AHI of 5 and disappointed

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Pugsy
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Re: AHI of 5 and disappointed

Post by Pugsy » Wed Oct 22, 2014 8:19 pm

Read up on Welbutrin should you be thinking about asking your doctor about it..it may not cause fatigue but it can sure mess with sleep. Insomnia is a known side effect and taking it in the AM didn't help for me and what sleep I got was highly fragmented as long as I was taking it. I saw it in the cabinet the other day...I quit taking it so I could get some sleep.
YMMV though..that's the way it is with most meds.

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EstelleS
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Re: AHI of 5 and disappointed

Post by EstelleS » Wed Oct 22, 2014 9:09 pm

Pugsy -
I know what you mean about Wellbutrin - sometimes it's a little too "energizing" . In my case though, I don't think it's responsible for any of my sleep problems - had them before I started taking it. And it doesn't seem to make them any worse, as long as I take it early enough. It's such an individual thing - like masks, you have to keep trying until you find the right one.
Estelle

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Pugsy
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Re: AHI of 5 and disappointed

Post by Pugsy » Wed Oct 22, 2014 9:49 pm

EstelleS wrote:Pugsy -
I know what you mean about Wellbutrin - sometimes it's a little too "energizing" . In my case though, I don't think it's responsible for any of my sleep problems - had them before I started taking it. And it doesn't seem to make them any worse, as long as I take it early enough. It's such an individual thing - like masks, you have to keep trying until you find the right one.
Estelle
I hear you...my comment was mainly for someone who might be thinking of trying Welbutrin and had never tried it. Just a heads up to research it ...same really with any meds a person is thinking of talking their doctor into trying ...just education mainly.
I wasn't meaning to sound negative towards your comments at all.
Just general warning for people to research meds side effects...you would be surprised at the people who have no idea what the potential side effects are to the meds they take.

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Re: AHI of 5 and disappointed

Post by EstelleS » Wed Oct 22, 2014 11:39 pm

Pugsy wrote:
EstelleS wrote:Pugsy -
I know what you mean about Wellbutrin - sometimes it's a little too "energizing" . In my case though, I don't think it's responsible for any of my sleep problems - had them before I started taking it. And it doesn't seem to make them any worse, as long as I take it early enough. It's such an individual thing - like masks, you have to keep trying until you find the right one.
Estelle
I hear you...my comment was mainly for someone who might be thinking of trying Welbutrin and had never tried it. Just a heads up to research it ...same really with any meds a person is thinking of talking their doctor into trying ...just education mainly.
I wasn't meaning to sound negative towards your comments at all.
Just general warning for people to research meds side effects...you would be surprised at the people who have no idea what the potential side effects are to the meds they take.
I couldn't agree more - no one should take any of these meds without being educated about side effects. And unfortunately, sometimes doctors prescribe them too casually. I was originally just meaning to support the proposition that Wellbutrin isn't likely to cause fatigue like some other antidepressants. In fact, as you pointed out, for some people it can be a little too stimulating. As I've been learning, depression and sleep apnea can become very intertwined, and finding the way out of the mess they create is challenging, to say the least - especially because what works well for one person won't be the answer for someone else. The sad thing is that it is easier for doctors to prescribe a drug than to properly diagnose sleep apnea. I was lucky because my doctor understands the connection - she was the one who kept bugging me to get a sleep study done. And boy, was she right.

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Re: AHI of 5 and disappointed

Post by zoocrewphoto » Thu Oct 23, 2014 2:16 am

cathyf wrote:Another thing to be aware of is sleep architecture. I'm going to construct an example which illustrates how you could wake up dead from an AHI of 5.5! Suppose you slept for 6 hours during the test, with an AHI of 5.5 that means 33 events during the 6 hours. Suppose you only had 10 minutes (600 seconds) of REM sleep, and 30 of the 33 events were during that 10 minute time stretch. Next suppose that those events lasted 18 seconds each -- and 600/30 means they are 20 seconds apart. So, in other words, you spent 9 minutes not breathing over a 10 minute period. If the test on my hypothetical example were to break out rem and no-rem AHI, it would be 180 AHI for rem and 0.5 AHI for non-rem. It doesn't have to be REM sleep, either -- maybe you are taking your life in your hands each time you sleep on your back, and you only did that for a very short time in the test.

The point is that if you stop breathing for more than a couple of minutes, you are going to be dead. Even a low AHI can mean enough not-breathing time to do serious damage if it's all clustered together over a short enough time window.

The only way that anyone can tell if alarming things are hiding behind a bland average is by seeing the full breakout of sleep test data.

So true. Once I had my followup with my sleep doctor, I let my mom try my machine for a couple partial nights. Her machine was really old, pre data, and she wasn't feeling like it was working well for her. I set it for her pressure of 10. The ahi was 3.4. Looked nice. Until I looked at the graphs. She had clusters of events that were over 30 seconds long. And one time was 62 seconds long! Her ahi was great, but she was still severe. We did another partial night of 10-13. We took the printed reports to my sleep doctor who reviewed them along with her sleep study from a couple years earlier. He prescribed a new auto machine for 10-15 with full data. She feels much better now.

My own example shows how a sleep study can't always capture everything.I did a split night study, so only 2 1/2 hours of diagnosis and about 6 hours of titration. I was told to sleep anyway I like, except propped up on the headboard. I do naturally sleep on my back without cpap so they got good data during the diagnosis, but not so much during the titration. Also, during the diagnosis phase, I never made it to deep sleep or REM. So, while I was already in the severe category with an ahi of 79, it most likely that my true ahi for a full night would be higher. Add in lots more back sleeping and REM sleep (typically higher ahi during REM), and my overall ahi would go up. When you are as severe as I am in, it really doesn't matter how much MORE severe I am, so it makes sense to do the split night study and be done with it. I clearly have sleep apnea, and they got enough data to set me up with an auto machine with a great range for me. I use 11-17, and I spend most of the night between 11 and 13 with short spikes into the 15 range and maybe a couple tiny spikes up to 17. My ahi is usually below 1 and extremely rare to go above 2, so it is working really well for me.

I think it also really helps us to understand what we are dealing with when we can see the data and graphs.

For example, here are the graphs showing my sleep cycles and oxygen saturation levels. It is is pretty easy to see in both graphs when the diagnosis phase ended and the titration began. The differences are huge.

Image

Your data should also tell what percentage of the night you slept in each position, if you had arrousals disturbing your sleep, and how low your oxygen went. My summary was 3 pages long and had the graphs and a variety of data. The doctor had a longer version with more graphs. Yours should be at least 2-3 pages and have more than just the ahi.

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Day_Dreamer
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Re: AHI of 5 and disappointed

Post by Day_Dreamer » Thu Oct 23, 2014 11:39 am

What was you RDI?

My AHI was always less than 3 with no desats less than 90%
My RDI was 16

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cathyf
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Re: AHI of 5 and disappointed

Post by cathyf » Thu Oct 23, 2014 12:16 pm

Guest wrote:When I wake up, my back, chest, neck, and sometimes my arms and legs feel incredibly sore. It feels sort of like the way it feels when you have a flu or had worked out extremely hard the day before. It tapers off as the day progresses, and I end up feeling my best late at night as a result.
Morning stiffness is also a symptom of a Spondyloarthropathy -- a particular group of arthritis types which are genetically linked. There are a particular group of symptoms that go along with these -- you should google it.

There have been many mornings when I have looked at my husband and said, "You would have noticed if a gang of thugs broke in and beat me with sticks during the night, right?"

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AHI of 5 and disappointed

Post by sleepstar » Sat Oct 25, 2014 5:27 am

Do you have a copy of your sleep study report?

I have patients who have an AHI of 5 or sometimes even less (technically "no OSA") and they have tried CPAP and had substantial benefit. I've had patients with AHI of 80 with no benefit from CPAP.

I think trialling CPAP is wise.

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TheBadger
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Re: AHI of 5 and disappointed

Post by TheBadger » Sat Oct 25, 2014 11:26 am

Hi, I'm new here and have a similar situation as yours. My sleepiness scale was 15, my RDI was only 1.3 on my level 3 sleep study, but my oxygen sats were below 90% 27% of the time. I don't have AHI numbers but my RDI doesn't reflect my symptoms.

Anyway, the sleep doc recommended a 30 day trial of Cpap. I am on a low pressure (5) and just completed day 4 of my trial. I feel like a million dollars! I am well rested, in a better mood during the day, and have more energy.

My point is, push for a trial of cpap in spite of your numbers. You might benefit!

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Re: AHI of 5 and disappointed

Post by sleepstar » Sat Oct 25, 2014 8:18 pm

TheBadger wrote:Hi, I'm new here and have a similar situation as yours. My sleepiness scale was 15, my RDI was only 1.3 on my level 3 sleep study, but my oxygen sats were below 90% 27% of the time. I don't have AHI numbers but my RDI doesn't reflect my symptoms.

Anyway, the sleep doc recommended a 30 day trial of Cpap. I am on a low pressure (5) and just completed day 4 of my trial. I feel like a million dollars! I am well rested, in a better mood during the day, and have more energy.

My point is, push for a trial of cpap in spite of your numbers. You might benefit!
That's fantastic. Exactly what I was saying above. See, it's real! so happy it's working for you.