Will I reach an AHI of zero? Should I?

[dseturam]

I have been using my CPAP machine for the last four weeks. I am finally becoming comfortable with the machine and am able to sleep through the night most of the time.
During the sleep study I was diagnosed with having an AHI of 25-42/hr with 92% O2 levels.
I don't have the sofware to look at the graph but here is what I gathered from my machine:

Leakrate: varies from 0.00 to 0.05.
AHI: 3.5 to 5
AI : 0.5 to 1.2

I wouldn't say that I feel remarkable after being on the CPAP machine but I think I feel better (though sometimes I wonder if it is psychological).
My settings are:

Pressure: 10
EPR: 3

My questions:

1) Are we expected to reach an AHI of zero?
2) If so, how long will it take to achieve this? Is there something I need to do?
3) How long does it take for someone who is on the CPAP machine to feel noticeably "refreshed"?

[kteague]

The numbers you are already getting would be enviable to some on here, others would strive to go lower still. Personally, I hit 0.0 AHI two or three times most weeks, but it seems there is nothing I can pinpoint that makes that happen. My routine is the same every night. Although I'm mostly a side sleeper, once in a while I do wake up on my back, and I'm guessing those are nights I don't hit zero, not to mention when I'm congested or hold my breath when flip flopping in bed, etc. There's a fine line between seeking to optimize our therapy and chasing rainbows. I did once increase my pressure by .6 to see if I hit zero more often, but since I didn't, I dropped it back down - why add any discomfort if to no benefit? One experiment I have been meaning to do is take steps to assure I can't roll on my back during sleep for a week then see how my numbers look. So, I don't have any real answers for you, just a personal philosophy based on what seems logical to me - the lower the better. That said, a less than perfect AHI is certainly not the only area of my life where I've decided to settle for my personal best.

How long it takes to see improvement varies so much, you won't likely get the same answer from two people. With therapeutic treatment, another thing you can do to give yourself the opportunity for recovery is to get adequate hours of sleep. Some unrealistically expect to feel better with less than enough sleep for maintenance, much less recovery. And how depleted you have become from the sleep deprivation is also a factor.

I do hope you'll keep us posted on your journey. Always good to hear how this is going for others.

Kathy

[LinkC]

Expected? No. The accepted definition of "effective treatment" is AHI under 5.0. I'm generally satisfied with AHIs under 1.0.

Obviously, you want it as low as possible, and you may see a night of 0.0...maybe even a couple of nights in a row. But, for most, that will be the exception, not the rule.

How long? I don't think there's a "norm". Some react to treatment better and sooner than others. Getting a mask that works and getting leaks under control are the big hurdles. Once that settles down, the numbers will come.

Some people feel better after their first night on CPAP. Others it's a gradual thing. I felt better after the first night (I dreamed for the first time in years my first night.) Since then, I've gradually improved ...some days more or less than others. But again, YMMV.

[araminta]

While a lot of the folks who post on the forum are dedicated to getting as close to zero AHI as possible, I am less concerned with the numbers.

My goal is to get back that feeling of vim and vigor, and waking up in the morning like I used to: ready to go out and get some exercise, or whatever activity I wanna do.

For some, that will be an AHI below 1. For others, it might be different.

[Gerald]

Picking up where Araminta left off......

I think you'll get the "vim & vigor" Araminta is talking about when you are able to maintain 93% blood Oxygen saturation all night. Whether your AHI is 0.5 or 5.0 makes no difference...provided your O2 saturation levels are where they should be.

All of us here are trying to prevent "suffocation".....and each of us does it in a slightly different way....depending on our individual physiology and overall health situation.

Unfortunately, our CPAP machines don't give us O2 saturation readings.

Those of us without recording Oximeters are doing a lot of educated guessing,,,,based on our AHI scores. In general, the lower the AHI, the better the O2 saturation. However, that can be a "fooler". A couple of weeks ago, I got an AHI score of 0.0 and my software printouts looked "great"......but I didn't feel right. The next night I used my Oximeter and discovered a bunch of bad "desats". I wasn't snoring.....my APAP machine recorded no problems....I got an AHI of 0.4...but, still, my O2 wasn't where it was supposed to be.

Because I was very concerned, I had another titration last Monday night (my last one was in 2006) and they couldn't find the problem....probably because I didn't sleep well (crummy bed and horrible air conditioning).

What all of us do is "tweak & tune".......making our therapy the best it can be. Most of us find that to get decent results, we have to manage that care ourselves.

There are no firm answers to your questions. All you can do is work at it the best you can......and never give up.

Gerald

[socalmonkey]

Gerald - or any one else with an Oximeter...

How often do you use your Oximeter? Every night or only when your suspect things aren't going well?

[sagesteve]

I use mine every night just as I'm going to bed. I put the mask on and the CPAP comes on automatically. I get my humidifier turned on. I use my oximeter to see how I'm doing. It usually registers 94/95. I then turn on my Oxygenator and wait for a reading of 98% and then take it off and go to sleep. Sometimes during SOME nights I'll wake up to see how it's (the oxygen saturation) is doing...always reads 98%. Good for the organs! Good for longevity. I'm 62 and feeling GREAT!

[socalmonkey]

To those who wear the SPO-7500 Oximeter on your wrist all night... is that hard to get used to?

And it looks like the included software is capable of very detailed report.

If you use it every night, that big data unit on your arm w/wire going to index finger doesn't bother you? You can sleep wit it every night?

And why that style machine over a the smaller all in one finger mounted units. Which is the best?

[Goofproof]

I have been using my CPAP machine for the last four weeks. I am finally becoming comfortable with the machine and am able to sleep through the night most of the time.
During the sleep study I was diagnosed with having an AHI of 25-42/hr with 92% O2 levels.
I don't have the sofware to look at the graph but here is what I gathered from my machine:

Leakrate: varies from 0.00 to 0.05.
AHI: 3.5 to 5
AI : 0.5 to 1.2

I wouldn't say that I feel remarkable after being on the CPAP machine but I think I feel better (though sometimes I wonder if it is psychological).
My settings are:

Pressure: 10
EPR: 3

My questions:

1) Are we expected to reach an AHI of zero?
2) If so, how long will it take to achieve this? Is there something I need to do?
3) How long does it take for someone who is on the CPAP machine to feel noticeably "refreshed"?

Everyone that's answered you post uses a Remstar, If you had a Remstar the answer would be AHI 0.0 is possiable, however with your brand of XPAP, the answer will probably be NO. Not totally because you don't get treatment, your brand tends to score the results higher, resulting in compairing Apples and Oranges. It would be nice to get the software and reader, if you want to track your progress., and get a better picture of your progress. Jim

[dseturam]

Thanks all. I will try to get an Oximeter.

As I said, my main concern is that I am not feeling too 'bright' even after I started using the CPAP. But I will definitely keep going and may be report back. I would like to get the software but with the software not being available here, I am not sure I want it shipped from Australia.

I will keep you posted after about 4 weeks.

Happy breathing till then.

[Gerald]

Monkey.....

The SP-7500 is relatively comfortable......and wearing it all night is not a problem.

I don't use mine every night....only when I suspect something has changed...or when I want to view my progress in a way different than CPAP charts.

I can highly recommend the SPO-7500......They're selling for about $409 at turnermedical.com

Gerald

[araminta]

"I think you'll get the "vim & vigor" Araminta is talking about when you are able to maintain 93% blood Oxygen saturation all night. Whether your AHI is 0.5 or 5.0 makes no difference...provided your O2 saturation levels are where they should be."

Gerald-
That's a very interesting comment.
So it begs the question: It's one thing to measure it, but how do ya try to control or improve Oxygen saturation?

[twokatmew]

To those who wear the SPO-7500 Oximeter on your wrist all night... is that hard to get used to?

And it looks like the included software is capable of very detailed report.

If you use it every night, that big data unit on your arm w/wire going to index finger doesn't bother you? You can sleep wit it every night?

And why that style machine over a the smaller all in one finger mounted units. Which is the best?

I got a CMS50F wrist oximeter first, which is basically the same as the CMS50E fingertip PO, but in a wrist unit. I got dropouts of 15-20% and up, which really skews the data. Also, I found the unit uncomfortable. Needless to say the CMS50F got returned. I really didn't want to spend the $409 for the SPO 7500, but since it comes with a 15-day trial, I went for it. First, this unit does not have alarms, nor does it have the beautiful OLED display. BUT ... I get motion artifacts of less than 1% on average. I had one bad night where motion artifacts were 3%. The unit is smaller, and the wrist band is much more comfortable, having a bit of elastic in it. Further, batteries are easily replaced. Unlike the CMS50F which turns off the display when recording, I can press one button to turn on the backlight and see both my SPO2 and pulse using the SPO 7500. At 1s logging, the unit only records about 6.5 hours, but I upped it to 2s logging, and I can sleep as long as I want and record the whole session. I like the software, which also allows me to check for updates right from the application. The only downside I've found is that when I print reports, the desaturation report only prints one page which lists up to 32 desaturations. On a bad night, I can have 50 or more, so I can't see the data for those after #32. I've been using the SPO 7500 nightly since I got it to help me find the right CPAP pressure. I'm still desaturating into the low 80s, but I'm only there for 20 seconds to a minute or so. In short, I'm glad I got the SPO 7500 and will be keeping it.

I'm frustrated because I'm still struggling to find the right pressure, but that's not the SPO 7500's fault!

[dseturam]

Araminta - I have the same question for Gerald/others. So if the number of AHIs I have has no bearing on my oxygen level, then how can I increase my oxygen level?

[twokatmew]

Araminta - I have the same question for Gerald/others. So if the number of AHIs I have has no bearing on my oxygen level, then how can I increase my oxygen level?

AFAIK, the only way to increase oxygen levels is to decrease AHI, assuming one does not need an oxygen bleed. I wouldn't say that AHI has no bearing on oxygen level. My AHI is too high, and I simply cannot keep my O2 saturation above 93%. I suspect if I could get my AHI low enough, my oxygen saturation would be better.