AI vs. HI

Can anyone tell me what I might do to lower my HI#? The AI average over a month is 1-2. The HI is around 7. Therefore, my AHI index is usually somewhat "higher than expected", but with the AI # low, I have not really worried over it.

I have yet another mask coming in the mail. This time a nasal mask. I have tried FFM and now using Optilife nasal pillow. My leak rate is always very low with any mask. I have had my CPAP at the prescribed pressure of 10 based on a sleep study and have upped to to 11, seeing little difference. It is now back on 10.

Any ideas?

Enjoy the forum and advice.

Thanks.

mtoddrussell wrote:Can anyone tell me what I might do to lower my HI#? The AI average over a month is 1-2. The HI is around 7. Therefore, my AHI index is usually somewhat "higher than expected", but with the AI # low, I have not really worried over it.

I have yet another mask coming in the mail. This time a nasal mask. I have tried FFM and now using Optilife nasal pillow. My leak rate is always very low with any mask. I have had my CPAP at the prescribed pressure of 10 based on a sleep study and have upped to to 11, seeing little difference. It is now back on 10.

Any ideas?

Enjoy the forum and advice.

Thanks.

ResMed machines typically report higher hypopnea numbers than the Respironics machines. Usually, raising the pressure will lower them. You didn't say how long you left it at 11......and then, it might take a bit more than that, too. You want to leave the changes for at least a week.


Den

What Den said.

And in addition, if you feel well, you can disregard those hypopneas.


O.

I was @ 11 a little over a week with little difference in the HI. Do you think there is something that I could be doing that is causing this? After many failures with chinstraps, I now use facial tape, which works great for me, as I also snored with the chinstap. The tape was the only solution. I have read the many threads on taping, and not trying to re-open that can of worms.

Thanks for all of the good advice. I am thinking I may just ignore that number since the REAL problem seems to be solved.

Thanks,

Todd

mtoddrussell accidentally guested wrote:I am thinking I may just ignore that number since the REAL problem seems to be solved.

Thanks,

Todd

I think you're right to ignore the HI number now. With every resmed machine I've used, they've chalked up a higher HI than what I see on the data with other brands. At least double the HI reported for me when using a resmed machine. Since I felt exactly the same -- well rested -- using any machines, I ignored the way resmed reported my HI.

I really think it's just a matter of different algorithms resulting in different reporting. It's not that one brand is necessarily over or under reporting, or giving less or more effective treatment.

I was using Resmed before and now just purchased the 420E. Certainly the Resmed HI is always like 5-10.

I have just turned off the IFL1 as my breathing may be quite shallow. I would need the opinion of rested gal and others on the significance of:

1. Lots of runs/Flow limitations. I saw in your previous posts and your recording seemed to show lots of runs like mine.

2. It seemed that when I up my lower pressure to 9, the acoustical vibrations disappeared. Is it beneficial to have no acoustical vibrations?

3. I noticed some apnoeas with cardiac oscillations only on some nights. What is the acceptable no of central apnoea?

4. Is AHI for 420e means the sum of apnoea, apnoea with cardiac oscillation, hyponoeas and flow limited hypopnoea?

5. Is shallow breathing due to blocked nose sometimes?

6. Is remstar apap with aflex better than pb 420e?

Sorry for so many questions.

bman wrote:I was using Resmed before and now just purchased the 420E. Certainly the Resmed HI is always like 5-10.

I have just turned off the IFL1 as my breathing may be quite shallow. I would need the opinion of rested gal and others on the significance of:

1. Lots of runs/Flow limitations. I saw in your previous posts and your recording seemed to show lots of runs like mine.

2. It seemed that when I up my lower pressure to 9, the acoustical vibrations disappeared. Is it beneficial to have no acoustical vibrations?

Yes. Acoustical vibrations are snores. When you snore, that means something's not very stable in your airway, and that might develop into an obstruction. It is beneficial to have no acoustical vibrations.

3. I noticed some apnoeas with cardiac oscillations only on some nights. What is the acceptable no of central apnoea?

I think anything beneath 5 is OK though if I had something in that vicinity I would want it checked in a sleep lab. When the PB says an apnea is central, it is right most of the time. The problem is that there are some central apneas it does not identify. Having only some on some nights sounds perfect. Especially if some of those happen as you're falling asleep, or waking up.

4. Is AHI for 420e means the sum of apnoea, apnoea with cardiac oscillation, hyponoeas and flow limited hypopnoea?

More or less...

5. Is shallow breathing due to blocked nose sometimes?

Flow limitations can be a result of a blocked nose.

6. Is remstar apap with aflex better than pb 420e?

The Remstar with A-Flex has exhalation relief, which many people apreciate. The 420E does not. However, the 420E has more used definable treatment parameters, which are necessary for some users. I did not get good treatment from a Resprionics with C-Flex - the 420E was better for me. Autopaps are not created equal, and neither are people's needs.

O.
_________________

Many thanks.

How about the first question of getting too many runs?

It's so nice to see you posting again, bman!

ozij did a great job answering your questions.

I'll work a little more on just your question where you mentioned why I turned off IFL1 on my 420E:

bman wrote:I have just turned off the IFL1 as my breathing may be quite shallow. I would need the opinion of rested gal and others on the significance of:

1. Lots of runs/Flow limitations. I saw in your previous posts and your recording seemed to show lots of runs like mine.

It was -SWS who alerted me to the possibility that turning off IFL1 might be better for me. He kindly looked at my 420E data and spotted the problem.

It was not just the sheer number of "runs" being recorded. It was the drastic rises in pressure the 420E was using for me.

With IFL1 off, I still have many, many runs appear on the data, but they don't cause the machine to start soaring the pressure up.

The IFL1 trigger was trying to correct breathing that for me is apparently normal. My breathing (according to three PSGs) shows slight flattening at the top of the wave form.

For lack of a better word, I used to describe my breathing as normally being shallow breaths, but that's probably not the correct phrase. Probably mine should be called slightly "flow limited" breaths.

Anyway, my point is that unless you were seeing sharp, extreme rises in pressure on your Silverlining 96 hour graph, there might have been no reason to turn off IFL1.

If you were seeing big rises in pressure with IFL1 on, and the pressure settled down after you turned off IFL1, you were right to turn it off.

Here's a link to your original thread, bman, where -SWS discussed flow limitations and the 420E's two FL triggers:

Jan 11, 2005 subject: Bman: Spirit Overnight Indices
viewtopic.php?t=817

Topic started by -SWS accidentally logged in as "Guest".

Even though that topic starts out talking about the ResMed Spirit autopap, the topic moves quickly into a very thorough discussion about the PB 420E autopap's IFL1 and IFL2 triggers. It's a "many pages topic", so keep turning the pages!

Thanks RG for completing that comlex part I (consciuosly...) skipped.

It was not just the sheer number of "runs" being recorded. It was the drastic rises in pressure the 420E was using for me.

With IFL1 off, I still have many, many runs appear on the data, but they don't cause the machine to start soaring the pressure up.

That's exactly where I'm at too.

O.

Many thanks.

I do find that quite often I have drastic rises in pressure. Some nights I am fine.

I have just read Dr K's post and now thinking I should try to eliminate the runs and snoring etc.