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Extreme AHI values affect the daily average
#1
Extreme AHI values affect the daily average
Hi there! First of all I’m new here, so I’d like to say hello to everyone. Have to say… it’s somehow conforming that I’m not the only one with this condition.

I’ve been on CPAP for about two weeks now. First week was an adjustment probe after which my doctor said that the result was good, since I had achieved quite a low AHI (less than 5) on pressure below 10. So the next day I went to the shop for my first CPAP machine looking forward to getting enough sleep for the first time since forever. So, each morning I checked the stats, and the AHI was more or less fine (always below 6, usually below 5), but I felt no better than before starting the treatment. So I started to think that maybe something is wrong with the average AHI - I’m definitely no expert on statistics, but it’s well known a fact that average not always describe what’s going on in actuality, right?

And I apparently hit the point. After installing SleepHead (huge kudos go to the author , Mark Watkins, great job man! the official Phillips app is not available in my country  Oh-jeez ) and seeing the charts all became clear. AHI stays low at all time, but there is an hour or so, usually in the morning, where AHI peaks to 15 or even 19, the machine puts maximal pressure of 9.90, and sadly this is over of my sleeping in most cases: I wake up not being able to fall asleep again. Of course, as it's just an hour or even less, the average daily AHI stays low, but (at least the way I see it) it's simply false.

So my question is: do your AHI values are nearer the average  (which basically means that charts are flat)? In my case, should I have the pressure range increased despite the fact that average AHI are low on the current range?
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#2
RE: Extreme AHI values affect the daily average
The first thing people here will say is raise your minimum pressure to at least 6cm to help you breath better.

If you can post a chart from sleepyhead it would help. The directions are on the links below.

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#3
RE: Extreme AHI values affect the daily average
I am not knowledgeable enough to give you any recommendations. Other than to encourage you to post SleepyHead charts because no one will be able to answer your question without seeing what is happening. Since you have less than 4 posts and cannot add links yet, you'll need to alter the text of the link by using a space.

With my own AHI, I have noticed recently that the machine screen shows an AHI of 1-ish if I wake up during the night (usually after about 4-5 hours of sleep, around 2am), and then whatever is happening between 2am and 4:30-5:00am is enough to sometimes raise the AHI up into the 7's. My computer is currently dismantled while doing some remodeling, else I'd give more accurate numbers.
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#4
RE: Extreme AHI values affect the daily average
(11-23-2017, 01:01 PM)Walla Walla Wrote: If you can post a chart from sleepyhead it would help. The directions are on the links below.

My bad, should’ve post those charts in the first place. I followed instructions, but there is no Flow limit chart in my app version or CPAP data, I put AHI chart instead. Here two sample charts illustrating what I mean: imgur.com/a/USHf6 (as a new member, I’m not allowed to put clickable link here, you need to copy-paste that ¯\_(ツ)_/¯  ).
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#5
RE: Extreme AHI values affect the daily average
(11-23-2017, 01:45 PM)kiwii Wrote: Since you have less than 4 posts and cannot add links yet, you'll need to alter the text of the link by using a space.

Yes, I somehow managed to do that, thanks. Smile

Quote:With my own AHI, I have noticed recently that the machine screen shows an AHI of 1-ish if I wake up during the night (usually after about 4-5 hours of sleep, around 2am), and then whatever is happening between 2am and 4:30-5:00am is enough to sometimes raise the AHI up into the 7's. 

So similar case to mine. Also in my case, the closer the morning, the more probable I would wake up lying on my back. But I fall asleep lying on the side, and during the night, usually wake up in this position as well. Of course lying on the back worsen sleep apnea, so that’s my hypothesis – it's because lying on the back. It is recommended to somehow sew tennis balls in one's pajamas to avoid lying on the back. Need to try that, though seems kinda silly, doesn’t it?
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#6
RE: Extreme AHI values affect the daily average
Another technique to avoid back sleeping is to place a weighty object behind you, so that if you were to roll over, your back would instead press against this object. Two things have worked for me: a heavy blanket folded into a  thick rectangle, and a cylindrical buckwheat pillow. Having these against my back are actually comforting - not sure why.

I have been a dedicated side-sleeper until recently. I'm beginning to suspect that the side-sleeping was a byproduct (survival mechanism) of sleep apnea. Now that I am successfully using cpap, I am moving around when sleeping.

I've also noticed that just the act of turning over can generate 'events', or maybe they are bogus events since they are not occurring during sleep. I also get lots of events in the early morning hours and I believe it is when I am not solidly asleep, but maybe drifting in and out of sleep.
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#7
RE: Extreme AHI values affect the daily average
If it was my chart and I had a dreamstation, I would raise the min pressure to 7 for now, it may need 8.
I would also raise the max to 12, in case you have a bad night and the machine wants more pressure.

Position apnea is common, chin tucking seems to be the worse one, backsleeping can be done, it's just a matter of getting enough pressure to overcome the throat closing. I just kept increasing the minimum pressure till I could. Your apnea is being controlled at a low pressure, so there is room to move for you.

You can get the clinical manual from this link
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

this is the quick info on how to adjust pressure
http://www.apneaboard.com/dreamstation-c...structions
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#8
RE: Extreme AHI values affect the daily average
Huh, to be honest I would prefer to consult changing the pressure range with my physician. I read those links, but to me me it sounds a bit like ”sovereign citizen” talk.  Bigwink  Yeah, of course it is not illegal per se, but to me it's like with drug dosage, you should not make that kind of decisions on your own.

Basically I was more like: should I meet my physician ASAP to adjust the pressure or wait until the next appointed visit.
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#9
RE: Extreme AHI values affect the daily average
Hi wampeter,
WELCOME! to the forum.! Good luck with CPAP therapy.
It's not sovereign citizen talk, some of us want to take our healthcare into our own hands and there is nothing illegal about adjusting pressure, on your machine. This is what this forum is for, to help people with adjusting to their therapy and to empower us to get the best treatment.
Of course, you want to talk to your doc about your therapy, though, just as you would talk to he/she about your drug dosages.
Hang in there for more answers to your questions.
trish6hundred
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#10
RE: Extreme AHI values affect the daily average
(11-23-2017, 02:59 PM)wampeter Wrote: So similar case to mine. Also in my case, the closer the morning, the more probable I would wake up lying on my back. But I fall asleep lying on the side, and during the night, usually wake up in this position as well. Of course lying on the back worsen sleep apnea, so that’s my hypothesis – it's because lying on the back. It is recommended to somehow sew tennis balls in one's pajamas to avoid lying on the back. Need to try that, though seems kinda silly, doesn’t it?

If the sleep position is (part of) the cause, please go to http://www.nightbalance.com/spt/. It is a Dutch invention and it works! Nothing on your back, a simple band with a tiny device in a pocket on the front...
Arie KLERK: Member of the Dutch Apnea Association staff (https://apneuvereniging.nl) and proud to be the OSCAR Translations Team Coordinator. 
***Please help us: We’re always looking for more translators and language editors***

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients, but just dedication to AB. 
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