, and worrisome all at once. This confirms my fears about how the figure was derived, and confirms my attitude that almost everyone can benefit from CPAP treatment because almost everyone has an AHI of at least 1. It should be a lifestyle choice about how much strain a person wants to put on his/her heart during sleep, just like diet and exercise are a lifestyle choice that we each make for ourselves. The problem is right now, the devices cannot be purchased on the open market like running shoes or organic produce. They should be.
Daniel said:Last week, I heard Dr. William Dement speak, and he talked about the origins of AHI of < 5 being normal. Turns out that he and Christian Guillemanault basically pulled the number out of their ass. They both felt that 1 event per hour was basically normal. One felt that 10 per hour represented problems and the other felt that 3 per hour was problematic, so they settled on 5 per hour. Done. No commitees, no journals, no standards. It has been accepted that an AHI of 5 or less per hour is normal respiration ever since.
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