"please keep me updated about oximeters "
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Changes in AHI and perception of "how I feel"
I was in Florida for a few weeks -- a change from my home in VA. Almost immediately, I started feeling worse, more tired during the day, a little more grumpy...almost like I was starting all over again on my auto titrating bipap therapy. I was checking the daily numbers (ahi, leaks etc) on the LCD of my respironics auto bipap and could see that the averages were going up. After a about a week (I didnt want to be obsessive and wanted to give it chance), I pulled out the reader and looked at the stats for the individual days and the trend.
As I would have guessed, my AHI (mostly AH) climbed from about 1.1 ish pre Florida to about 3 while in FL. My average pressure numbers on the autotitration were rising from about 9/12 to more like 15-16 on the inhalation (dont remember the exhale at the moment).
I made several dramatic changes and almost immediately all my numbers started heading in a more positive direction (AHI average around 1.1 with a number of nights below that)...pressure coming way down etc. I started to feel better (except for a later bout of asthma which I think was unrelated)
Here's my question:
I understand that "they" say that waking up every 12 minutes (ie 5x an hour is normal :-)
I reported my experience to my sleep doctor and he said that it was unlikely that my feeling better was related to that small a drop in my AHI and that it was a coincidence....and that anything under 5 is considered normal. He said that there were NO studies that showed any difference in sleep quality once you got under 5 AHI. So, their would be no difference in how someone feels at 5 AHI versus 1....
I like him and he has worked pretty well with me during this period....and we are entitled do our differences, I suppose.
I am eager to hear what your experiences have been once you get under the "normal" AHI 5 range.
(As an aside, and not to bias your responses, I am betting that the 5 is normal number has something to do with insurance cut offs. It is impossible for me to think that people REALLY think that waking up 40 times in one night is OK or normal. (5AHI x 8 hours).
What does your experience suggest?
As I would have guessed, my AHI (mostly AH) climbed from about 1.1 ish pre Florida to about 3 while in FL. My average pressure numbers on the autotitration were rising from about 9/12 to more like 15-16 on the inhalation (dont remember the exhale at the moment).
I made several dramatic changes and almost immediately all my numbers started heading in a more positive direction (AHI average around 1.1 with a number of nights below that)...pressure coming way down etc. I started to feel better (except for a later bout of asthma which I think was unrelated)
Here's my question:
I understand that "they" say that waking up every 12 minutes (ie 5x an hour is normal :-)
I reported my experience to my sleep doctor and he said that it was unlikely that my feeling better was related to that small a drop in my AHI and that it was a coincidence....and that anything under 5 is considered normal. He said that there were NO studies that showed any difference in sleep quality once you got under 5 AHI. So, their would be no difference in how someone feels at 5 AHI versus 1....
I like him and he has worked pretty well with me during this period....and we are entitled do our differences, I suppose.
I am eager to hear what your experiences have been once you get under the "normal" AHI 5 range.
(As an aside, and not to bias your responses, I am betting that the 5 is normal number has something to do with insurance cut offs. It is impossible for me to think that people REALLY think that waking up 40 times in one night is OK or normal. (5AHI x 8 hours).
What does your experience suggest?
Views: 52
Replies to This Discussion
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Permalink Reply by Rock Conner RRT on
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Based on your report I agree with your physician that an AHI change from 1.1 to 3 is unlikely to yield a perceptible change in symptoms. I suspect that the IPAP jump from 9 to 15-16 is more likely to be involved.
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Permalink Reply by Judy on
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WELCOME BACK, Rock Connor!!! Haven't see you post in quite a while. Or have I been reading the wrong threads?? Good to see you posting.
Rock Conner RRT said:Based on your report I agree with your physician that an AHI change from 1.1 to 3 is unlikely to yield a perceptible change in symptoms. I suspect that the IPAP jump from 9 to 15-16 is more likely to be involved.
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Permalink Reply by Mike on
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I think you're right to be suspect of the doctor's claim that anything under 5 doesn't merit attention. A friend of the family just told him that he was "cured" of Sleep Apnea because his severity was too "moderate" to worry about.
There are plenty of folks on here -- Dr. Mack Jones included -- who would say that any AHI over zero puts undue strain on the heart.
Of course, it's not realistic for most of us to attain a perfect AHI. I suspect most of us would be very happy with your results. Congratulations on getting it that far under control. And keep up the good work problem solving and searching for an even more restful sleep, irrespective of what the doctor says.
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Permalink Reply by RockRpsgt on
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I agree with Rock. Go figure eh
Rock Conner RRT said:Based on your report I agree with your physician that an AHI change from 1.1 to 3 is unlikely to yield a perceptible change in symptoms. I suspect that the IPAP jump from 9 to 15-16 is more likely to be involved.
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I just assumed that the jump in ahi and the increase in ipap were related to eachother...ie. sleeping worse, require higher pressure to eliminate apneas etc...
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Permalink Reply by bonesigh on
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Just a suggestion. Maybe you were having asthma problems but had not noticed it yet? Your apnea's increased because of the higher pressure needed.
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I think that you could be right on that....thankfully, things are starting to look better on both fronts.
Jan
bonesigh said:Just a suggestion. Maybe you were having asthma problems but had not noticed it yet? Your apnea's increased because of the higher pressure needed.
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AHI is just a number. If you have one event per hour and it's a 2 minute long obstructive apnea, then it's probably more significant than (5) 10 second long hypopneas, especially since the "AHI" as reported by your machine is really a UAR event or apnea (there may be no obstruction, desaturation or RERA at all, just flow curve waxing/waning). Likewise, if the 1.1 events per hour were all flow-limitation events or central apneas accompanying the transition from wake to sleep (not pathological), with no desaturation or arousal, you would very likely expect to feel worse if those converted from 1.1/hr to 3 hypopneas or apneas/hour with significant oxygen desaturations. Also, consider that if you are awake and breathing normally the whole night, your machine would read AHI=0 --though you got no sleep at all.
The standard of 5x/hour is just an arbitrary cutoff to account for variations in analysis, that would indicate PAP therapy may be an effective treatment modality. It doesn't have a static value for qualitative pathology from patient to patient.
You might check your humdifier for over humidification in the Florida environment. excess condensation can reduce the flow of therapy,
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