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Is "0" Events Achievable?
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2tired2sleep Offline

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Post: #1
Is "0" Events Achievable?
My length of time has improved significantly as has my events per hour rate. And while 2-5 events per hour is markedly better than my sleep study results of 67/hr; is it possible to achieve a ZERO events per hour goal? Again, still waiting on ENT consult for possible/probable surgery on uvula, soft palate, adnoids...etc...
04-02-2015 10:09 AM
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Terry Offline

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Post: #2
RE: Is "0" Events Achievable?
(04-02-2015 10:09 AM)2tired2sleep Wrote:  My length of time has improved significantly as has my events per hour rate. And while 2-5 events per hour is markedly better than my sleep study results of 67/hr; is it possible to achieve a ZERO events per hour goal? Again, still waiting on ENT consult for possible/probable surgery on uvula, soft palate, adnoids...etc...

I randomly get "0", but almost always hang around 0.2 - 0.3. The machine usually logs an apnea or two per night, when I fall asleep or wake up or roll over.

It takes some tinkering with pressure and sleeping habits and equpment to get there (or close), but should be possible.

I'd certainly do all you can with the machine before hacking off soft parts in your throat.

This all works unless I'm stupid and go have a plate of chicken wings or a big cheeseburger and a couple of beers and then go to bed, in which case, I can easily hit 2 or 3 and feel like crap in the morning.

Terry
(This post was last modified: 04-02-2015 10:14 AM by Terry.)
04-02-2015 10:13 AM
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2tired2sleep Offline

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Post: #3
RE: Is "0" Events Achievable?
Thanks Terry. The uvula is a significant problem that needs addressing. There's times when my throat actually tries to swallow it! Its that long. It has bled on more than one occasion because of esophageal peristalsis. When laying on my back, I can't speak clearly, breath right, feel like I'm being water-boarded...
04-02-2015 10:19 AM
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OMyMyOHellYes Offline

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Post: #4
RE: Is "0" Events Achievable?
Is it achievable? Probably. Is it worth pursuing? Probably not.

Good enough is good enough. What would somebody think they would achieve in spending all that extra effort to get there?
04-02-2015 10:37 AM
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retired_guy Offline

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Post: #5
RE: Is "0" Events Achievable?
Agree with what "OHMY" says. In my case I hit zero about 60% of the time. The rest of the time I'm always under 1.0. So you can get there. But your wonderfully low events are great!

What I did when I got to 1.5/2.0 ahi is I took a look at my "Flow Limit." It was rather jagged, so I said to myself, "Self, how come your flow limit is rather jagged?" The answer seems to be that although I had kicked the "sensed" apnea events in the back section, I was still having a significant amount of near-misses. That's when I upped my pressure another .5. The Flow Limit leveled off, and I started throwing zero's. I didn't really strive to do that, it just happened once everything else fell into place.

The other thing that helps is positional. I can sleep on my back or my side, but always with my head elevated enough so that if I wanted to I could actually see my toes. I think that's another ingredient to managing this stuff. (the elevation thingy, not necessarily the "see the toes" thingy.)

So can you hit zero? Sure. Do you need to do that? Well, why not? But don't obsess over it.
04-02-2015 11:55 AM
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Napmeister Offline

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Post: #6
RE: Is "0" Events Achievable?
My story is very similar to retired-guy but it took me a couple of months to fine tune everything, thanks to software and guidance here.

My first month or so results were 3-6 per night, now 0- 1 AHI with the rare bad night. Patience is required when you first start therapy, takes time to get our mind/bodies comfortable with the changes and get a really good mask fit and all the settings that suit your needs. Was a rocky road for the first bit with most of the problems experienced by newcomers.

G'luck with your choices.
04-02-2015 01:46 PM
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TyroneShoes Offline

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Post: #7
RE: Is "0" Events Achievable?
Three times by me, last month.

It feels good, like a clean windshield or a full tank of gas, but doesn't really mean much more than that, other than my average level over 30-90 days will only be going down. Not a bad thing; also not really significant.

I think it is valuable to pursue the lowest AHI you can get, but possibly a little misguided to consider "0" of any actual importance. Under 5? You're essentially not a SA sufferer any more, by definition.

I am also a little suspect of those who claim "I was at 0.1 last night". Mathematically that is only possible if you sleep for 10 hours and have one event. One event in a night of fewer hours is always above 0.1. Often, reported AHI is a fish story.
(This post was last modified: 04-02-2015 04:08 PM by TyroneShoes.)
04-02-2015 04:02 PM
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PaytonA Online
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Post: #8
RE: Is "0" Events Achievable?
(04-02-2015 04:02 PM)TyroneShoes Wrote:  I am also a little suspect of those who claim "I was at 0.1 last night". Mathematically that is only possible if you sleep for 10 hours and have one event. One event in a night of fewer hours is always above 0.1. Often, reported AHI is a fish story.

0.1 AHI is possible in less than 10 hours of sleep with the Rescan statistics. The AHI is either truncated or rounded off to one decimal place. I have gotten an actual 0.1 in Rescan with less than 10 hours sleep.

Best Regards,

PaytonA
04-02-2015 04:38 PM
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Napmeister Offline

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Post: #9
RE: Is "0" Events Achievable?
I can find you many similar SmileSmile

[Image: icaTVbtt.png]
04-02-2015 08:11 PM
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AshSF Offline

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Post: #10
RE: Is "0" Events Achievable?
I get 0.0 AHI probably 10 days a month. A 0.0 RDI about 5 days a month and a 0.0 RDI and 0.0 FL once a month.

I also realized that AHI is only the first piece of the puzzle of getting restorative sleep. When I started APAP, my AHI quickly came down below 0.5 but I saw that I felt foggy on some days with 0.28 AHI than on days with 1.2 AHI. For me, the pressure changes of APAP were causing problems. When I moved to a fixed pressure, all that brain fog went away.

I have come to believe that Sleep docs are right in recommending that mindless reduction of AHI is not a goal worth pursuing. Once your AHI is below 5, its law of diminishing returns kicking in. After that you should look at reducing RERAs or reducing FLs or eliminating pressure changes (whatever seems to be bothering you). Unfortunately, a lot of machines don't measure RERAs so you have to you FL as proxy for RERAs.

While reducing RERAs and FLs, your AHI may come down further from 5. That is why, anecdotally, a lot of forum members say they feel good only when AHI is less than 1 or some such number. Whats probably happening is that to get to AHI of 1, they raise their pressure and that takes care of RERAs and FLs.

Some don't feel good even when AHI is 0.0 (like me on some days on APAP), so you need to investigate if pressure changes are causing you sleep microarousals where you are thrown from a deeper sleep stage (like REM or SWS) to a shallower sleep stage.

So don't sweat AHI if it is lower than 5.

Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
(This post was last modified: 04-02-2015 11:28 PM by AshSF.)
04-02-2015 11:27 PM
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