Why U.S is 5 or below while international is 10 and below

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
JimP
Posts: 181
Joined: Thu Oct 02, 2014 2:49 pm

Why U.S is 5 or below while international is 10 and below

Post by JimP » Thu Oct 23, 2014 10:28 pm

I read somewhere on these threads that the target AHI in the U.S. is 5 and below where everywhere else its 10 and below.

Does anyone know anything about this?

User avatar
Wulfman...
Posts: 6688
Joined: Mon Sep 01, 2014 6:41 pm
Location: Nearest fishing spot

Re: Why U.S is 5 or below while international is 10 and below

Post by Wulfman... » Thu Oct 23, 2014 11:37 pm

JimP wrote:I read somewhere on these threads that the target AHI in the U.S. is 5 and below where everywhere else its 10 and below.

Does anyone know anything about this?
"Everywhere else"? Like in other parts of the world? Are you talking about "successful treatment" levels or diagnosis? Don't know about other countries. But, I believe I have read that there are higher thresholds of diagnosis for older people (seniors) in the U.S., but don't have any links handy.

If you search and find something, let us know what you find. And, if you've got links to the other countries, please post them.
I suspect that if there ARE differences between countries, it's because of the different governing bodies, medical criteria and "influence" by the insurance entities in the respective countries.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05

User avatar
billbolton
Posts: 2266
Joined: Wed Jun 07, 2006 7:46 pm
Location: Sydney, Australia

Re: Why U.S is 5 or below while international is 10 and below

Post by billbolton » Fri Oct 24, 2014 3:45 am

JimP wrote:Does anyone know anything about this?
Just one of the urban myths of Sleep Disordered Breathing

_________________
MachineMask
Additional Comments: Airmini, Medistrom Pilot 24, CMS 60C Pulse Oximeter, ResScan 6

User avatar
johantv
Posts: 42
Joined: Wed Oct 15, 2014 1:42 pm
Location: The Netherlands

Why U.S is 5 or below while international is 10 and below

Post by johantv » Fri Oct 24, 2014 5:07 am

In the Netherlands an AHI below 5 is also considered ok (no OSAS). Gradations of OSAS are 5-15, 15-30 and 30+.
Start therapy: 2014/3 | AHI before 43, Now <1 | APAP 6.6 - 8.0cmH20 | EPR 1
No Pressure, no Diamonds

User avatar
Lazer1234
Posts: 301
Joined: Sat Aug 17, 2013 5:08 am
Location: Sweden

Re: Why U.S is 5 or below while international is 10 and below

Post by Lazer1234 » Fri Oct 24, 2014 6:49 am

johantv wrote:In the Netherlands an AHI below 5 is also considered ok (no OSAS). Gradations of OSAS are 5-15, 15-30 and 30+.
It's the same in Sweden

_________________
Mask: TAP PAP Nasal Pillow CPAP Mask with Improved Stability Mouthpiece
Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control
Additional Comments: APAP 7,8 - 20 EPR 3 No Ramp ResScan 5.1 SleepyHead 0.9.8.1
Everything I write I translate through Google Translate.
Hope you have patience with that, sometimes it can get a little crazy.
/Lazer1234

User avatar
Samaniego
Posts: 56
Joined: Fri Dec 02, 2011 7:11 am
Location: Siguatepeque & Brooklyn Heights

Re: Why U.S is 5 or below while international is 10 and below

Post by Samaniego » Fri Oct 24, 2014 7:38 am

In Honduras it doesn't matter at all.
Doctor write: Age 42. Diagnosed with mild obstructive sleep apnea AHI 21, mild oxygen desaturations, moderate snorer. Overall health good.

User avatar
BlackSpinner
Posts: 9745
Joined: Sat Apr 25, 2009 5:44 pm
Location: Edmonton Alberta
Contact:

Re: Why U.S is 5 or below while international is 10 and below

Post by BlackSpinner » Fri Oct 24, 2014 7:55 am

Canada 5 or less

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear
Additional Comments: Quatro mask for colds & flus S8 elite for back up
71. The lame can ride on horseback, the one-handed drive cattle. The deaf, fight and be useful. To be blind is better than to be burnt on the pyre. No one gets good from a corpse. The Havamal

User avatar
johantv
Posts: 42
Joined: Wed Oct 15, 2014 1:42 pm
Location: The Netherlands

Why U.S is 5 or below while international is 10 and below

Post by johantv » Fri Oct 24, 2014 8:07 am

Samaniego wrote:In Honduras it doesn't matter at all.
does that mean everyone has a pap or nobody? Image
Start therapy: 2014/3 | AHI before 43, Now <1 | APAP 6.6 - 8.0cmH20 | EPR 1
No Pressure, no Diamonds

User avatar
Samaniego
Posts: 56
Joined: Fri Dec 02, 2011 7:11 am
Location: Siguatepeque & Brooklyn Heights

Re: Why U.S is 5 or below while international is 10 and below

Post by Samaniego » Fri Oct 24, 2014 8:29 am

No one has one. Not even the rich. Only if they are immigrants from rich countries.

No shops are selling machines. No shops are selling supplies. I keep one in U.S.A. and one with family. If I get home and something is broken or missing could only get from U.S. and I do not know how.

Social medicine is very bad. Economy is controlled by government. Too much regulation. Too much debt. Many, many killings. Hard to do business because of many regulations and corrupt government people. A new constitution is needed and new politics. Most people are poor.
Doctor write: Age 42. Diagnosed with mild obstructive sleep apnea AHI 21, mild oxygen desaturations, moderate snorer. Overall health good.

User avatar
johantv
Posts: 42
Joined: Wed Oct 15, 2014 1:42 pm
Location: The Netherlands

Re: Why U.S is 5 or below while international is 10 and below

Post by johantv » Fri Oct 24, 2014 8:36 am

Sorry to hear...
Start therapy: 2014/3 | AHI before 43, Now <1 | APAP 6.6 - 8.0cmH20 | EPR 1
No Pressure, no Diamonds

User avatar
chunkyfrog
Posts: 34378
Joined: Mon Jul 12, 2010 5:10 pm
Location: Nebraska--I am sworn to keep the secret of this paradise.

Re: Why U.S is 5 or below while international is 10 and below

Post by chunkyfrog » Fri Oct 24, 2014 9:00 am

Often treatment level depends on the insurance contract.
When I was diagnosed, 15 was the line, but it was 10 with co-morbidities (BCBS)

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments: Airsense 10 Autoset for Her

User avatar
andy5805
Posts: 153
Joined: Fri Sep 13, 2013 2:25 pm

Re: Why U.S is 5 or below while international is 10 and below

Post by andy5805 » Fri Oct 24, 2014 10:58 am

my take on this is as follows

point 1: the 1 to whatever scale is psychological incentive - if our Doctors tell us anything is bad, we get scared, we ensure by our fear that the AHI goes up, the AHI can go up for two reasons, through sleep apnoea or through fear of it going up leading to fragmented sleep which is shallower sleep where the snoring gets us, a self fulfilled prophecy! but for anyone who has had sleep apnoea they don't CARE where it came from it's horrible and it has to go away - wherever the poor sleep came from is equally nasty whether that is blind obedience to a scale and marking yourself out of 5 (or 10) and becoming worried, or through rubbish pressure, or through wrong humidity! we don't care why, we just feel it, which leads to point 2 being the making of point 1...

point 2: this is a positive post not a negative post if you've read this far -the scale is a complete myth otherwise known as how long is a piece of string. if I had an AHI of 12 and a great day at work and met someone who was sleep deprived with an AHI of 3, I'd back my 12 all the way. Sometimes feeling is the only measurement, a number cannot tell me how I have slept - only I can do that, so the scale is both a fraud and a comfort blanket, many follow it, ...but the point we can take home from this is only that the voodoo only works because people think it does!

all the best!
Andy

_________________
Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear
Additional Comments: over the moon to have finally got there with therapy!

User avatar
cathyf
Posts: 515
Joined: Mon Sep 01, 2014 11:56 am

Re: Why U.S is 5 or below while international is 10 and below

Post by cathyf » Fri Oct 24, 2014 12:35 pm

There is also this weird thing where we count events not time in AHI. So Joe falls asleep and sleeps for 55 minutes with no events. Then he stops breathing for 5 minutes. Then he's dead. One event, one hour, AHI is one. But Joe is quite dead. Not mildly dead, not moderately dead, not severely dead...

The other thing we count is oxygen saturation -- that is a much more direct measurement of the problem. If you are having a wild and crazy dream that is causing erratic breathing, but you are keeping your oxygen at 98-99%, that is a lot more significant than the number of events that you are having.

When the insurance, etc. has guidelines and criteria, good medical practice understands that those are good for the "no-brainer" cases. If somebody feels crappy, and has an AHI of 50 and desats to 75%, you don't really need to think that hard. "Guidelines" are supposed to mean that if you have the odd patient who is NOT the no-brainer, then you have to think, and you have to figure out what's really wrong, and you have to justify the treatment. The no-brainer rubber-stamp cases are supposed to save time/energy that you need to think about the weird cases.

User avatar
palerider
Posts: 32300
Joined: Wed Dec 16, 2009 5:43 pm
Location: Dallas(ish).

Re: Why U.S is 5 or below while international is 10 and below

Post by palerider » Fri Oct 24, 2014 1:56 pm

cathyf wrote: But Joe is quite dead. Not mildly dead, not moderately dead, not severely dead...

moderately dead, is that like "a little bit pregnant"?

_________________
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

js12278
Posts: 41
Joined: Thu Sep 25, 2014 8:28 pm

Re: Why U.S is 5 or below while international is 10 and below

Post by js12278 » Fri Oct 24, 2014 2:58 pm

I have a report that was compiled in January 2008

Sort of Interesting how SOME of it was or is applied
https://cms.fmcsa.dot.gov/sites/fmcsa.d ... ns-508.pdf

_________________
MaskHumidifier
Additional Comments: Sleepyhead 9.6 test build