[Diagnosis] How to Interpret My Low AHI

[SteveSchechter]

Hi everyone,

Around 2003 I did a sleep study and was diagnosed with OSA. I was prescribed a CPAP machine with pressure set to 5. I could never get used to the machine even after trying several different mask types and I stopped using it. When I moved in 2015 the machine was lost and I didn't bother to replace it as I hadn't used it in years. 

Fast forward to the present. I'm over 65 years old. I'm always tired. I wake up several times per night. I take 3 or 4 naps per day. I thought that my untreated sleep apnea might be getting worse and that I shouldn't ignore it any more, but I could not afford a new sleep study. I decided to get a new CPAP machine (prescriptions not required where I live) as it would be cheaper to buy the machine and subsequently sell it off if I wasn't using it or it wasn't helping. 

I've had the ResMed AirSense 10 Autoset for one week now. The advances in technology blow me away. I was able to use the machine successfully from the very first night. Two nights out of the last six I was able to get more than 6 hours of use, with my nightly numbers increasing as I get better at fitting the mask. I wake up and I'm fully awake for the first time in years. I don't need during the day naps. I'm feeling noticeably better. 

And yet .... I see posts here and there about how AHI's around 5 are good. I see people posting triple digit AHI's. My AHI in the past week has ranged from 0.23 to 0.91. 

How do I interpret this? Is it telling me that I don't really need this, that the benefit I perceive I'm getting is just psychological? Or is it just that my OSA is not severe and the machine is working so very darned well for me that I should just shut up and be happy? 

Thanks all.

[Deborah K.]

You are doing great!  The experts will come along soon, but if you are sleeping and feeling better and having nice low AHI's, then it sounds like the machine is doing just what it should.  It doesn't mean you don't need it.  It means it's working!  Yay!

[SteveSchechter]

[cathyf]

There's a recent thread called "Am I just an apnea wannabe?" where several of us angsty types hashed out this very question!
http://www.apneaboard.com/forums/Thread-...ea-wannabe

My advice then was to look at what your machine is telling you. If you stay at minimum pressure all night, ok, maybe you don't need CPAP? But if your machine keeps zooming up off the minimum, then you can say that at least the machine algorithm thinks that you have apnea!

[SteveSchechter]

There's a recent thread called "Am I just an apnea wannabe?" where several of us angsty types hashed out this very question!


My advice then was to look at what your machine is telling you. If you stay at minimum pressure all night, ok, maybe you don't need CPAP? But if your machine keeps zooming up off the minimum, then you can say that at least the machine algorithm thinks that you have apnea!

Thanks - will check out that thread. My machine is set for min 4 and max 20 and I can see that on some nights it has maxed out at up to 19.64, so I guess I really do need it. Thanks!

(Oh, interesting, as a new member I am not allowed to post links in messages, and apparently that also means quoting a previous message that has a link in it. Oh.)

[OpalRose]

First, be assured that your machine is working to treat your apnea.  It is, however set to a wide open range 4-20, and can be optimized for comfort.  Your AHI is under 1 and that is exceptional.  

Suggestion:   Download the free OSCAR software.  Then use the links in my signature line below to guide you on taking a Screenshot of the daily page and posting it here by using the attachment feature.  We can then take a look and better advise.

[SteveSchechter]

First, be assured that your machine is working to treat your apnea.  It is, however set to a wide open range 4-20, and can be optimized for comfort.  Your AHI is under 1 and that is exceptional.  

Suggestion:   Download the free OSCAR software.  Then use the links in my signature line below to guide you on taking a Screenshot of the daily page and posting it here by using the attachment feature.  We can then take a look and better advise.

Thanks. I already have the OSCAR software installed and have been looking at it. Curiously, while I had over 6 hours on the machine last night, when I checked the SD card in OSCAR today it wasn't showing me results for last night, only the day before (when I had well under 4 hours). I think it has something to do with the time difference. My machine is set to US time and I can't seem to change that to my local time. (Probably there's a way to do a hard reset but I haven't checked yet.) I think the time difference may be messing up the display, if that makes any sense. So I've attached screenshots from 2 nights ago, when I had 5-1/2 hours on the machine. 

   
   

[cathyf]

Thread here describes how I crept the clock back when it was set a day into the future: http://www.apneaboard.com/forums/Thread-...-fix-OSCAR

[SteveSchechter]

Thread here describes how I crept the clock back when it was set a day into the future: 

[OpalRose]

Steve,
Without seeing the actual graphs, I can only assume the pressure is being driven by Flow Limitations.
The usual fix for that is to use EPR.  

Let's move your minimum pressure to 8cm and set EPR TO 3.  
So your new settings will be 8min and 20 max.  EPR 3  
Expect some adjustments as EPR may trigger clear airways.

Note:  Your AHI is good.  My recommendations are to try and limit Flow Limitations and provide more comfort by using EPR.

Next time you post a chart, use the F12 button to take a screenshot.  This way, the graphs we need to see will be included.