What's the Highest AHI that you have ever seen?

[Sleeprider]

98taco, nice to see you back

Okay, it happened, but what became of you? You were not much of a candidate for CPAP since most apnea was central.

[98taco3]

well its been an ongoing struggle unfortunately.  

Originally I was set up with a Bipap ASV however I havent tolerated it well.  A combination of severe sinus issues (working with an ENT on this) and What I believe to be poor machine setup has forced me off the machine.  Essentially I feel that I was setup for failure by the first doc and medical equipment provider.  The doc I was seeing has been a nightmare to work with.  Appointments are only available months out, wont return phone calls, and just generally not easy to work with. 

Im currently seeing another doc at a Sleep Institute to hopefully get to the bottom of this once and for all.  I am trying to get a third sleep study scheduled at a completely different facility to confirm what the first 2 studies found and try to find a treatment that works. 

The new doc ordered a ECG a month ago or so and I havent heard anything which is generally a good sign...

Im hoping to get this taken care of, it sucks knowing that youve got issues that havent been addressed.

[SaldusMiegas]

hi 98taco3,

best wishes with your new doc.  With an AHI of 150+ I don't know you manage to function on so little restful sleep.

keep your chin up and don't give up until you find a doc that can help.  

Saldus Miegas

[Sleeprider]

If you want to work with the forum members on some potentially more successful settings, we're here for you. If you are using a Philips or Resmed ASV, then download the free #Sleepyhead software. We can review settings and see what your response has been, even if you have minimal data. Best of luck, and let us know if we can help.

[98taco3]

hi 98taco3,

best wishes with your new doc.  With an AHI of 150+ I don't know you manage to function on so little restful sleep.

keep your chin up and don't give up until you find a doc that can help.  

Saldus Miegas

Thanks for the words of encouragement!  The ability to function, not falling asleep constantly etc, is what is leading me to believe there is something up with the first studies.  I find it a bit hard to believe that I can function at all with those sorts of numbers.  Hopefully this new sleep doc is able to get to the bottom of this...

[Yaatri]

My first PSG study in the U.S. was done in Sept 2008. Prior to that I had had a sleep study in India when I had to undergo unexpected surgery on my visit there. The sleep study was done as a prep work for the surgery. I am not sure I can find that report.
The one done here had an AHI of 90.3 with episodes lasting as much as 43 seconds. My saturation levels went down to 66%, IIRC.

I asked my doctor how bad it was. He said "pretty bad." When I asked him if he had seen higher AHI, he said that he had but not many.
I see several people here have higher AHI, which seems to match my doctor's experience too. I was diabetic and hypertensive. I had been diagnosed with aortic insufficiency (aortic valve leaked as it did not close completely) in 1972 in a medical exam after I had been selected to be an airforce pilot. That was the end of my dream to be an airforce pilot.

Fast forward to 2020, in the middle of the Covid pandemic, when my aortic valve had become worse enough to warrant replacement. I had gone in for an cardiac cathterisation so that the doctors could take a good look at my heart. The plan in the morning was to evaluate me for TAVR--Transcatheter Aortic Valve Replacement-- a minimally invasive procedure. That's when they discovered that 4 of my coronary arteries were blocked between 80 and 90 percent. TAVR plan was dropped and an open heart surgical replacement of the aortic valve and bypass grafts were recommended. I now have a bio prosthetic valve ( made using a cow's heart valve tissue). I had some complication after the surgery but the surgeon handled it quite well. I am doing quite well now, even got back on my motorbike a few times.

I am on my 6th BiPAP now, soon will be on my 7th. Three of my Resmed 10S's died a noisy death. I am thinking of replacing the motor on the 6th one.

[Crimson Nape]

Hi Yaatri!  -  

CPAP therapy is not supposed to be a full contact sport.  Just what are you doing to those poor little defenseless devices?  

[Yaatri]

Hi Yaatri!  -  

CPAP therapy is not supposed to be a full contact sport.  Just what are you doing to those poor little defenseless devices?  

Why didn't anyone tell e before?  

But seriously, I have often wondered why my Resmed AirCurve 10 have been failing. I think my high pressures may have something to do with it. My current unit has 11200 hours in just under 4 years.  The first two failed within a year. Basically the motor starts making noises.  My current unit has been noisier for more than a year. This one lasted longer, maybe because I lowered the pressure to 18 two years ago.

[cathyf]

When I first heard about AHI, I was confused. Why do they only count events/hour? I have no medical education, but my engineer mind tells me that you also need to consider how long the events are. As already said above, a small or moderate condition with low AHI could be very serious if each event is very long, say one minute. I guess the AHI unit is something that was invented before we had computer programs to calculate things more easily.

In the last couple of months I've started having apneas in the 45-65 second range, with desats into the 80's or high 70s. I can always tell when I've had one the night before, because I wake up with vertigo.

So for me, at least, a single apnea can wreck an entire night of sleep. And of course if I just have that one my AHI will look trivial

Before I got the chin-tucking under better control, I would have bursts of apneas where my AHI over just that intense period would go into the 60s-70s-80s. And the next day I would be groggy and have a splitting headache. But that was still not as bad as the day after one of those 60-second events.

[hh9797]

While I can not answer the question as to what the highest has been what I can answer is that it is literally impossible to be anything over 359 and even that is impossible, because in 1 hours there is 60 minutes or3,600 seconds, even if you had the shortest possible events to be counted as events at 10 seconds and only had 0.01 seconds between each event the max you could fit into one hour is 359 in which the person only breaths for 3.596 seconds per hour which is obviously impossible to get that little air and still be living.  Even if we say 10 second event 5 second breathing 10 second event 5 second breathing that would still max out at 240 max and that is assuming all the events are literally the shortest possible to be considered an event. 

With that said that is one of the biggest issues with just looking at how many events per hour because if you take someone who has say an AHI of 20 but the average length of each event is 15 seconds and compare them to someone else who has say and AHI of 10 but the average length of event is 30 seconds, then even though person A number wise looks twice as bad as person B both spent the exact same amount of time not breathing per hour of 5 minutes per hour. As such while AHI is a great tool for spotting sleep disorders and the probability of severity a lot of other numbers are needed to know actual severity, because an AHI of 30 with an event length of 12 seconds per event (a total of 6 minutes per hour) is considered severe apnea while as an AHI of 14 with an average event length of 30 seconds per event (a total of 7 minutes per hour) is considered mild apnea if you base the severity off of AHI alone and don't take into account any other numbers. As such the AHI is a useful tool but can also be slightly misleading in times as well. For example on the 8th I had an AHI of 4.77 where as on the 12th I had an AHI of 5.35, as such the 12th looks to be about 12% worse right? but then you look at the time in Apnea the 8th was 7:48 seconds and the 12th was 7:21 which makes the 8th look 7% worse because while I had more apnea events they were of a shorter time, think of the numbers as a guideline and not as something that is the be all end all. 

Another way to look at it is while driving you could have one route be 50 miles long and take 3 hours because of traffic due to an accident and another route be 75 miles but only take 1 hour because there wasn't an accident on that route, as such you need multiple numbers of data to draw any conclusion because while 50 miles looks better then 75 miles on paper the thing it lacks looking at just the length of drive is the amount of traffic during that length of drive.