How to get AHI numbers down?

rxforsleep · Post by **rxforsleep** » Tue Aug 02, 2005 11:11 am

I know this is probably the million dollar question, BUT, does anybody have any tips on how to get my AHI numbers down? I have been using the Respironics Encore AutoPAP and tracking my results with the Encore Pro and MyEncore software for the past few months and just can't seem to get a handle on what may cause such variable AHI's. The best I have ever done was a 5 but I am in the double digits 95% of the time...usually around 20. I have tried raising both the minimum and maximum pressures, lowering both the minimum and maximum pressures, using different levels of C-flex, different humidification levels, you name it, I've tried it. Does it sound like I just need to give in and go to my ENT for surgery? I haven't seen him in quite awhile as I thought I would try to be pro-active in getting my apnea under control on my own.

Thoughts?

rx

sleepy gal · Post by **sleepy gal** » Tue Aug 02, 2005 11:25 am

Wish I had an answer for you....hopefully someone more knowleadgeable will pop in....but in the meantime, have you tried contacting your doc or RT or DME or whoever might be able to give you some help?

Sometimes you have to be fairly aggressive in getting some help...sounds like you are at the point where you need help!!

Hope you can get some answers.

Best of luck to you.

ozij · Post by **ozij** » Tue Aug 02, 2005 11:49 am

You really have to be more specific about the pressures and ranges yout tried and the results.
O.

GoodKnight · Post by **GoodKnight** » Tue Aug 02, 2005 12:43 pm

I am just getting started on that long journey with APAP. My AHI's are in the 5-10 range for the last week and I feel a lot better than I ever have. i will follow this thread with great interest and post any answers I get.

loonlvr · Post by **loonlvr** » Tue Aug 02, 2005 2:24 pm

My Ahi also is higher than most-in the 8-13 range usually. I found the best results were using a real narrow range. I am now at 12-14 and have had the best results. But it never stays consistent-always going up and down.

chrisp · Post by **chrisp** » Tue Aug 02, 2005 2:27 pm

What are the numbers specifically. AI =, HI =. Then we might give you a better answer.

:twis ted:

th · Post by th » Tue Aug 02, 2005 2:32 pm

What is your leak rate like? If you have a lot of leaks (mouth breathing or mask leaks) your number can be higher. Also, My wife has better numbers when she run just straight 9 to 9 . Her AHI number is 1 and below. Put her on auto 5 to 10. Her pressure stays at 5-7 never goes higher and her AHI run a little over 5 ............hope this helps. Sometime people do better on straight CPAP like my wife. For me the auto works great my number is always 1 or below and my setting is 6-11 CFLEX 3. I hope you get t worked out
th

rxforsleep · Post by **rxforsleep** » Tue Aug 02, 2005 2:35 pm

Oz & all who may be able to help,
I have tried pressures from the initial setup of 4-20 (terrible!!!) down to 6-10 with various results. When I was able to get into the single digits my pressure settings were 8-12 but I have also had AHI's of 30 plus with that setting. My original sleep study showed a pressure of 13 as the optimum but when I let the Respironics Remstar Auto do its thing, it would usually go to 18 or even all the way to 20. The problem with the higher pressures is that it blows the mask right off your face, even with the Activa mask. So I have tried to find a level where I can sleep comfortably without major mask leaks, yet keep my apneas down. Even with the mask blowing off my face at 18, I still was having AHI's over 30 so having a higher setting isn't the answer.

I am a 41 y/o male, 5'11", 165 lbs. with no other significant medical problems. I was initially diagnosed with OSA in January and have been battling it ever since...I think it's winning

Thanks for any help that the great people on this board can give me.

rxforsleep · Post by **rxforsleep** » Tue Aug 02, 2005 3:46 pm

I do recall that Derek mentioned in a previous post that he does better with straight CPAP instead of using the auto mode so maybe there is something to the whole narrow range (ie 10-12) theory that I need to explore.

rx

rested gal · Post by **rested gal** » Tue Aug 02, 2005 4:18 pm

rxforsleep, if I were you I'd experimentally try switching your Autopap to cpap mode (with or without C-Flex, as you choose) on the straight 13 you were titrated at.

Also try it on auto at a narrow range of 12 - 14.

Also try some experiments with various C-Flex settings and with C-Flex off.

I'm not a doctor; that's just what I'd try given that that particular autopap may be "running away" with your particular breathing. Another autopap might not do that at all with you....or might. Trial and error is the way. Expensive to try other machines, though.

ozij · Post by **ozij** » Tue Aug 02, 2005 9:04 pm

I agree with Rested Gal.
In addition, you should know that:
AHIs (and the tendency to obstruct) do vary.
For some of us, higher pressure brings on higher AHI.
On the other hand, others find that the the auto does not treat them as well (of should this be as good?) as a bi level machine because it doen't created the needed pressure at the right time. Ballast949 is a case in point.
And as th said, leaks can affect you AHI (and cause an automatic machine to rais pressure in an attempt to compensate for them).

In any case give yourself time in each rage you check. I would say that unless you feel dreadful, a week is the minimum.

Keep a diary, write down all the other things that happened - what and when you ate and drank it the hours before going to bed, how tired you felt, etc. All those things can affect your AHI.

The data to explain most of your results is at your fingertips - but you've got to collect it and organize it.

O.

neversleeps · Post by **neversleeps** » Wed Aug 03, 2005 7:25 am

rxforsleep,

Here is the link to derek's post regarding CPAP mode vs. APAP mode:

CPAP is better than APAP (for me..)

All I can say is thank goodness for APAPs so we have the ability to conduct these experiments to determine our best treatment. Good luck!

Sleepless on LI · Post by **Sleepless on LI** » Fri Aug 05, 2005 8:19 pm

Does this mean if my AHI with auto 9.5-15 is 0.8 to a max so far, once in one week, of 3, the average AHI of about 1 - 1.6, I should try to turn off the auto and use the 10 cm. I was titrated at? Or on the alternative, should I try to use auto with it at 10-10? Will that make a difference? I am so totally mixed up at this point, I don't know what to think. People are now saying DON'T use apap??? My head is about to explode!!!

chrisp · Post by **chrisp** » Fri Aug 05, 2005 8:33 pm

An AHI of 1.6 is fantastic. Don't mess with it !

To all .. Be specific . AI = , HI= . I had an AI of 1 , HI of 16. AHI mixes apples and oranges. I have 2 apples and 15 oranges. AHI says I have 17 pieces of fruit. We don't know wether to suggest you make orange juice or apple pie. So you just get fruit salad. ........ So we may better suggest treatment. Or another Machine.

:twis ted:

Sleepless on LI · Post by **Sleepless on LI** » Fri Aug 05, 2005 8:43 pm

Chrisp,

You are too funny.

So don't mess with the settings? I was thrilled this morning with the 0.8, let alone the 1.6. I just figured maybe with straight cpap at 10 or putting the auto at 10-10, I could get less than 1.0 every night??? Don't get greedy, I believe, is what you're telling me???

Mask

Mask	Humidifier