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5 Or Less... - player - 03-13-2015

Will 5 or less (2.4 etc.) events still cause that irritated feeling in my brain?

Does 5 or less events allow for proper sleep and balanced brain and body chemistry?

Does the medical community say 5 or less is not apnea because that's as good as they can do with xpap?


RE: 5 Or Less... - eseedhouse - 03-13-2015

(03-13-2015, 12:41 PM)player Wrote: Will 5 or less (2.4 etc.) events still cause that irritated feeling in my brain?

Does 5 or less events allow for proper sleep and balanced brain and body chemistry?

Does the medical community say 5 or less is not apnea because that's as good as they can do with xpap?

Well, really only your particular body/mind determine if that is true. In order to diagnose, an event rate of 5 per hour is used. But that's just a number, and if we're going to establish diagnostic rules we have to draw a line somewhere.

My AHI's are well below 5 since I started therapy but I haven't suddenly become Superman. I feel a little bit better with the aid of CPAP and supplemental O2 for sleeping. I seem to have stopped deteriorating and I felt I was definitely deteriorating before I started therapy.

It depends on many things, your age, your general state of health and fitness, how long you've been suffocating yourself every night with apnea, and so on.

Although we have to draw a line for diagnostic purposes, your body itself doesn't draw such lines. The lines are extremely useful, but not part of physical reality (except to the extent that minds and the thoughts they produce are physical realities).

Hope that doesn't confuse you even more!




RE: 5 Or Less... - AshSF - 03-13-2015

5 or less is a good line to have. If you have achieved < 5 AHI consistently without any major leaks, that means that:

You have done all you can to improve your sleep quality by eliminating/reducing Apnea events. If you still have some issues (like brain fog, irritated feeling, headaches), you should ideally look elsewhere than trying to get AHI to < 1 or 0.0 of whatever number. Getting AHI much below 5 is unlikely to fix any residual issues.

If you are otherwise healthy (no COPD, no CHF etc.),The residual issues may be the following:

1) You may have a high RDI even though you have a low AHI. Those RERAs are disrupting your sleep stages (by kicking you in a shallower sleep stage from a deeper sleep stage). RERAs can be measured by some new gen machines (PRS1 60 series machines, Resmed A10 for Her). A bit higher pressure may help here.
2) Pressure changes during the night (if you are using APAP) may be causing microarousals which again disrupt the sleep stages like RERAs. In this case, a straight pressure or a straight bilevel machine will help.
3) You may need a Bilevel machine since you don't take in enough air on CPAP/APAP.

Once all these are exhausted and you are still not feeling up to the mark, then you need a full sleep study to evaluate:
1) You may need supplemental o2.
2) You may need ASV/Bilevel of other kinds.
3) Meds for RLS/PMLD/Narcolepsy etc etc.

My 2 cents. YMMV. I am hoping some other experienced members will chime in here.



RE: 5 Or Less... - herbm - 03-13-2015

5 is not a magic number (neither in a good or a bad way -- it's just a number the medical profession agreed to use.)

You might not feel good at 3 and you might feel great at 7 or higher.

However, if possible, I would work to get a bit below 5 -- I am not satisfied with being near 5.

But it is mostly about how you feel and what you CAN do without going crazy.


RE: 5 Or Less... - TyroneShoes - 03-14-2015

(03-13-2015, 12:41 PM)player Wrote: ...Does the medical community say 5 or less is not apnea because that's as good as they can do with xpap?
My best guess would be that this is not the case. Many of us have proven that a regular AHI well below 5 is common with xPAP; mine is currently at 1.6 for the last 90 days.

Also, if they could call "under 5" a "case" of apnea, sleep tests would not be necessary to diagnose it, and they would try to see that everyone, including those "under 5" went into treatment. They don't.

The threshold is not just an arbitrary number pulled out of....somewhere (!Ahem!), it is a real indicator of where treatment is necessary and where it isn't.