Help my understanding of AHI (newbie)

[ughwhatname]

I just got my machine three days ago. I am proud to say that I used five hours the first night, and ALL NIGHT the past two nights. I'm very pleased with my progress since I had a near panic attack when I had my sleep study done. I was afraid I wouldn't be successful, but failure is not an option.

I have severe apnea with 63 per hour (yikes!) My machine has programmed settings 4 to 14. Highest setting on my daily report has been 10.2.

I am reading the results each morning and my AHI has been 0.6, 1.7 and 0.6. That's terrific, isn't it? Does that mean that the machine is doing exactly what it is designed to do?

I don't feel a whole lot different yet. I did notice that even after only five hours the first night, that the edema in my lower legs and feet just about vanished overnight, literally. I couldn't be more thrilled.

I get a sore nose come morning, and that is about the best complaint I can come up with. I am exceedingly grateful to live in a time of this technology to benefit from it.

[robysue]

I am reading the results each morning and my AHI has been 0.6, 1.7 and 0.6. That's terrific, isn't it? Does that mean that the machine is doing exactly what it is designed to do?

Yes, the machine is doing exactly what it is supposed to do.

Instead of haveing 63 apneas and hypopneas per HOUR, with the machine you are having between 3 and 8 apneas/hypopneas per NIGHT (as in the whole five hour period you slept with the machine.

I just got my machine three days ago. I am proud to say that I used five hours the first night, and ALL NIGHT the past two nights. I'm very pleased with my progress since I had a near panic attack when I had my sleep study done. I was afraid I wouldn't be successful, but failure is not an option.

Attitude is very important! With an attitude like yours, you will be successful!

I don't feel a whole lot different yet. I did notice that even after only five hours the first night, that the edema in my lower legs and feet just about vanished overnight, literally. I couldn't be more thrilled.

It takes time to start feeling different. Some people are lucky enough to suddenly wake up feeling much more alive one morning. For most of us, the improvement in how we feel during the day is gradual.

The vanishing of the edema is indeed likely the use of the CPAP. Keep track of such things. They matter too.

[ughwhatname]

Thanks so much for the quick response.

When my doctor suggested I had sleep apnea, it all made sense. When I looked at the symptoms related to it, it was so clear. When he told me I had 63 events per hour, I just laughed. Its so ridiculous. My oxygen levels were falling to 60% during the night. Its a wonder I didn't die already.

I am so happy for an explanation for so many things going on. Two years ago, I was participating in half marathons. Today, I walk my dog 1/2 mile and feel I've had enough. I suspect with better oxygen saturation, I'll be much more able to do what I've done before.

[ReadyforRest]

I'm so happy to hear that you're doing so well so fast, especially since you have severe OSA. I also have the "severe" diagnosis, with 36 AHI, and 50+ AHI in REM, and oxygen desats at 78%. After diagnosis, I resisted getting on cpap for a full year due to a combination of denial and stubborness. Until three months ago, when it caught up to me, and I felt like a walking zombie. Finally I saw the error of my ways, and now am fully committed to it. I use it every night, all night long, and now have AHI's between .7 and 3.

Having a positive attitude, AND reading everything on this board ... absorbing the wonderful help that everyone gives here, and knowing that there is a support group here to help when you need it, is the best thing! It's the main thing that kept me going and what's made me successful in my own treatment.

You have come to the right place. Welcome!

[ughwhatname]

Thanks so much! I just woke from a nap, and used my equipment, no problem. Well, one problem. I tend to have trouble for the first few minutes. I ever so slightly freak out about the pressure. I have an autoset machine, with no ramp set. It automatically starts at 4. If I were to set the ramp, it would just do the same thing, would it not?

Once I've gotten over that, I'm fine the rest of the night. It actually oddly comforting to me, though the nasal pillows make my nostrils sore by morning.

[Pugsy]

Welcome to the forum.

For the sore nostrils in the mornings use a little bit of Lansinoh ointment. At night use a little bit and during the day more.
This is the ointment designed for breastfeeding moms for nipple soreness. Found in the baby aisle of most stores where bottles and nipples are located.
The nostrils aren't used to having anything rubbing up against them so they tend to get a little tender for first time nasal pillow users.
Make sure you aren't over tightening that top strap though. Anything more than minor tenderness usually means that the straps are too tight. Easy to do and the most common mistake that people make.

Using ramp can start at 4 cm but it can also be set a little higher. If the 4 cm pressure seems like you aren't getting enough air movement you might think about seeing if your starting pressure could be increased just a little so that it isn't so stifling (if that is the problem). For a lot of people 4 cm would seem like trying to suck air through a straw covered with cheesecloth. Technically we can't suffocate at that pressure but it can sure feel like it. You could use ramp starting a little higher or just use a little higher starting pressure to start with. Ramp doesn't have to start at 4 cm though.

[ughwhatname]

It hadn't occurred to me that the pressure might be too low. I thought the opposite! I'll try that and see what happens. Thanks.

Welcome to the forum.

For the sore nostrils in the mornings use a little bit of Lansinoh ointment. At night use a little bit and during the day more.
This is the ointment designed for breastfeeding moms for nipple soreness. Found in the baby aisle of most stores where bottles and nipples are located.
The nostrils aren't used to having anything rubbing up against them so they tend to get a little tender for first time nasal pillow users.
Make sure you aren't over tightening that top strap though. Anything more than minor tenderness usually means that the straps are too tight. Easy to do and the most common mistake that people make.

Using ramp can start at 4 cm but it can also be set a little higher. If the 4 cm pressure seems like you aren't getting enough air movement you might think about seeing if your starting pressure could be increased just a little so that it isn't so stifling (if that is the problem). For a lot of people 4 cm would seem like trying to suck air through a straw covered with cheesecloth. Technically we can't suffocate at that pressure but it can sure feel like it. You could use ramp starting a little higher or just use a little higher starting pressure to start with. Ramp doesn't have to start at 4 cm though.

[Pugsy]

Low pressures and the small openings of the nasal pillows sometimes creates a really restrictive feeling in regards to the air movement. You might also try one size larger in the nasal pillows to see if that helps.

[ughwhatname]

I did try both the small and extra small, and for the first time in my life, I wear an extra small... in anything! I liked the feel of the small better, but the RT thought the XS was a better fit. Since I only have trouble for the couple of minutes, I think I've probably got the right size. I have had zero leaks in 24 hours of usage, so I suspect I'm right-sized.

Low pressures and the small openings of the nasal pillows sometimes creates a really restrictive feeling in regards to the air movement. You might also try one size larger in the nasal pillows to see if that helps.

[Pugsy]

I can actually use both the Small and XSmall both quite comfortably and effectively. I alternate them depending on mood and which one I grab out of my stash to put on when I take off the used one to wash it. Other than looking at the sizing I can't really tell the difference when I wear them. I couldn't tell you right now what size is on the mask I used last night.

I started my therapy with the Swift LT nasal pillow mask. It was the same way with those. I suppose I am likely an "in between" size in true life. I know it was that way when I tried one of the nasal prong masks. The nasal prong fitting has to be much more precise and it didn't work for me. One size was too small and leaked badly and the next size was too large and hurt like the devil.

Use whichever you feel the most comfortable using.

Sounds like you have a good handle on things and are doing very well. I had a much longer "welcome" post this morning for you but the forum went bonkers when I tried to post it and it got lost.

We have a nasal pillow exchange thread for the sizes you don't use. Assuming your DME gave you all 3 sizes that are supposed to be included in the mask package.
viewtopic.php?f=1&t=36070&p=753606&hili ... ge#p753606

[avi123]

The following is a past post by the poster SWS about AHI and RDI:

[Lizistired]

Hmm, No idea what that has to do with this thread.

[-tim]

I can't use the nasal things so I can't help you with their problems. I use a nasal mask so I don't have those problems.

Your AHI is good just don't be worried about it getting a bit worse in the near future. An AHI of .6 means you have about 5 events over about an 8 hour night (or less for 5 hours) and your 1.7 means 5 events over about 8 hours. Both of those are very good but they may change in the near future. If those events are longer than 30 seconds, they may turn into two 10 second events which make your AHI double but its better for you. If you can read your data and look at the graphs, they will show what is going on. You may get to the point in the future where the leaks increase or the AHI goes up. That can be due to your headgear stretching or the mask wearing out where the headgear may be something you may see in the next few days and the mask seal wears out in many months depending on how you sleep.

There are plenty of people around to answer questions and an extensive database to look for answers so don't worry about using the resources.