How low can I expect AHI to go when I start using CPAP?

[TedVPAP]

Prior to treatment sleep study said AHI=60.
With treatment machine says AHI~0.5.

Low is good but zero is not the goal as some number of events is expected even when treatment is perfect.

[USMCVet]

And does it depend on how severe it is to begin with? In other words, are you likely to have a lower score if you started out with mild sleep apnoea than if you are classed as severe or does it make no difference?

Just random thoughts as I wait to get started with CPAP. It's been 10 months since I was referred to the sleep clinic and I'm just getting a bit impatient to start. My AHI is 45 by the way.

45 is way too high. You should start by including your equipment make and model and facemask and settings in your profile. Then if possible you should get sleepyhead (see apenaboard.com for a copy) download it and get some data posted to see. But at 45 you are far beyond untreated.

Thanks, that's helpful. As for the 10 months, I first went to the doctor towards the end of March last year and after some initial blood tests which were done almost immediately and came back normal, she referred me to the sleep clinic in Aberdeen, so that was probably early April. I was given an appointment in June and sent home with equipment to record my sleep. I didn't manage to sleep at all that night so I was given another appointment to do it all over again in October. I had to change the appointment to November as we were away on holiday. In December they told me to stop driving as I probably had severe obstructive sleep apnoea and I was referred for an urgent appointment with the consultant in January. At that appointment he told me I would get a date to come in for a CPAP machine. That appointment was on Thursday although it should have been the previous week but I couldn't make it.

So one or two delays caused by me not managing to sleep and also altering a couple of appointments. I do actually have the equipment but found I couldn't manage with the nasal mask so left a message next morning asking if I could have the full face mask which I had also had fitted the day before. I'm just waiting for them to get back to me now. I suppose I'm just getting a bit impatient because I was so near to the solution and now there's another delay.

I thought she wasn't being treated either until this post.

[palerider]

And does it depend on how severe it is to begin with? In other words, are you likely to have a lower score if you started out with mild sleep apnoea than if you are classed as severe or does it make no difference?

Just random thoughts as I wait to get started with CPAP. It's been 10 months since I was referred to the sleep clinic and I'm just getting a bit impatient to start. My AHI is 45 by the way.

45 is way too high. You should start by including your equipment make and model and facemask and settings in your profile. Then if possible you should get sleepyhead (see apenaboard.com for a copy) download it and get some data posted to see. But at 45 you are far beyond untreated.

Thanks, that's helpful. As for the 10 months, I first went to the doctor towards the end of March last year and after some initial blood tests which were done almost immediately and came back normal, she referred me to the sleep clinic in Aberdeen, so that was probably early April. I was given an appointment in June and sent home with equipment to record my sleep. I didn't manage to sleep at all that night so I was given another appointment to do it all over again in October. I had to change the appointment to November as we were away on holiday. In December they told me to stop driving as I probably had severe obstructive sleep apnoea and I was referred for an urgent appointment with the consultant in January. At that appointment he told me I would get a date to come in for a CPAP machine. That appointment was on Thursday although it should have been the previous week but I couldn't make it.

So one or two delays caused by me not managing to sleep and also altering a couple of appointments. I do actually have the equipment but found I couldn't manage with the nasal mask so left a message next morning asking if I could have the full face mask which I had also had fitted the day before. I'm just waiting for them to get back to me now. I suppose I'm just getting a bit impatient because I was so near to the solution and now there's another delay.

I thought she wasn't being treated either until this post.

doesn't have, doesn't use... same diff.

[USMCVet]

And does it depend on how severe it is to begin with? In other words, are you likely to have a lower score if you started out with mild sleep apnoea than if you are classed as severe or does it make no difference?

Just random thoughts as I wait to get started with CPAP. It's been 10 months since I was referred to the sleep clinic and I'm just getting a bit impatient to start. My AHI is 45 by the way.

45 is way too high. You should start by including your equipment make and model and facemask and settings in your profile. Then if possible you should get sleepyhead (see apenaboard.com for a copy) download it and get some data posted to see. But at 45 you are far beyond untreated.

Thanks, that's helpful. As for the 10 months, I first went to the doctor towards the end of March last year and after some initial blood tests which were done almost immediately and came back normal, she referred me to the sleep clinic in Aberdeen, so that was probably early April. I was given an appointment in June and sent home with equipment to record my sleep. I didn't manage to sleep at all that night so I was given another appointment to do it all over again in October. I had to change the appointment to November as we were away on holiday. In December they told me to stop driving as I probably had severe obstructive sleep apnoea and I was referred for an urgent appointment with the consultant in January. At that appointment he told me I would get a date to come in for a CPAP machine. That appointment was on Thursday although it should have been the previous week but I couldn't make it.

So one or two delays caused by me not managing to sleep and also altering a couple of appointments. I do actually have the equipment but found I couldn't manage with the nasal mask so left a message next morning asking if I could have the full face mask which I had also had fitted the day before. I'm just waiting for them to get back to me now. I suppose I'm just getting a bit impatient because I was so near to the solution and now there's another delay.

I thought she wasn't being treated either until this post.

doesn't have, doesn't use... same diff.

Not even close to being same. One has control over not using while one doesn't have control if they don't have it.

[SarahB]

Hello again SarahB,

Yes, they've given you a machine and one kind of mask. What the people here are hoping or expecting to be told is what make and model of machine. Ie, "It's a Ford (make). A Ford Escort (model)."

Knowing these details helps shape the advice people can give you.

If you go up to the top left-hand corner of the page, there's 'User Control Panel'. If you click on that, it opens up so you can add equipment details to your profile. The way you can see I've done below (The machine I use isn't on the 'pick from' list, so I've typed it in, in the space for additional comments.)

If you're not sure what make and model you've got, turn the machine upside down (removing any humidifier first ) and look on the bottom. Especially look for a box with REF inside it. The number next to that box is the model number.

Most of the NHS has standardised on either Philips Respironics (make) or ResMed (make) with just a few hospitals using other brands.

Same with the mask. There should be something on the mask itself and on the straps ('the headgear) which lets us all know what we're dealing with.

Ta.

Thanks Rick. I've updated the profile but it doesn't seem to be displaying the details.

The machine is a Resmed AirSense 10 Autoset Elite and the mask seems to be a Resmed AirFit N20.

[SarahB]

Prior to treatment sleep study said AHI=60.
With treatment machine says AHI~0.5.

Low is good but zero is not the goal as some number of events is expected even when treatment is perfect.

Why?

[SarahB]

What machine do you have? What nasal mask do you have? What issues were you having with it?

I have a ResMed AirSense 10 Autoset Elite, it seems, and a ResMed AirFit N20 nasal mask. On the first night I found I couldn't breathe in through my nose when lying down, or at best only a little. There seems to be some kind of blockage. I don't have a cold and it doesn't affect me when I'm upright. Also, and understandably, I was breathing through my mouth when I was asleep.

It's a pity because the mask is very comfortable but when I was lying on my back the air was hissing out of my mouth for a couple of hours when I was asleep. My husband got fed up listening to it and woke me up. I turned on my side but couldn't breathe through my nose at all and when I opened my mouth no air was coming out, showing how effectively the airway was blocked. I took the mask off at that point as it was of no benefit under the circumstances.

[SarahB]

Apologies for confusing everyone! I am in a bit of a no man's land at the moment with my treatment as I do have the equipment but can't use it - see previous post. (I've updated my profile with the details but it's not displaying the information in my posts.)

[rick blaine]

Hello again, SarahB - and 'Fitlike?'

The site was under a sustained attack recently, and some of the protections put in place may be what's keeping your details from showing on the page.

As far as using nasal masks goes, the mouth opening is the problem for some people. You can buy an extra strap to go under your chin and round the top of your head to keep the mouth closed. Eu-pap in Reading (England) is one place that sells them. They're on the internet. And of course, eBay.

In the meantime, micropore tape - 5 metres for 50p, from both Tesco's and Sainsbury's - is an alternative (unless you're reactive to the mildly sticky stuff).

Wrt to the model of machine - it's a wee bit confusing. The label 'Autoset' refers to the auto-adjusting machine in the Airsense 10 range. The label 'Elite' refers to the fixed-pressure machine.

The recommendation from NICE is that foundation trust hospitals issue a fixed-pressure machine - altho in some areas now, they are going beyond that minimum and issuing autos.

Can you take another look?

Also, the policy in some areas now is to give out a machine with the cellular phone chip in it. That means it can 'phone home' to the hospital over the mobile phone network. So the sleep medicine staff can see how you're doing. And also change pressures if they think you need it.

Did they tell you that's how they're going to manage your care? You can tell if that feature has been enabled by looking on the dial, and for the wireless signal bars. If they are green, it's on. If they are grey, it's off.

[SarahB]

Hello again, SarahB - and 'Fitlike?'

The site was under a sustained attack recently, and some of the protections put in place may be what's keeping your details from showing on the page.

As far as using nasal masks goes, the mouth opening is the problem for some people. You can buy an extra strap to go under your chin and round the top of your head to keep the mouth closed. Eu-pap in Reading (England) is one place that sells them. They're on the internet. And of course, eBay.

In the meantime, micropore tape - 5 metres for 50p, from both Tesco's and Sainsbury's - is an alternative (unless you're reactive to the mildly sticky stuff).

Wrt to the model of machine - it's a wee bit confusing. The label 'Autoset' refers to the auto-adjusting machine in the Airsense 10 range. The label 'Elite' refers to the fixed-pressure machine.

The recommendation from NICE is that foundation trust hospitals issue a fixed-pressure machine - altho in some areas now, they are going beyond that minimum and issuing autos.

Can you take another look?

Also, the policy in some areas now is to give out a machine with the cellular phone chip in it. That means it can 'phone home' to the hospital over the mobile phone network. So the sleep medicine staff can see how you're doing. And also change pressures if they think you need it.

Did they tell you that's how they're going to manage your care? You can tell if that feature has been enabled by looking on the dial, and for the wireless signal bars. If they are green, it's on. If they are grey, it's off.

It's definitely the Autoset machine as that's what's on the front of it. The instructions listed Autoset and Elite and I thought it was all part of the name.

The hospital will supply me with a chin strap if I need it but as the machine can't blow air past the nasal obstruction then I would have a slight problem!!!

It doesn't look as if the 'phone home' option is enabled. I have to send the data card back in two weeks marked urgent and already have an appointment with the consultant in a month's time to discuss the results. I'm hoping to get this mask issue resolved quickly otherwise I won't be able to submit the results in time.

Thanks for all your help Rick. Haha - fit like! That's going to confuse a few people!

[SarahB]

Ah! I've managed to display equipment details as a signature.

[TedVPAP]

Prior to treatment sleep study said AHI=60.
With treatment machine says AHI~0.5.

Low is good but zero is not the goal as some number of events is expected even when treatment is perfect.

Why?

While sleeping, there are times when you wake up - often changing positions. Breathing is often irregular when we are awake. The machine assumes you are asleep so it will flag those irregularities. There are also Central Apneas which can occur; and they can be unrelated to OSA. The medical community considers successful treatment when AHI is less than 5.

[palerider]

Prior to treatment sleep study said AHI=60.
With treatment machine says AHI~0.5.

Low is good but zero is not the goal as some number of events is expected even when treatment is perfect.

Why?

because nothing is perfect, least of all the squidgy meatbag that's going to be attached to the end of the hose.

[MrsRinPDX]

My final sleep study AHI was 71. I now average an AHI under 2 with my machine. I believe the others are correct. It does not matter what your initial AHI number is, just how well your pressures are set now.

[RicaLynn]

Prior to treatment sleep study said AHI=60.
With treatment machine says AHI~0.5.

Low is good but zero is not the goal as some number of events is expected even when treatment is perfect.

Why?

Because even those without sleep-disordered breathing WILL have the occasional apnea event throughout the night. It becomes a disorder when the events are frequent enough to affect the sleep cycle, overall sleep quality, and overall health. An average of less than 5 events per hour (AHI<5) is considered successfully treated apnea. Once your therapy is effective, your AHI should be below 5, and low enough that you are indeed feeling rested.