RDI vs AHI

When I had my overnight sleep study, they said my RDI was 144 and my AHI was 32. My doctor said that the RDI is higher because I was aroused due to some respiratory event that didn't quite fit the definition of an apnea or hypopnea. Does that sound right?

So my question is whether this machine software does anything with events that don't quite fit the definition of apnea or hypopnea but still could be causing an arousal? I'm so incredibly tired and wake up so much during the night. Of course it is complicated with Dx of narcolepsy as well. And also the mask is leaking more than usual on many nights. But even on those nights with the machine reporting AHI below 1.0 and mask not leaking badly at all, I still wake up a lot. I'm trying to figure out if this is because of narcolepsy or because of other respiratory problems or both or ... what.

Tired of being tired. Not even the ritalin works through this kind of tired.

nobody wrote:When I had my overnight sleep study, they said my RDI was 144 and my AHI was 32. My doctor said that the RDI is higher because I was aroused due to some respiratory event that didn't quite fit the definition of an apnea or hypopnea. Does that sound right?

So my question is whether this machine software does anything with events that don't quite fit the definition of apnea or hypopnea but still could be causing an arousal? I'm so incredibly tired and wake up so much during the night. Of course it is complicated with Dx of narcolepsy as well. And also the mask is leaking more than usual on many nights. But even on those nights with the machine reporting AHI below 1.0 and mask not leaking badly at all, I still wake up a lot. I'm trying to figure out if this is because of narcolepsy or because of other respiratory problems or both or ... what.

Tired of being tired. Not even the ritalin works through this kind of tired.

Try setting your machine to CPAP mode at 10 or 11.

I would venture to guess that your sleep will be better and your AHI may be better, too.

Den

I tried straight CPAP of 9 for a couple nights and couldn't breathe out against it even with CFLEX at 3. So I set it to straight 8.5 for several nights and my AHI went way up to 6.0. How would I get used to breathing with 10 or 11? It really seems impossible to breathe at 9.0

nobody wrote:When I had my overnight sleep study, they said my RDI was 144 and my AHI was 32. My doctor said that the RDI is higher because I was aroused due to some respiratory event that didn't quite fit the definition of an apnea or hypopnea. Does that sound right?

Absolutely.

So my question is whether this machine software does anything with events that don't quite fit the definition of apnea or hypopnea but still could be causing an arousal?

I'm not sure at all your machine identifies those events, and raises pressure in response to them. While all automatic algorithms claim to respond to flow limitations - each company seems to have its own way if finding a flow limitation in your breathing, and they don't agree. Additionally, nothing says than the breathing problems that cause your arousals are flow limitations.
So, taking all that together with the way you feel, I would think a fixed pressure, that is known to clear your RERA's (respiratory effort related arousal), or a minimum pressure set at that level may help you feel better. I would also suggest nasal irrigation (check www. neilmed.com for details) is worth a try.

I use a neilmed sinus rinse everynight plus a nasal steroid spray. My sinuses haven't been as plugged as usual. Also pressure from the mask causes my sinuses to clog, so it seems anyway.

nobody wrote:I tried straight CPAP of 9 for a couple nights and couldn't breathe out against it even with CFLEX at 3. So I set it to straight 8.5 for several nights and my AHI went way up to 6.0. How would I get used to breathing with 10 or 11? It really seems impossible to breathe at 9.0

Your pressure is already going to 10 and 11 during the night while you're sleeping (according to your charts and reports) with your Auto settings, and I would think the pressure changes are disturbing your sleep. You could try working up (CPAP mode) in .5 cm. increments, giving at least several nights to a week to get accustomed.

Den

Yeah it's been a few times I've woke and and felt I couldn't breathe. I'm not sure how to get from 8.5 to 9.0.

Wulfman wrote:

nobody wrote:I tried straight CPAP of 9 for a couple nights and couldn't breathe out against it even with CFLEX at 3. So I set it to straight 8.5 for several nights and my AHI went way up to 6.0. How would I get used to breathing with 10 or 11? It really seems impossible to breathe at 9.0

Your pressure is already going to 10 and 11 during the night while you're sleeping (according to your charts and reports) with your Auto settings, and I would think the pressure changes are disturbing your sleep. You could try working up (CPAP mode) in .5 cm. increments, giving at least several nights to a week to get accustomed.

Den

nobody wrote:I tried straight CPAP of 9 for a couple nights and couldn't breathe out against it even with CFLEX at 3. So I set it to straight 8.5 for several nights and my AHI went way up to 6.0. How would I get used to breathing with 10 or 11? It really seems impossible to breathe at 9.0

I know what you mean! My machine was set to 9 when I first started, but I complained to my sleep doc that I was short of breath all day long. He looked at my sleep study and said to go ahead and put it back to 8. (Well, he didn't tell "me" to, but said he'd send a revised script to the DME. Of course, I changed it myself! ) Anyway, 8 made my AHI too high, so now I'm sitting at 8.5.

(Moving the pressure down did eliminate the daytime shortness of breath feeling.)

My sleep study reported RDI's, and many of those were categorized as RERA's (UARS). I, too, am thinking that if I could move it back up to 9, I may feel more rested even though my AHI's are almost always below 2 now. It's been awhile since I've tried 9. Maybe now that I've been a hosehead for two years, my body would take the 9 without issue.

(I just know people here with higher pressures think I'm a wimp!!

Thanks I'm glad you said that. My doctor and DME all think it's just in my head that I can even tell the difference between 8.5 and 9.0 It's a big difference!! One I can breath fine, the other I feel like the air is being forced into my lungs and I can only push it back out with a lot of difficulty!!

WearyOne wrote:

nobody wrote:I tried straight CPAP of 9 for a couple nights and couldn't breathe out against it even with CFLEX at 3. So I set it to straight 8.5 for several nights and my AHI went way up to 6.0. How would I get used to breathing with 10 or 11? It really seems impossible to breathe at 9.0

I know what you mean! My machine was set to 9 when I first started, but I complained to my sleep doc that I was short of breath all day long. He looked at my sleep study and said to go ahead and put it back to 8. (Well, he didn't tell "me" to, but said he'd send a revised script to the DME. Of course, I changed it myself! ) Anyway, 8 made my AHI too high, so now I'm sitting at 8.5.

(Moving the pressure down did eliminate the daytime shortness of breath feeling.)

My sleep study reported RDI's, and many of those were categorized as RERA's (UARS). I, too, am thinking that if I could move it back up to 9, I may feel more rested even though my AHI's are almost always below 2 now. It's been awhile since I've tried 9. Maybe now that I've been a hosehead for two years, my body would take the 9 without issue.

I could tell the difference between 5.5. and 6. Just try to make the change gradually, as Den suggested.

O.

nobody wrote: I use a neilmed sinus rinse everynight plus a nasal steroid spray. My sinuses haven't been as plugged as usual. Also pressure from the mask causes my sinuses to clog, so it seems anyway.

Are you sure it isn't the humidity? I glanced at another thread you had.....about "waking up in a lake". There's only so much moisture that the air can hold. And, too much heated humidity can cause a person's nasal passages to close up.

I don't know.......just trying to offer you some options to help you with your therapy.

Den

Thanks man, I really dunno either. There are too many variables. I've adjusted the humidifier, even had it just passover, it doesn't really make much difference. *shrug* My doctor says it's the narcolepsy making me so sleepy in the daytime and waking up over and over at night, not the apnea. He said "that's the nature of the beast" (re: narcolepsy). I'm sure he's not perfect, but I really don't know maybe he's right.