Over 8 AHI for years. How bad is it?

[jakeroviks]

I've been using CPAP since 2019. Since then, my AHI has been all over the place, but is on average around 8 recently. Lowest was when I first started, around 5. It has been as high as 40+, even with the machine. 

I want to try and get this to a lower number as I can feel my sleep is suffering. I have a few questions:

1) How low should my AHI be with CPAP? 

2) How would a consistent AHI of 8+ affect someone over the years?

3) If it's bad and fixable, how do I fix it?


P.S. Here's some OSCAR logs to help.

[Psychotech]

would suggest to increase min preasure to 8-9, turn flex to 2 and increase ramp pressure to 6 or turn ramp off

[jakeroviks]

Thanks, I'll try that. 

I haven't used flex before. Is it similar to bipap? I had really bad results with bipap (40+ AHI, mostly central apneaas) that made me switch away from it.

[mesenteria]

The industry and medical field standard is less than 5 events detectable per hour of sleep/rest.   Most of us, not all of us by any means, but most of us manage to get ourselves to under 2.5 or so, and of those, at least half are routinely between 0.5 and 1.5 events per hour.  Your rate is too high for comfort.  Respiratory therapists would work with you to get the rate under 5 events.  Your sleep physician would not be happy with your current treatment.

If your blood pressure is normal, or at least close, you aren't gaining weight suddenly, or having other disorders show up (heart arrhythmias, for example), I would say your AHI of 8 is not apparently injurious to this point.  It doesn't mean you're not slipping into something that will require intervention.  So, if you can, play with treatments, get professional assessment, and try for a substantial improvement down to an AHI of about 3 if you can manage it.

If BiPAP hasn't served you well in the past, it doesn't follow that it wont' now, but I would doubt that things have changed much unless your health and physical properties have changed quite a bit.  For example, if you have lost weight, and it is obvious to everyone and not just yourself, maybe your pressures, or the way it the therapy is delivered, is no longer optimal.

Your chart shows many events, and those tend to cluster.  It is quite possible your chin tucks down, like what happens in side sleeping or when supine (on your back), and this tends to close off the airway.  The result is more measured events and flow limitations.  The remedy you might wish to try that we recommend, and it's only a few dollars plus shipping unless you have a nearby medial supply or health store that carries a variety for you to try, are soft cervical collars. 

Please be patient while others log in and view your question and charts.  You'll get more opinions.