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AHI under 1
#11
I have been on cpap for 4 years and I've almost always been under 1 ahi. The very best I've felt was after my first night on cpap. I woke up thinking, so this is how I should feel on wakening.
Since then it mostly depends on other influences on how I feel (I still love a beer) as my ahi is under 1.
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#12
Thanks for this, RobySue. It made me do some thinking. At first I thought "No, there's not really much more that I can do in the way of sleep hygiene."

Not that I do all the stuff on the sleep hygiene list, but I've done all of it at one time or another and sort of figured out what does seem to affect my sleep and what doesn't seem to make any difference.

But then I thought "Wait, all that knowledge is based on pre-CPAP sleeping me."

Since I've started CPAP therapy, I've noticed that I've lost the "tired but wired" feeling. I also don't feel the need for afternoon naps 3 days a week like I used to.

So maybe those other sleep hygiene things might have an effect now.

It's the difficult stuff that I'm not doing, though. Thinking-about



(04-20-2016, 04:24 PM)robysue Wrote:
(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.

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#13
(04-19-2016, 09:06 AM)tmoody Wrote: 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.

I have been on APAP 15-20 pressure for 3 months. I cannot tell any difference to how I feel in the morning unless now I may feel a little more tired on APAP. I also never had any of the typical symptons - diagnosed with severe OSA (AHI=83). I could drive 500 miles on trips and not be sleepy, no headaches, drowsiness, etc. My study was result of a shortness of breath episode while on vacation and subsequent visit to Pulmonologist (Heart doc said My heart was fine). I am an early riser 6 AM also.

My AHI has been below 5 since I started and ranges from 0.5 to 2.4 with an occasional 4 or 5. Some nights seems I do not get good sleep because of leaks - make no changes and next night leaks less than 10L/m. Seems that mask has a mind of its own.

My 95% pressure is usually 15.0 to 15.6 with an occasional short peak to 18 (1 in 10 nights). So I plan to reduce the pressure and watch the impact on AHI and leaks. I have very few OA (only about 25 total in 3 months), mostly CA with a few H. CA seem to cluster after mast removal/replacement. A pressure of 15 or higher sure makes the mask leaks more difficult to control and may be the source of more CA.
It does not matter how slowly you go as long as you do not stop. --Confucius
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#14
Sleep hygiene and Machine Data/Settings are just two sides of the same coin, so to speak. Both are important. Apnea711 thanks, it's an interesting and a FUN thread topic.
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#15
Other than the big number differences I have got used to not chasing AHI. When using my A10 my AHI was 0 to 1.8 while on the PRS1 it's normally 1.2-4. But I feel better with the PRS1. Like people have mentioned I cannot accounting for confounding variables such as sleep hygiene. Also, I don't think the various machines AHI are calibrated such that they are directly comparable within 0.1AHI (at least within 1 or 2AHI). I know they should be but I have a sneaking suspicion that there is variance. I guess think of them more akin to a car speedo which is only calibrated within +/-8.7miles/hr at 62mph in Australia (although can now only show faster than actual not slower).
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#16
(04-18-2016, 03:29 PM)apnea711 Wrote: 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.

I saw some of those mouth guards on a youtube video but it looked like the hole in the front through which you can breathe was so small...do you feel like you can get enough air through it if mouth breathing?
Inspired
Bigwink
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#17
(04-18-2016, 03:29 PM)apnea711 Wrote: 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.

Thanks for the tip.

For some reason my tongue sometimes rubs on my bottom teeth. Last night I picked up a mouth guard at the national discount store everyone loves to hate for 97 cents. It has to be fitted to the mouth the same way yours does. I am using it on my bottom teeth instead of the top. It seemed to work OK last night.


"....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 .
robysue's Beginner's Guide to SleepyHead
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#18
I know where your coming from here. I was the same way before starting therapy, (no symptoms) My wife's observations were a bit different. She said. "He snores a little bit, but not very loud, his breathing get very quite and slow".

I had none of the tradition symptoms. Thy wanted me on therapy because I am obese, diabetic, have a 23 inch neck, and I could on sleep on my back or side. Which is a problem during hospitalization.


(04-19-2016, 09:06 AM)tmoody Wrote: ........., 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.

2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
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#19
(04-20-2016, 05:07 PM)dwd1249 Wrote: I have been on cpap for 4 years and I've almost always been under 1 ahi. The very best I've felt was after my first night on cpap. I woke up thinking, so this is how I should feel on wakening.
Since then it mostly depends on other influences on how I feel (I still love a beer) as my ahi is under 1.

I think that under 1 is a great thing, I was told mine (AHI under 1 was great/good) thumbs up! CoffeeBigwink
I enjoy being with a group who like to share their "Hosehead" experiences, to remind me I am not alone.
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#20
(04-23-2016, 11:40 PM)Dafod Wrote: Other than the big number differences I have got used to not chasing AHI. When using my A10 my AHI was 0 to 1.8 while on the PRS1 it's normally 1.2-4. But I feel better with the PRS1. Like people have mentioned I cannot accounting for confounding variables such as sleep hygiene. Also, I don't think the various machines AHI are calibrated such that they are directly comparable within 0.1AHI (at least within 1 or 2AHI). I know they should be but I have a sneaking suspicion that there is variance. I guess think of them more akin to a car speedo which is only calibrated within +/-8.7miles/hr at 62mph in Australia (although can now only show faster than actual not slower).

This is from a Post I found, but don't remember who wrote it or what thread I found it in.......SORRY, but it might help explain your AHI difference and why you prefer the PR

Difference In Algorithms:

"The PR machines in general are much slower to raise the pressure than the Resmed machines. And that is an issue for some people, but not for everyone.
On the other hand, the PR machines are also slower to lower the pressure after raising it, which is also useful in preventing more events.
What it boils down to is this: Every manufacturer of an APAP or an Auto bilevel has made their own decisions on both when and how the machine will respond by increasing or decreasing the pressure. You can see the implications of those decisions in the pressure curves of the various brands.
Unfortunately, there's not been much objective testing of those algorithms to determine which auto algorithms are actually "best" in terms of managing OSA in which patients. The only benchmark study comparing the auto algorithms from the various manufacturers that I've seen is this one from Sleep Review: http://www.sleepreviewmag.com/2009/09/a ... -pressure/
This article is somewhat old (2009) and the machines they tested are now 2 or 3 generations "old", but many of the decisions manufacturers made back before 2009 are still present in their current Auto algorithms"
"
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