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Why APAP if Sleep Study result is 3.5 < 5AHI - Printable Version

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Why APAP if Sleep Study result is 3.5 < 5AHI - ICEMAN - 06-23-2021

Just more curiosity, have seen a posted Sleep Study, which leaves me questioning as to WHY a Sleep Study if resulted in AHI 3.5, and No CA or Complex Apnea, but then repots it as:        as Mild Obstructive Apnea ?  

Description below ?
Apnea Hypopnea Index (AHI)
The AHI is the number of apneas or hypopneas recorded during the study per hour of sleep. It is generally expressed as the number of events per hour. 

Based on the AHI, the severity of OSA is classified as follows:
  • None/Minimal: AHI < 5 per hour
  • Mild: AHI ≥ 5, but < 15 per hour
  • Moderate: AHI ≥ 15, but < 30 per hour
  • Severe: AHI ≥ 30 per hour

Sometimes the Respiratory Disturbance Index (RDI) is used. This can be confusing because the RDI includes not only apneas and hypopneas, but may also include other, more subtle, breathing irregularities. This means a person's RDI can be higher than his or her AHI.

Oxygen Desaturation
Reductions in blood oxygen levels (desaturation) are recorded during polysomnography or limited channel monitoring. At sea level, a normal blood oxygen level (saturation) is usually 96 - 97%. Although there are no generally accepted classifications for severity of oxygen desaturation, reductions to not less than 90% usually are considered mild. Dips into the 80 - 89% range can be considered moderate, and those below 80% are severe

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - Dawnstar - 06-23-2021

If you’re having 3 to 4 incidents per hour (I assume this is without pressure support), it’s still going to reduce the levels of deep sleep you get at night, and you’ll be more tired than otherwise. Lack of deep sleep will negatively impact your physical health over time.

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - ICEMAN - 06-23-2021

Hi Dawnstar, Yes thanks reply, I do understand your comments and many strive for magical ZERO AHI ! 

But then under 5 is considered Normal "presume that" thus intention that PAP treatment not required and then yes is the question ok AHI 6 do may start to looking for need of some type treatment ? PAP or other type Oral appliance ? and may presume also may be difference between if the events spread and constant so waking over whole night sleep in comparisons if the all the events condensed over short time frame, which I would I presume would be much less contributing to Sleep deprived/fatigue on waking from nights sleep ?  

Resmed Shows:

An AHI less than 5 is considered normal, and some patients with severe sleep apnea may be told by their doctor that they can accept even higher numbers so long as they’re feeling more rested each morning, experiencing fewer symptoms and their AHI is progressively decreasing.

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - SarcasticDave94 - 06-23-2021

I personally do not suggest chasing zero events, magical or otherwise. In order to get there, if you actually can, it'll likely sacrifice comfort and sanity. One likely will drive themselves crazy in pursuit of zero for probably not any added benefit over just less than 5 AHI with maximized comfort and rest.

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - Dog Slobber - 06-23-2021

CPAP is often prescribed for UARS sufferers who may have an AHI less than 5.

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - ICEMAN - 06-23-2021

Yes Dave I have never really, been too concerned much about my treated AHI, as long on wake up, quick look machine for around 3 AHI "with a Smile " well that will do me. With out all sorts to try prevent sleep on back without the worries wear "Shirt back to front with a tennis ball in the top pocket"! I just try take waking effort to sleep Non Supine, but when restless sleep which ever will help quicker get back to sleep ? Supine and Non Supine, as initially treated AHI often under 5 AHI except more late  AHI more often random up around 7-9 CA then back to CA 2 ? do think if is some more triggered of the random CA spikes? but what ?  and also generally if doing a lot of physical work mostly, then often also minimal CA well under the 5 AHI if not 2-3AHI  ? so figure it or unless is just being more physical, more tired? making the sleep more sound, without or reduce any restless junk sleep ?

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - Ratchick - 06-24-2021

It's about symptoms. In many cases, even if you have an AHI over 5 but less than 15, if you're asymptomatic, they often won't treat you with CPAP initially.

CPAP is indicated for those with either an AHI/RDI > 15 or those with an AHI/RDI >5 and symptomatic.

CA is not treated by APAP or CPAP. It can sometimes happen as a result of APAP, but it's going to depend. And centrals are very variable. Some days only a few occur, some days there are more. It's just going to depend on why you're having those centrals (i.e. it's part of your normal sleep pattern, it's a result of the APAP, it's all SWJ or there's something else causing it). If indeed when you are more active, you sleep more soundly, and that always results in fewer centrals then you are probably right, that it's Sleep-wake junk. We can only tell by looking at the chart though.

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - Dawnstar - 06-24-2021

Reaching zero AHI for its own sake certainly isn’t my point here, my point is that most people would find that they have more deep sleep and better overall physical health with fewer apnea related wake-up incidents. An AHI of 4 translates into a sleep interruption every fifteen minutes, whereas one half that means an interruption only every half hour. In terms of restful sleep and overall health that’s a huge difference. 

Most nights my treated AHI is 1 or lower, the nights where it’s 2 or more, I really notice the next morning, and the day after.

If you’re not resting fully at night, your physical and mental health are likely to trend downhill over time.

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - Ratchick - 06-24-2021

OH absolutely - I don't think anyone here is denying that some people just feel cruddy with a supposedly "treated" AHI. It's more about people who feel well and aren't suffering OSAS symptoms anymore, but who are so determined to get rid of every single event even if they're only having a few and it's not providing any better experience day-to-day, and just more stress and anxiety about not being able to get everything gone.

RE: Why APAP if Sleep Study result is 3.5 < 5AHI - ICEMAN - 06-24-2021

In addition with Sleep Studies in reality is short Snap Shop such as APAP Data machines will show at times quite a AHI variation on night's very Low and other random times excessive High AHI, so if have a Good Night " low AHI" or Random "High AHI Night" on the night of the Sleep Study ? may not accurately represent in reality actual average AHI sleeping pattern?