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Poll: Should we have an index, which includes the length of events, as described in my post?
This poll is closed.
Good idea
93.75%
15 93.75%
Bad idea
6.25%
1 6.25%
Total 16 vote(s) 100%
* You voted for this item. [Show Results]

AHI and length of events
#11
you wrote -
[Image: attachment.php?aid=1268]

hey, nice plaque! love those numbers.

QAL
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#12
Thank you!
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#13
(08-15-2014, 12:07 PM)Ghandi Wrote: Hi everyone,

I have been doing this AHI quest for a couple of months now. With the sleep report from sleepyhead(insert other sofware here) we can always track the length of events and see what may have caused sleep disruption etc.

I noticed that some times there AHI is way higher but the nature of events is very mild. And sometimes IT's the contrary. Very few events but long and most likely disruptive to sleep cycles.

First of all i dont understand why and hypopnea scores as much as an apnea episode if the are different in length , intensity and repercussions. Dont they have a different name for something? I'm thinking th AHI in itself should be protraying that. I'm thinking the algorithm should have a scale or a multiplier of event that are over x amount of time. Let say 10 seconds counts as 1. For 20 seconds * 2 and so on.

Imagine how usefull an index like that would be.

Imagine an idex that could include oxygen desaturation level into account . For those monitoring with oximeter it could evaluate the score of an event according to the desaturation.

I may be missing something rigth now i have the feeling AHI could be improved. Just like rera were integrated into the AHI for RDI.

What do you guys think? good idea? Bad idea? Why?

Ghandi,
Agree with you about the AHI being improved, but won't look for that to happen.
An example, got up this morning not feeling great, not bad but not great either.
My AHI was 0.6, which is excellent. So I look at Sleepyhead and see a few Hypopaneas, one obstructive, no clear airways.
But RERA, flow limitation, and PB are higher, but they aren't included in the AHI
number. So just because we have a low AHI (which is all the Doctors seem to care
about) doesn't mean all is well. I guess we just need to watch for a trend. One night isn't something to worry about.
OpalRose
OpalRose
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#14
In Sleepyhead there is a "total time in apnea". This comes close to what you're describing. Showing the overall impact of the events including their duration.
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#15
I am glad someone posted about this - I was actually thinking of writing something along these lines myself, though I wasn't considering a poll.

I think the main reason simple AHI became the standard is that it is easy to measure., and so the studies used it as a metric. Recently fully data capable PAP machines are becoming widely available so we can get more information easily, and it makes sense to use it somehow.

It is intuitively obvious, I think, that ten ten second apneas are less harmful than ten thirty second apneas. Proving it scientifically is another matter.

Just how harmful is a matter of research of course. I hope that research will be done. I am certainly not qualified to do it myself or to develop a revised measurement. Still I think we should be cognizant that AHI alone doesn't tell the full story.

Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
Your brain is not the boss.
Our forefathers took drugs.
He's no fun he fell right over.
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#16
Here are some numbers from my nine days so far, for reference.
The 3rd column is in minutes (rounded to nearest minute).
The 4th column is in seconds. It's a mean, not a median or weighted.


Code:
AHI         Events        Time in Apnea        Avg Apnea
13.2        105               30                    17
10.1         84                32                    23
10.9         88                32                    22
10.3         86                34                    24
21.3       202                70                    21
12.4       106                31                    18
8.2         63                18                    17
14.1       120                30                    15
4.3         40                10                    15


It shows that while my AHI was coming down in days 2,3,4 my average apnea duration had increased.

And in the last two days, the AHI was quite different from each other, but the average duration was the same. Both of those days were on the new pillow mask (P10), compared to the ffm I had been using in the beginning. The first night with the P10 I woke up a lot more (and got a lot more CA's). But both nights were the lowest average apnea duration of any of the other nights.

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#17
(08-17-2014, 07:38 PM)surferdude2 Wrote: [quote='Ghandi' pid='80079' dateline='1408320376']
S
I suppose I should be grateful that he finally agreed to write me a prescription so I could buy a CPAP machine out of pocket, which I have done. The S9 rendered a 16.9 AHI on my first session with it but I doubt that will impress the good doctor since the machine isn't one of his certified sources. :

-----------------------------------------------------------
Surferdude 2
Just noticed your above quote from a 8-17-14 entry and wanted to ask if I'm reading it right that you felt the 16.9 AHI was a desirable AHI? Or is that a misquote? Kinda new at this but thought that would be a high , undesirable AHI value unless of course it came way down from a much high number once you changed to the S9 machine.
Old82
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#18
Ghandi and superdude:
You are right to be concerned. At my sleep study 10 years ago, I was told that the reason I was depressed was that I couldn't dream. MY apnea kept me out of the dream stage and the mind needs to dream, usually 3 cycles a night.

The reason I couldn't learn anything new, which was an essential part of my job, was that I had no deep sleep and it is only in deep sleep that long term memories are formed. I also had no problem-solving abilities or creativity, which were also important to me. Plus, I was tired all the time, needing naps to get through the day. An important aspect also is that when you stop breathing and your oxygen level in your blood drops and drops, your body gets panicky and gives you a jolt of adrenalin to make you gasp and start breathing again. Adrenalin irritates your arteries and your body's response to that is to lay down cholesterol. My pulmonologist told me in January when I picked up my new machine that there is a 100% correlation between untreated sleep apnea and arteriosclerosis. I got my first machine in March of 2005. In December of 2005 I needed a quadruple by-pass for my severely clogged arteries, getting to the hospital just in time to be saved. I refuse to sleep without my CPAP, going to a motel if the power goes out to our house from a storm. My long-term health and life is at stake, so I take this seriously. I will eventually get a battery back-up or portable battery powered machine for oversea's travel, just haven't gotten there yet.
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#19
(04-21-2015, 03:26 PM)old82 Wrote: Just noticed your above quote from a 8-17-14 entry and wanted to ask if I'm reading it right that you felt the 16.9 AHI was a desirable AHI? Or is that a misquote? Kinda new at this but thought that would be a high , undesirable AHI value unless of course it came way down from a much high number once you changed to the S9 machine.
Old82

Old82, Thanks for asking, I'll clear that up. I meant to convey that my starting point for therapy, at a guessed at setting, indicated that I actually had a level of apnea incidents (16.9) to justify treatment and qualify for insurance coverage. No doubt I had even more than that but without the data capable cpap machine, I can't say. Subsequent self-titration has reduced the AHI rate to less then 1 on most nights and zero on several.

The machine works well and the need has been well demonstrated. The former sleep doctor is no longer on my go-to list.

All the best, Dude

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#20
(02-09-2015, 07:31 PM)Sparkle Wrote:
(08-17-2014, 08:39 PM)Ghandi Wrote: I had the cpap for such a short time and i dont recall ever beeing that healty and energized. This thing changed my life. i would just miserably hang through the day and crave to get home to sleep and sleep almost all weekends too for like 15 years. I dont ever want to feel that way again.

I'm with you! I am approaching my one month anniversary with auto CPAP. I feel fortunate in that as best as I can tell it went 2.5 to 3 years undiagnosed/untreated. I hear you when you talk about sleeping through the weekends. I lived for weekends and to sleep. Just to make myself feel better about not "wasting away time" I would gather up my energy on Saturday and Sunday mornings and go to the lake and sleep there. Now that I think of it i must have been quite a sight if I was snoring - lol.

Congrats and here's to better days and nightr!Big Grin

PS I have my follow up in Ten days

Sparkle, what type of FFM have you been using? I have tried both the F10, and the F&P Simplus. The F10 hurt my nose, and the Simplus is digging into my face, and leaking when I loosen it even a little.

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