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How serious is this?
11-19-2013, 12:23 AM
I have known I snore at night for years, however my wife had convinced me to get a sleep study done because I stop breathing in my sleep. I got the results, showed them to my doctor, and he pretty much said he was surprised that I am still alive. I have an AHI of 107. Is he over reacting or is it really that bad?
11-19-2013, 12:26 AM
I don't think your doctor is over reacting! I'm just glad you are still "with us" and have found this forum. So, welcome and I know you'll find a lot of help and support here.
11-19-2013, 12:30 AM
Keepingmywifeawake, welcome, it is very, very bad and you need to be on a CPAP ASAP. Apart from you stopping breathing 107 times an hour which is bad enough, every time you have one of the 107 apnea's per hour your body goes into the flight or fight mode, you wake up either consciously or subconsciously which means you never sleep, your blood rushes from your extremities to your vital organs, your heart and your brain, can you image the stress this is putting on your body. A friend of mine had an AHI of 120, he had a heart attack, diabetes and depression and finally got onto CPAP. Do yourself and your wife a favour and get on a CPAP, I'm surprised your Dr didn't order you one urgently.
11-19-2013, 12:30 AM
107 is indeed really bad. Get on CPAP and stick with it, it will make a world of difference for you. Good luck.
11-19-2013, 12:52 AM
(11-19-2013, 12:23 AM)Keepingmywifeawake Wrote: I got the results, showed them to my doctor, and he pretty much said he was surprised that I am still alive. I have an AHI of 107. Is he over reacting or is it really that bad?To give you a concrete idea of just how serious your OSA is consider this arithmetic.
Your AHI = 107 means that for each hour of sleep, you experienced an average of 107 respiratory events called apneas or hypopneas. One way to look at that figure is that on average you are having an apnea or a hypopnea on average about every 33 or 34 seconds when you were asleep.
And note: An apnea is a complete cessation of air going into or out of your lungs for at least 10 seconds. A hypopnea is scored when the airflow drops substantially: Typically a hypopnea either requires a 30% drop in airflow for at least 10 seconds along with a 4% drop in O2 saturation OR it requires a 50% drop in airflow for at least 10 seconds with either a 3% drop in airflow or an EEG arousal. In either case, a hypopnea means that your breathing is seriously compromised for at least 10 seconds.
Now recall: You have an average of 107 apneas+hypopneas per hour. And each one of those events is at least 10 seconds long, and some of them are likely much longer (as in 20 or 30 seconds long). Hence for each hour of sleep, you are either NOT breathing at all or you are NOT breathing sufficiently well for at least 1,070 seconds (on average) during each hour of sleep. And 1,070 seconds equals 17.83 minutes.
In other words, during each hour of sleep, you are essentially not breathing for at least 18 minutes. It's true that it's not 18 minutes at one stretch. Rather: You have one apnea or hypopnea on average about every 33 seconds of sleep and it lasts at least 10 seconds in length. Hence, for every 33 seconds of sleep, you are breathing normally for at most 23 seconds and you're NOT breathing (or NOT breathing well) for 10 seconds.
To put it very bluntly: About 1/3 of the time you are asleep, you are NOT breathing (apneas) or NOT breathing sufficiently well (hypopneas). That's an issue.
11-19-2013, 12:56 AM
An AHI means that every hour, you stop breathing (apnea) or had shallow, choking-like breathing (hypopnea) 107 times for at least 10 seconds each.
An hour has 3,600 seconds in it.
For at least 1,070 of those seconds, nearly a THIRD of that hour, you weren't breathing or were choking.
This was my response to someone with an AHI of 30. So multiply it by, what, 3.5 or so?
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11-19-2013, 01:22 AM
You,re not alone, my RDI was 85, here is the report:
the patient reported that the quality of his sleep was worse than usual .Sleep efficiency was poor (52.7%)with frequent awakenings and several prolonged wake across the night. sleep latency (33mins) was prolonged and the proportions of both slow wave sleep (3.9%) and REM sleep (9.3%) were reduced .continuous soft to moderate intensity snoring was reported by the overnight technologist.
Runs of repetitive hypopnoes and obstructive apneas occured during both NREM and REM sleep in all position ,and caused frequent arousals (arousal index 84.8) and moderate oxygen desaturations (min SaO2 85%) . small numbers of RERAs were noted . the overall RDI was 85.0 .there were no periodic leg movements. the ECG showed normal sinus rhythm (mean HR 68 bpm ). Severe OSA
Whats the next step, CPAP titration?
If your apnea is obstructive than CPAP/APAP would be recommended and bi level if high pressure needed
Mixed or central apnea, another type of machine altogether
Machines choices and what to avoid http://www.apneaboard.com/wiki/index.php...ne_Choices
keep us posted of any updates and keep the question coming, folk here been on the same journey and most helpful
Best of luck and welcome to the forum
11-19-2013, 06:35 AM
My initial AHI was 60 something When I asked the specialist how bad that was he asked me 'would I still be your friend if I roused you every minute while you were asleep?'
(My reply was to say that since I had not yet seen his bill the jury was still out on whether he was friend to start with...)
On another topic- its not universal but a common problem that travels with OSA is Nocturia.... Pre CPAP I was getting up on the hour every hour most nights... That stopped on my first night on CPAP.
11-19-2013, 07:37 AM
WELCOME! to the forum.!
I echo what everyone has said so far.
You need to deal with your apnea, it is serious.
Best of luck to you and ask as many questions as you need to.
11-19-2013, 08:23 AM
(11-19-2013, 12:56 AM)PaulaO2 Wrote: An AHI means that every hour, you stop breathing (apnea) or had shallow, choking-like breathing (hypopnea) 107 times for at least 10 seconds each.Your response on the other thread was nicely written.
The math for an AHI = 30 looks like this:
An hour has 3,600 seconds in it.
Each of the 30 apneas/hypopneas lasts at least 10 seconds (maybe longer). So for a patient with an AHI = 30, the patient is NOT breathing or NOT breathing well (choking) for at least 300 seconds, maybe more.
Hence, if the AHI = 30, the patient is NOT breathing or NOT breathing well (choking) for at least 300/3600 = .08333 = 8.33% of the night.
As an interesting side note: If those 30 apneas and hypopneas last an average of 12 seconds instead of the minimum 10 seconds needed to be scored, then an AHI = 30 translates into NOT breathing or NOT breathing well (choking) for at least 10% of the night.
Since many, many apneas/hypopnea that are scored on PSGs are longer (or even much longer) than the minimum 10 seconds needed to score an event, it's not an unreasonable conclusion that someone with an AHI = 30 is probably NOT breathing or NOT breathing well (choking) for at least 10% of the time they are asleep.