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AHI under 1
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apnea711 Offline

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Post: #1
AHI under 1
My sleep doctor had low expectations. He was ecstatic that I used my machine every night and told me any AHI below 5 was 'excellent'.

But I have higher expectations and aim to get below 1.

I thought it might be a good idea to start a thread on what people have done to lower their AHI.

Mine now varies from 1 to 3, with some nights below 1. My goal is all nights below 1.

So here is what I have done.

1. Lost weight. Not much, just the 10 lbs. of fat around my middle. I lost the weight by walking and cutting back on grains.

2. Raised the head of the bed. I have GERD, so it was recommended to raise the head of the bed at least 8 inches. I had the local foam shop make a wedge that is the width and length of my queen bed, with one end 8" and tapered down to zero at the other end. The wedge goes under the mattress. GERD got better, but so did AHI.

3. No eating 3 hours before bed. I am an early riser, so I am usually asleep at 9. This means no food after 6 pm. This was the hardest thing to do but it really helped my GERD, and also lowered my AHI.

What I tried that did not work was raising my pressure. It lowered my OA but increased my CA and pumped air in to my stomach. So I set it back to what it has always been, 6 & 14 on my Respironics Bipap Auto 760P. I use a Quattro Air full face mask.
04-18-2016 03:22 PM
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apnea711 Offline

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Post: #2
RE: AHI under 1
I forgot #4, which is I made a mouth appliance from a martial arts mouth guard. I have an overbite, so my lower jaw is pushed back a little. The mouth guard brings the lower jaw forward about 1/8th inch, but reduces my OA. The commercial appliances I tried were all too thick and pushed my lower jaw too far forward. Plus, the mouth guards are really cheap on Amazon. Just put them in hot water and they mold to your teeth.
04-18-2016 03:29 PM
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JSL747 Offline

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Post: #3
RE: AHI under 1 Gross Grin Exclaimation Cool Brick Arrow Angry Your Message: Smilies
Well after trying for 3+ years to get my AHI down to <1. As of Feb this year I started using a soft cervical collar, my OAs have gone to ZERO. I have maybe 1 Hyponea every 10 days or so. However my CAs range from .5/hr to 1.5/hr....still working on those.


EDIT: Grin Exclaimation Cool Brick Arrow Angry Your Message: Smilies (I have NO idea where this came from!!)
(This post was last modified: 04-18-2016 05:01 PM by JSL747.)
04-18-2016 04:47 PM
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tmoody Offline

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Post: #4
RE: AHI under 1
Well, although I used CPAP for nine years, I have no idea what my AHI was, until they put me on APAP last November, and I eventually learned I'd graduated to complex apnea. Between November and now, I've yet to get below AHI, but since I was switched to ASV on March 23, I've come as close as 1.05 a couple of times. I suspect there are many other factors that have little to do with the strictly mechanical aspects of breathing. I've made some minor adjustments in pressure settings but I've seen no consistent response pattern yet. But it's still early days. I've had this ASV less than a month. I think my brain is still learning how to work with it.
04-18-2016 05:28 PM
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GrammaBear Offline

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Post: #5
RE: AHI under 1
Until I came to this forum, I never knew what my AHI was and I've used CPAP for 7 years. Most of the time my AHI is anywhere from 0.3 to 2.4 or somewhere in between. I have no idea why the variance, although I suspect it could be seasonal allergies. I mentioned the variety of AHI readings to the sleep doctor and he suggested taking a 24 hr allergy tablet which I have started to do. It would be helpful if everything in sleep apnea was 'cut & dried' but I don't think it is for any of us.
04-18-2016 06:18 PM
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FrankNichols Offline

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Post: #6
RE: AHI under 1
I am not opposed to researching and figuring out what is going on with AHI and other aspects of your treatment, but, for me quality of sleep out weighs the numbers behind that sleep. To me the numbers are just indicators to what is going on. So, the number one criteria for me will be how I feel each morning and what the numbers are associated with that feeling. I am keeping a sleep long and noting various things about the therapy and trying to see what helps me feel better as opposed to how to get numbers down to 0.

But, that is just me, each of us has to find their own path along this journey.

I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
04-19-2016 08:40 AM
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tmoody Offline

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Post: #7
RE: AHI under 1
I've been keeping a sleep log too, but the trouble with that, for me, is that I always feel pretty much the same when I wake up in the morning. In fact, even ten years ago when I was diagnosed with severe OSA (AHI=42), I didn't have any of the symptoms that people talk about. No headaches, daytime drowsiness, etc. I felt fine. The only reason I got the sleep study was because my wife noticed me stopping breathing.

When I got the no-data CPAP, I didn't feel any different, but just used it. Of course, I was a youthful 52 then. Eventually I started feeling a bit less fresh during the day, but then I was getting older. Everybody tells you how you feel it when you hit 60, so I didn't think much of it, and didn't go back to the sleep doc.

One of my lowest AHIs was a few days ago, at about 1.5. I didn't feel especially perky; in fact I experienced one of my personal symptoms of bad sleep, which is a slight sensitivity to glare and noise during the day. Nothing extreme, but it was there. My more typical AHI these days is closer to 4, and I generally feel fine.

I think we have to remember there are a lot of things that affect quality of sleep other than breathing. Moreover, how we feel when we first wake up can have a lot to do with what stage of sleep we were in just prior to waking up, which may have little to do with what was going on the rest of the night.

Example: My personal circadian rhythm seems to want me to wake up at around 6 or maybe 5:45, no matter what time I went to bed (within reason). So, it's generally a good idea for me to turn in no later than 10. If I stay up later, I'm unlikely to make up the time in the morning. I don't know how much actual sleep time I get, but I do seem to do best with at least 8 hours from lights out to waking up. But it doesn't seem to have much to do with AHI.
04-19-2016 09:06 AM
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green wings Online

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Post: #8
RE: AHI under 1
I suppose about all I've done so far to try to lower my AHI is to increase my therapy pressure. I started using CPAP about three months ago. I started off at a treatment pressure of 7.0 cm and am now at 10.5 cm.

I just had my first night of <1.0 AHI last night. Do I feel great today? No. My head feels less headachy, but I still feel very tired and not terribly alert. To be fair, I had several RERA events toward the end of my sleep, so although my AHI was <1.0, my RDI was not.

I have had a few days where I woke up and felt really good (okay, about three days) and those have made me want to chase that feeling.

I suppose my main motivation for wanting my AHI to be lower is so that I can know that my sleep apnea is well-treated and that I'm doing as much as I can in that area to help myself to feel better.

I agree with tmoody, though, in that feeling good is more important to me than having an AHI under 1. If I was feeling great but my AHI was 3 or 4, I doubt I'd worry about it too much.
04-20-2016 11:01 AM
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pupcamper Online

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Post: #9
RE: AHI under 1
I've been sort of chasing numbers. While my AHI has always been low I have always had a significant number of RERA events and I didn't think I was feeling as well as I should.

The first thing I did was start running my DreamStation on CPAP-Check. It eventually raised my pressure from my prescribed 8 cm to 9 cm. While I felt somewhat better, I still didn't think I was where I needed to be so I turned on Auto-trial. The auto trial settled on a 90% pressure of 10 cm so I set that as my straight CPAP pressure. Not being able to leave well enough alone (I tend to do that sometimes), I started inching my pressure up to see if things would get even better. All the higher pressure accomplished was to start triggering CAs so I have gone back down to 10 cm. I did learn to trust my machine, though.

At 10 cm I have very few RERAs and very few obstructive events which most of the time translates to an AHI of less than 1 and usually an AHI of less than 0.5. The overall effect on how I feel has been tremendous. I find I don't require as much sleep, wake up feeling refreshed and no longer feel like I need a nap during the day.

"....respiration,—a troublesome practice, but one which custom has rendered necessary to our easy existence...." Oliver Twist, Charles Dickens- 1837

I use FlashPAP to load data from a FlashAir III wifi sd card in my machine to my computer and display it with SleepyHead .
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04-20-2016 03:30 PM
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robysue Offline
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Post: #10
RE: AHI under 1
(04-20-2016 11:01 AM)green wings Wrote:  I suppose about all I've done so far to try to lower my AHI is to increase my therapy pressure. I started using CPAP about three months ago. I started off at a treatment pressure of 7.0 cm and am now at 10.5 cm.

I just had my first night of <1.0 AHI last night. Do I feel great today? No. My head feels less headachy, but I still feel very tired and not terribly alert. To be fair, I had several RERA events toward the end of my sleep, so although my AHI was <1.0, my RDI was not.

I have had a few days where I woke up and felt really good (okay, about three days) and those have made me want to chase that feeling.
Rather than chasing numbers, you may need to chase non OSA, non CPAP related variables.

On the few days where you woke up feeling really good, was there anything different about your overall sleep hygiene? Caffeine consumption? Total sleep time? Did you get to sleep a lot quicker on those nights than you usually do? (If so, why?) Did you wake up less frequently? Did you just go ahead and get out of bed when you first woke up rather than staying in bed trying to get just a few more minutes of sleep?

A lot of us have pretty lousy sleep hygiene and sometimes it's the sleep hygiene issues that are the real culprit that causes us to feel not at our best even though our CPAP numbers look good on paper.

So you might want to focus less on the CPAP and more on all those other things that can adversely affect the overall quality of our sleep.

Questions about SleepyHead?
See my Guide to SleepyHead
04-20-2016 04:24 PM
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