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Are very low AHI's realistic for everyone?
#1
I've been using an APAP machine for 3 months now and have been averaging an AHI of about 6. I see these posts with very low AHI's and seem to consider anything over 2 as a bad night. I've only had two nights under 2(1.7 and 1.8). Is it realistic that everyone could or should try to achieve these very low AHI's?
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#2
it seems (from my observation) like those with OSA only can expect to get to that, but those with a component of Mixed Apnea or CA don't very often. Possibly that is different with ASV treatment, but I am fairly ignorant of that.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#3
In general, yes, lower AHI is achievable but also depend on type of events, obstructive, central or hypopneas
Slight increase of the lower pressure or higher pressure (if pressure maxing out) might helps with obstructive events but do nothing for central events. On most nights, AHI below 0.5 but I consider a good night when the machine shows usage around 8 hours .... YMMV

Edit: events flagged while you're awake, need to be discarded



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#4
I think it depends on the person, too. I had an experienced respiratory tech who had been on CPAP for years. He had several patients tell him that they could sense their AHI's upon waking. He was initially skeptical, but then realized that he could feel the difference, too. For him, the number was 5. Anything above that, he could feel it. Below that, he felt fine.

Me, I've got multiple sleeping disorders and some autoimmune issues on top of that. For me, the number is definitely 2.

Ultimately, what matters is how you feel. Do you feel rested or drowsy? If you feel fine at 6, then it's not bad. If you feel awful at 3, then you need to aim lower.
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#5
I'm very new to this, but I've noticed that AHIs below 3 normally end up in a good day for me, whereas anything higher I end up feeling it later in the day.

Again, I'm very new and I might just be adapting to the therapy, so take that for what is worth.
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#6
Normal for me is 0.3 to 1.5. Clear airway events will drive my AHI higher, and I know when I wake up how I feel. Sad

A real good night for me is sleeping for 5 to 6 hours, without waking up.

My point is this: After you are at this awhile (at least 6 months to a year), you will know what is normal for you and what isn't.
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#7
(01-17-2016, 05:46 PM)Jimsp1 Wrote: I've been using an APAP machine for 3 months now and have been averaging an AHI of about 6. I see these posts with very low AHI's and seem to consider anything over 2 as a bad night. I've only had two nights under 2(1.7 and 1.8). Is it realistic that everyone could or should try to achieve these very low AHI's?

You don't mention what your untreated AHI was. Have you experimented to see if you can get it lower (I offer some ideas below)?

I don't think it's realistic that everyone can achieve them but I think that many can, and since it can being benefits, I think it makes sense to get them as low as you can and then be happy with whatever that is. Experimentation (pressure, mask type, sleep habits) may help you to get there. Everyone who manages to lower their AHI is in affect succeeding, and it's important for people to not feel like they are failing just because they can't hit a certain number.

My AHI during study was 40. As I was adapting to cpap I was seeing numbers around 10, so a big improvement, but still much higher than I wanted. Then they made it down to around 5. Now I'm finally down to under 1. All I really did was:

1. Adapt and get better at it. I think I lot of it was just time, it took me a couple of months.

2. I find that my sleep schedule and hygiene is super important. The better my sleep habits the better my AHI numbers.

3. I found a mask that I love. I've read many different threads where people find that changing masks affects AHI. Of course sometimes that could also just be a matter of adapting to one mask verus another.

4. I also played with pressure settings but in my case never varied from the range that was established during my sleep study, as I found no improvement from raising starting pressure. However I've read a lot of people achieve success by experimenting with pressure settings, especially by bumping up the low end a little if you are working in a range.

On points 2 and 3 I theorize that the better a person sleeps the better AHI. Now maybe the two should not be related, in theory one might think cpap should be stopping AHI whether sleep is good or bad. But since high AHI causes poor sleep, I think there are mechanisms in reverse where better sleep helps to lower AHI. In essence it's circular. So I think cpap combined with good sleep habits brings about the best results.
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#8
I have just finalised my reports for the Sleep Doctor.
Over the past 12 months, Encore Basic advises me that I have averaged:

Hours of Use 7 hours, 44 minutes, 37 seconds,
Cheyne Stokes Respiration 0.1%
CA Index 0.0
OA Index 0.0
Hypopnea Index 0.1
RERA Index 1.1
AHI 0.1
Sleepyhead agrees with these figures.

For the Specialist, I report all of the above on a daily basis, so we can check for any possibly developing problems. It may appear that this is an overkill, but we learned a long time ago that the machine display is at best just an indicator.
I have experienced one day where my AHI shot up to 2.6 caused by a mask malfunction.

So, yes we can achieve near zero AHI, but there are many things that can influence this result. Persistence and discipline are the keys!

Cheers to all.Sleep-well
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#9
I have been on a Resmed Aircurve 10 ASV for 7 months. My ahi are almost always 0 with an occasional .1. Always hypopneas. I feel great and have adapted to the therapy from the get go. Stick with it, work with your doctor and it will all fall into place. I started with an Aircurve s10 until my second sleep test and was diagnosed with complex sleep apnea, at which time they prescribed an ASV. I'm sure glad they did.
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#10
I think most people that actually use their machine every night can get their AHI down to a low number. My untreated AHI was 49. I have been in treatment for 8 months, and I consider an AHI over 3 to be a bad night. I normally have a mixture of obstructive, central, and hypopnea.
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