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Is anything above an AHI of 0 considered a failure?
#1
This is my first experience with CPAP. I have only been using my Dreamstation for 1 month. My AHI during my sleep test was 38. I am now starting to consistently be around 14-15 AHI every night. I have NEVER been below 14. I would of course love to be around 0 AHI every night but feel good that I am on the MILD end of the scale, considering I was at the SEVERE end before CPAP therapy. Is 14 -15 not low enough? Should I be trying other ways to reduce this number?

Thanks for the input from seasoned users!
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#2
Hi slumberland and Welcome to Apnea Board!

Your AHI is still a bit too high, but don't forget you just started. Trying to achieve an 0.0 AHI isn't realistic. Oh sure, we get a few here and there, but an AHI <5 is considered treated.

Just looking at your profile and see that your machine is set to what we call a "wide open" range, and I will assume that this is not optimal for your treatment.

A minimum pressure of 4 is just to low. Most will feel "air starved" with a pressure that low.

Since it looks like you have sleepyhead installed, pop in your SD card and tell us what your AHI breakdown is: Obstructives, hypopneas, clear airways. Also, what is your 90% pressure number?

From there we may be able to advise on a better pressure range for you. But for now, I wouldn't hesitate to change that minimum pressure to at least 6.

Get the Clinicians manual for your machine....link at top of page.

Also, get a few more posts under your belt, so you can then post a screenshot of the daily page in SleepyHead.

A couple links to help you get started.
https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur


OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#3
An AHI > 5 is considered inadequately treated sleep apnea (you can get a prescription for a PAP device if AHI > 5 for your sleep study). That said, you probably need to optimize your setup more. I noticed that you have a very large treatment pressure range, and in particular your minimum setting is likely too low. Most people feel starved for air at a pressure of 4 cm H2O, and 20 is simply the maximum pressure that most devices are capable of.

Have you been actively following your data in SleepyHead? What is your typical 95% Pressure for a night? A good starting point for your range is to set it to +/- 2 within your 95% Pressure (e.g. if P95 is 12, set range as 10-14). Also, if you can, post some screenshots of a typical night, and everyone here will have a look and offer their insight.
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#4
I'll let others work with you, but what did your titration say? If you don't know, ask for a copy of the raw data (tech report to doc) as well as the doc's summary. Were they ABLE to eliminate your apneas?
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#5
Thanks for the responses so far. Here is a screen grab from SleepyHead that shows AHI, USAGE and PRESSURE.

[attachment=2753]
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#6
Hi slumberland,
WELCOME! to the forum.!
Hang in there for more responses to your post and much success to you with your CPAP therapy.
trish6hundred
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#7
Hi slumberland,

I am a newbie in this new world. Just began on 5/25/16.
I began in the forum and it was a really nice option for myself. First I learned a lot of this new world. Second I learned that I am not alone. Third there is a lot of guys in the forum with a lot of years of experience using CPAP, and some of them are Drs. and can give you a lot of good advises.
I think you have improved a little bit, but you can not stop with this high AHI.
I got 9.9 in my study, began with the machine and the AHI was 4-7 and after almost 2 months my Dr. make the first machine adjustment It went down a little bit and after my own adjustments I am 2-4 now, and I am feeling very well. Still coping with a few minor problems with the CPAP stuff.
You must work hard and study about this setting problem, speak with your Dr., read the advises and MAKE YOUR OWN CONCLUSIONS,.
At the end , it is your body , your health and YOUR MACHINE. NOBODY WILL CARE BETTER THAN YOURSELF.
Your goal is make the necessary adjustments in your way of life, and machine settings. Do not stop until your average is less than 5 AHI.
When you get there, you will feel really great. I am promising a new life.
Ralph.
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#8
Hi, slumberland. Welcome

We can get a better idea of the dynamic response of your machine to your apneas from a screenshot of graphs on the "Daily" tab, but just from the graph you've posted, I'd say that your minimum pressure is probably too low. If you set your minimum pressure closer to your median pressure value, the algorithm would be able to respond more quickly when you have apneas.

How to Organize Your SleepyHead Graphs
Screenshot of Your SleepyHead Screen
Using imgur or some other outside image sharing site to post your SleepyHead graphs

If you look on the "Statistics" tab in SleepyHead, you will be able to see your average median pressure value.

Also, it seems that your machine is reaching its maximum pressure of 20.0 most nights. (If I'm reading the graph correctly.) If you keep hitting 20.0 every night and your AHI is still high, you may end up needing to switch out your machine for a bilevel machine, because those generally go up to 25.0 cm pressure.

Oh - no, you don't need a zero AHI. That's not even achievable for most of us. Most doctors will be happy if your AHI is 5.0 or less. That's an average of 5.0 over whatever period of data they are reviewing when you see them.

Most of the people in this forum seem to work to have a lower AHI. It sort of comes down to the characteristics of your apnea, how much time you want to put into fiddling with your machine settings, and how you feel. If you get your AHI down to 2, and you feel terrific, you may say "hey, that's good enough". It's a very individual decision.


(08-11-2016, 12:27 PM)slumberland Wrote: Thanks for the responses so far. Here is a screen grab from SleepyHead that shows AHI, USAGE and PRESSURE.

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#9
Remember there is no cure - yet. There is only treatment so far, and lower numbers are indicative of better treatment. The best way to judge your results are by how you feel, if you are feeling better when awake then you are making progress. As has been said, AHI of 5 or lower is for most places considered "successful" treatment. Personally I feel best when my AHI is consistently around 3 to 4. I seldom have it below 3 for many days.

I think 14 is a bit high, and would hope to see you improve on that. For some people it takes longer than others. Hang in there and you will get good advice.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
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#10
(08-11-2016, 03:39 PM)FrankNichols Wrote: Remember there is no cure - yet.

Well.. the way I've heard it is,...

Death cures:
  • Sleep Apnea
  • Heart Issues
  • Smoking
  • Obesity
  • Stupidity
  • Foolishness
  • <_ insert additional items here _>
Warning: Eating chocolate may cause your clothes to shrink!
[Image: ry6XtE9.gif] <---- That's ME!
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