Thoughts on AHI of 4.5 to 5.0

[ScottGA]

I an currently using a new Devilbiss Intellipap autoAdjust machine set for a range of 10-20. The machine generally runs at 10-11. When I input the daily Smartcode from the machine into the Devilbiss SmartLink app, it shows me an AHI of usually 4.5-5, sometimes 3.5. When I look at the same data on Sleepyhead, it will show an AHI of around 3-3.5 for the same data the SmartLink shows as a 5.0. I understand there may be some differences in the algorithms of the software, but generally speaking, what are your thoughts on an AHI of 5? I know that is supposed to be within range of acceptable treatment, but do you think it is good enough? Should I tinker with the pressure settings and try to get the AHI lower? I have been on APAP for about 12 years using a few different autopaps and have seen AHI's as low as 1.5 with some of the machines I have used, but of course, I was a few years younger at that time. I have only recently resumed looking at the data from my machines. Any thoughts? Thanks for any input you offer.

[palerider]

what are your thoughts on an AHI of 5? I know that is supposed to be within range of acceptable treatment, but do you think it is good enough? Should I tinker with the pressure settings and try to get the AHI lower?

*I* think it's too high. if mine isn't under 2, I feel it the next day. (generally speaking). it may be 'medically acceptable', but it's, on average, a poke in the side every 12 minutes.

[ChicagoGranny]

what are your thoughts on an AHI of 5?

How do you feel the next day? Energy level is what? Any excess sleepiness?

[tan]

I an currently using a new Devilbiss Intellipap autoAdjust machine set for a range of 10-20. The machine generally runs at 10-11. When I input the daily Smartcode from the machine into the Devilbiss SmartLink app, it shows me an AHI of usually 4.5-5, sometimes 3.5. When I look at the same data on Sleepyhead, it will show an AHI of around 3-3.5 for the same data the SmartLink shows as a 5.0. I understand there may be some differences in the algorithms of the software, but generally speaking, what are your thoughts on an AHI of 5? I know that is supposed to be within range of acceptable treatment, but do you think it is good enough? Should I tinker with the pressure settings and try to get the AHI lower? I have been on APAP for about 12 years using a few different autopaps and have seen AHI's as low as 1.5 with some of the machines I have used, but of course, I was a few years younger at that time. I have only recently resumed looking at the data from my machines. Any thoughts? Thanks for any input you offer.

I was diagnosed with OSA when my AHI was 4.95 and had excessive daytime sleepiness, but my RDI was about 18, which often times is left behind the scene.

I would suggest optimizing further.

[70sSanO]

As already noted, it is important how you feel. But beyond that, what may be more important is getting into the data and finding out the buildup of those numbers.

I was on CPAP for the first 10 years without any data and at the same pressure, which may not come as a surprise... 10cm. I then got a data machine and software and I got a totally new perspective on AHI, AI, OSA vs. Central Apneas, etc. I immediately tweaked my pressure up a bit and for the first few years my AHI was around 5.2. I felt great and was very active, but went on this quest to lower the AHI. However, about 3.5 of that AHI was identified as central apneas, and more importantly my CA would jump a whole point in the last 5-10 minutes before I would wake up. I have since lost a considerable amount of weight (took up mountain biking at 61 and was concerned I would be found dead on some trail by a girl scout troop if I didn't) and my pressure has dropped considerably and I have gotten my AHI down a bit, but I still get more centrals than anything else.

Since you have an APAP you can set a range and you should be able to dial it in to find the best pressure range. If you really have a CPAP, it is a lot tougher because the pressure tweaks might be great for a night and then they may go in the opposite direction since there are too many factors and the biggest one is being a human being and not a robot so short term results are not conclusive.

Your machine may just not like you, well, not really, but I have this S8 backup that was given to me and it really hates me. I use it for vacations. But there is no pressure that I can run the machine at to get any good numbers and generally I don't feel quite as good the next day. I know it is just blowing air, but for some reason that machine is possessed.

Finally, you should probably post your data and have one of the real data experts (not I) decipher it for you. You may have an issue that is not apparent with just an AHI number. Sometimes a thread will derail for a few pages as dissenting opinions fight for supremacy, but overall it is very helpful and there are people here that could probably teach a few sleep docs a thing or two; and everyone here is trying to help.

John

[Sheriff Buford]

I agree with Pale... I think the 5 AHI is way too high. Forty events in an 8 hour period is way too high. I had a ahi of 2 the other day. I felt lousy all day.

Sheriff

[jnk...]

The numbers given from home machines are for trending purposes. In other words, they are only a way to see if things are getting better or worse. Trending numbers can be used to assess changes in your therapy. So it doesn't hurt to try things to see if you can get the numbers lower over time in order to have the best therapy possible, but it isn't really about an arbitrary line in the sand that is useful for judging whether the therapy is successful or not. Some would LOVE to get their home-machine-reported AHI lower than 5 but may not be able. For others, an AHI of 5 would represent a terrible night for them. So the point is to try things in order to get numbers as low as possible, but not lower than is possible. One thing to try is posting anonymized data in this forum in order to get observations from other PAP users. But know in advance that you may end up learning a lot more about other people's conditions and experiences than you do about your own--so take it with a grain of salt. But take it either way, in case you learn something amazing that makes sleep, and thus life itself, much better for you.

[Setj]

The numbers given from home machines are for trending purposes.

That certainly wasn't the case for me. The first time I downloaded Sleepyhead and looked at one night, I could see my minimum pressure was too low. I could see that because of things I learned reading in this forum.

Still today, if I have one night where the machine shows large leak, I know that my headgear needs adjusting before the next night.

It hasn't been about trending for me. It's about taking immediate corrective action.

But know in advance that you may end up learning a lot more about other people's conditions and experiences than you do about your own--

Maybe that is the case with some people who give advice here. But, I never learned the personalities here. I just learned how to manage my own therapy.

You give the forum far too little credit.

[jnk...]

You learned you were able to improve the trending numbers, yes.

Leak data is another matter altogether. Thanks for pointing that out.

Taking action based on trending numbers is good. That's what trending is for.

My point isn't about giving credit or not giving credit. This forum has been invaluable to me. My point is that the experiences of others, such as the statements made here about where AHI numbers should or shouldn't be, may be highly individual and not always applicable equally to all PAP users in all circumstances.

Sorry if my points offended you. I'll be more careful.

[ScottGA]

As far as, how do I feel the next day? Generally tired, but part of that is because I am only getting 5-6 hours in bed(I say in bed because maybe not all that is good sleep). That is due to work schedule, long commute and just generally too much to do and don't get to bed soon enough....I would think that affects how hard the APAP has to work to keep me sleeping well too. Here is another bit of data. I have a PR system one APAP that I have had for about 4 years as a travel machine. Well, whenever I travelled with it, I felt terrible the next day, seemed like I was short of oxygen too. Yet, the AHI daily was around 1, sometimes less, sometimes up to 2 or so. I checked the machine several times to make sure it was properly set on APAP not CPAP. Finally I checked the data and it was auto adjusting through the nights. So, the data for that machine looked much better but I didn't feel rested using it. this machine, I feel more rested but data doesn't look as good. I am going to try to post some reports from the new machine and hopefully a day from the system one machine if I can figure out how to post the charts as others have done.

[Pugsy]

How to post images and some examples of what we like to see...explained here
viewtopic/t103468/Need-help-with-screen-shots.html
if you want to use imgur for hosting the images
https://sleep.tnet.com/reference/tips/imgur

how to organize those graphs
https://sleep.tnet.com/resources/sleepyhead/shorganize
be sure to read all 3 pages.
doing so makes it a whole lot easier for someone to help you if you put things in an easy to see format

[ScottGA]

Testing links

<a href="http://imgur.com/wL8X6Mb"><img ... om" /></a>

[ChicagoGranny]

Copy the one that says, BBCode. It's all you need to paste here.

[ScottGA]

The first chart is data form the System One that left me feeling lousy. The second is the new Devilbiss machine results from one night this week. I really don't understand the high leak rate shown on the chart for the Devilbiss because the Devilbiss software shows no leak for it. Any items you guys note in particular?

[Pugsy]

I would doubt that DeVilbiss large leak.. You might have hit LL territory when the pressure spiked and you hit near 108 L/min but that would have been the only time you maybe hit it. Large leak territory for a DeVilbiss is more up where Respironics large leak territory begins...at up around 90 L/min.

SleepyHead defaults to the ResMed 24 L/min threshold though...and while I don't think that is the problem you need to adjust the threshold if you want anything near accurate for % of time in large leak.
Go to Preferences/CPAP tab and on the right side change the 24 L/min threshold to something around 80 to 90 L/min...or remove the check mark and turn it off.

I am unable to read (at least very well) the report you posted.
Would you please review the link I posted about examples and just do the daily detailed report in the format shown in that link. We don't need all the extra graphs that are included in the report you posted.