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AHI Low but trending up, should I be nervous?
#1
A little over a year ago I started using Sleepyhead. Subsequently I was much better able to correlate behaviors with results and my AHI plummeted to an average of around .75 over an extended period. I started feeling very superior. Recently my wife and I have gone on a restricted calorie diet in advance of our 40th high school reunion. The diet is going swimmingly and I am down from 204 to about 190 in 3 weeks. I plan on getting to 185 and deciding from there if I want to go any lower.

My problem is that my AHI has begun trending up. This started around the 4th week of May and has been pretty consistent. Whereas my 6 month AHI is .75, my last 30 days AHI is 1.30. I know these are still good numbers. Should I just accept that I am still at a very good number or should I be concerned that I am trending in the wrong direction?
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#2
Not great deal of difference in AHI numbers, below 5 considered good
Any changes in leak numbers or in sleep quality

The important question being consistently asked 'how you feel'
I blame the low calorie diet, just joking, loosing weight and feeling great
That what matter most at the end of day, not listening to some couch potato Coffee
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#3
I wouldn't be concerned at all.

Cold with sore throat, seasonal allergies, weight loss and mask not fitting the same, weight loss and sleeping in a slightly different position, mask getting older and time to replace cushion, new bed pillow, different temps in room resulting in different sleeping positions/blankets.

Lots of possible variables that could result in very slight changes in AHI and is NOTHING to be concerned about IMO.

I would seriously consider talking to your provider about LOWERING your pressures. In most cases, lower weight = lower pressure needed to keep airway open = mask doesn't have to be as tight to keep air in.
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#4
It doesn't sound like a big deal to me.

Look at your data in more detail if you want. Especially look at how long your apneas are.

However, that small a change in the numbers isn't a big thing. It sounds like a big percent change, but the difference is less than one event per hour. You might only be stopping breathing for 10 seconds or so.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#5
6 months is a much longer average than 30 days. If you have a couple bad nights in a month, it can pull the 30 day number up a fair bit without doing much to the 6 month numbers. I'd keep an eye on it, but not be in a panic yet...an AHI of 1.3 isn't bad at all, especially if you're still feeling good and rested in the morning.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
Thanks for all the feedback. In fact I have been experimenting with sleeping with a pillow on my side so that there's a little lift around my face. Previously I've curled one hand up under me but inevitably it falls asleep and I end up waking and switching sides. Maybe that's contributing. It is likely that my pulmonologist will lower my pressures but I don't see her again for a few months.
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#7
And of course, you can lower the pressure yourself. If you've been watching your data in SleepyHead, you know more about your sleep apnea than your doctor does. You don't HAVE to go to the sleep doc to discuss it or even have them do it.

You can lower it a half point or even full point then watch the data for a week or more. Just keep a log of what changes you made and when. And keep track of how you feel which is just as important as the AHI!

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#8
(06-25-2014, 02:46 PM)Tom in RI Wrote: Previously I've curled one hand up under me but inevitably it falls asleep and I end up waking and switching sides. Maybe that's contributing. It is likely that my pulmonologist will lower my pressures but I don't see her again for a few months.
Possible if we,re talking about central apnea, lowering the pressure does not help with obstructive or hypopnea
What pressure are you thing thinking lowering, EPAP or IPAP
Now you,re on EPAP 9, IPAP 16, pressure support 7 (16-9)
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#9
Central apneas have been my bigger issue. I find my sleep is also affected quite a bit by the stress level in my life, which currently is way up. I have a lot of confidence in my doctor and am hesitant to change my pressures myself. My preference would be to lower the IPAP a little.

I suppose this is something we all deal with at times but when I wake up in the middle of the night I sometimes have trouble getting my breathing in synch with the machine. Since I am currently on a diet I am also drinking more water than usual, so I am having to get up in the middle of the night, something I have not had to do at all in the past.
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#10
(06-27-2014, 07:34 AM)Tom in RI Wrote: I suppose this is something we all deal with at times but when I wake up in the middle of the night I sometimes have trouble getting my breathing in synch with the machine.

I've heard that more with the PR machines that the resmeds... I've never noticed any 'reluctance' in my VPAP Auto following my breathing like a love starved puppy, whether I breath in slow or fast, shallow or deep, it's right there with me.
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