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Can you get to zero AHI?
06-21-2015, 05:43 AM
I'm relatively new to CPAP and its good to hear some of these numbers. Every night my AHI is < 1. I've had some zeros. When told I want to keep it < 5 I had to wonder - why the heck am I being treated (except to minimize the snoring so other people in the house can get some sleep, maybe). But I guess that's more a testament to the success of the treatment rather than the need for treatment.
06-21-2015, 06:05 AM
Hi CH, welcome to Apnea Board and congratulations on the great numbers. You're right - the low numbers are a reflection of the success of your treatment. If you were to stop using your machine your AHI would jump back to where it was before you started.
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06-21-2015, 07:36 AM
(03-05-2013, 11:24 PM)JJJ Wrote: If by "diagnosis" you mean "sufficient that an insurance company will pay" or "sufficient that a prescription for therapy is indicated," then I agree - under 5.0 is not a "diagnosis" of sleep apnea. But I consider that anything other than zero events means that there are apneas or hypopneas going on, and that is sleep apnea. Perhaps not yet bad enough to bother doing anything about, but the body is nevertheless not getting perfect sleep and a small amount of damage is being caused as a result. In my definition, that is still "sleep apnea."
If 90% of everyone (and I bet that is a bit on the conservative side) has an apena at some point in their life, then that makes only 10% the "normal" group? Strange logic to me.
Occasional apeneas are "normal" events for almost everyone.
Apnea and hypopnea events are symptoms, not the disease. Would be like saying anyone that sneezes has the flu.
06-21-2015, 07:37 AM
I get zero AHI frequently. When I examine the data I still see flow stoppage but all are under 10 seconds. 10 seconds is an arbitrary boundary as is 5 AHI per hour. These kinds of metrics are necessary in the medical field (as well as other fields) in order to manage treatment procedures for the interests of people and insurance companies. The best medical research is examined and analyzed to determine when treatment is both called for and cost effective. Insurance companies don't want to pay and doctors don't want to trade one risk for another more serious one. These determinations are not made with you or me in mind, only "on average". "Normal" is a tailored word in this context.
if you can't decide then you don't have enough data.
(03-05-2013, 01:14 PM)PaulaO2 Wrote: An AHI of 5 or more is needed for the diagnosis. That means that an AHI of less than 5 means you do not have sleep apnea.
True, but it's like diabetes. There is a range that is not normal, but not sufficient for diagnosis and treatment. Pre-sleep apnea, I guess you would call it. That said, AHI is not the only qualifier. Having average oxygen levels below 88% also qualifies you for the insurance or Medicare coverage. I'm sure there are other instances, but they are probably one off exceptions.
06-22-2015, 11:08 AM
I view it more as you need to have a level >5 for it to be worth treating, not that <5 is "ideal" or the target.
It's like pain management: just because you have pain doesn't mean that you should be given painkillers, but once you're being treated you should optimize the level of painkillers to minimize or eliminate the pain. That's what chasing an AHI <1 is: optimizing the level of treatment to completely minimize or eliminate the condition being treated.
Maybe some feel that they can live with the "Pain" (AHI of 4) because it's still much better than it was, but that doesn't cheapen the efforts of people trying to live "pain free".
It also depends on your diagnosis. I had enough "real" events to be considered to have sleep apnea (mild)...but...my rest disruption index (RDI) was 50+ as I have Upper Airway Resistive Syndrome (UARS). In my case, my brain is too quick in putting the kybosh on events for them to register as proper events....but my lower AHI didn't mean my sleep was anywhere near "normal."
I have been fortunate, with therapy, to have lots of "0" nights...but with my condition, I know that my RDI is ~9-10x my AHI, so the lower the AHI the better is what I shoot for.
Overall, I think a couple folks have hit the nail on the head, so to speak...the AHI number is just that. It is a number indicating how many recordable events you had that night. It doesn't say how well you slept or how well you feel in the morning. I have had some "0" nights where I have felt awesome the next day....and others where I feel like the leavings of the south end of a northbound dog. A low AHI is good and a good goal, but it's not the entire story.
06-22-2015, 06:21 PM
That is why I was so happy to see mark's post, here - http://www.apneaboard.com/forums/Thread-...#pid118430 that shows how he adjusted the user flags to show the "almost-apneas".
He says that really does correlate to the feeling of well being after a given night of sleepish behavior.
Dedicated to QALity sleep.
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06-22-2015, 06:25 PM
I just had a zero last night. I probably have had a 4 in a year and a half.
06-23-2015, 06:51 PM
Still searching for a zero, one month in - lowest has been a .8 AHI so far.