Acceptable AHI numbers

[tattooyu]

I second Hawthorne's post, but you really have to go by how you feel, and even moreso if your O2 levels drop (with oximeter).

For me...

• An AHI below 4 is acceptable.
• An AHI below 3 is good.
• An AHI below 2 is best.

Also, it depends what contributes to the total AHI.

Example #1

Code: Select all

  AI = 1
+ HI = 1
--------
 AHI = 2

I would probably feel so-so the next day.

Example #2

Code: Select all

  AI = 0.1
+ HI = 1.9
---------
 AHI = 2

I would probably feel good the next day.

[sagesteve]

The number that is "acceptable - good - great" is 93%.

Sleep apnea is "suffocation"......and "suffocation" means that we're not getting enough O2.

Regardless of what the "AHI" is, we need to keep our blood O2 saturation levels at or above 93% while sleeping.

The arbitrary "OK" number of "AHI 5.0" is....in my not-so-humble opinion......just plain wrong.

Focus on what's important....your O2 saturation levels.

A low AHI is just an indication that we might be "doing something right"....but it isn't a confirmation.

Gerald

DITTO! I run an oxygenator and I sleep everynight at 98%... (sometimes) hitting 99% saturation. AHI is 0.2 to 0.9
GEEZ tattooyu I'm eating breakfast!!! Now your Avatar is MOVING!!!

[DaleK]

This is such a great forum. I was questioning my own experience today since my DME told me that my events are "minimal" when plenty of nightly average AHI's are over 10 and many are over 5. I feel rotten when my nightly average AHI is over 5, not bad when it is around 3, and best when it is less than 2. I am not so patiently waiting to receive my card reader to figure out what is really going on.

[mars]

I second Hawthorne's post, but you really have to go by how you feel, and even moreso if your O2 levels drop (with oximeter).

For me...

• An AHI below 4 is acceptable.
• An AHI below 3 is good.
• An AHI below 2 is best.

Also, it depends what contributes to the total AHI.

Example #1

Code: Select all

  
  AI = 1  
+ HI = 1  
--------  
 AHI = 2  

I would probably feel so-so the next day.

Example #2

Code: Select all

  
  AI = 0.1  
+ HI = 1.9  
---------  
 AHI = 2

I would probably feel good the next day.

Hi All

I go with the above.

Another possible scenario is as follows -

Having a hypopnea - SpO2 goes down,
Hypopnea stops, SpO2 starts to go up,
Another hypopnea starts before SpO2 gets back to normal level,
this time SpO2 goes down a bit further
Hypopnea stops, SpO2 starts to go up again
but another hypopnea comes along, and SpO2 goes down even further
etc etc etc

So while this is going on the SpO2 level never gets the chance to get back up to its normal level (around 97 SpO2), it stays down low for an extended time. Not good.

This means that a group of hypopneas together is far more dangerous than the same number spread out over the night, and producing the same AHi result.

So looking at our wave-form reports would be essential to know what is really happening. This combined with an oximeter would probably give us the best information.

And, of course, there is how we feel in the morning.

Credit for the above must go to my new Sleep Doctor, who spent 90 minutes with me yesterday going through my Overnight Sleep Study, and progress since then. He was simply pointing out that, as stated in the posts above, that we need to look at more than AHi numbers. I learned a lot from him, and he wasn't in the least fazed to discover that his original prescription for cpap at pressure 10 had somehow turned into apap at 10 to 13, nor was he surprised that I had sacked my last sleep doctor.

I just knew that my clean and upright living had to be rewarded eventually

cheers

Mars

[roster]

Quoting from Deadly Sleep by Dr. Mack Jones:

One apnea per hour is eight per night or 2,920 per year. In seventy

years you have obstructed 204,400 times (that is if you have managed to live that

long). Is that enough to cause adverse consequences? Potentially yes, because what

must be taken into account is how prolonged are the apneas and how severe are the

drops in blood oxygen levels. How are the apneas distributed through out the night?

For example, are they occurring mostly during the latter part of the night when REM

sleep predominates? There is presumably greater risk if apneas are grouped together

rather than spread out evenly through out the night. Remember, the AHI is the total

number of apneas and hypopneas divided by the number of hours of sleep. The

severity of any one or combination of these factors can make a significant difference in

the overall outcome over a period of many years.


The adverse effects of each apnea are likely additive or cumulative, a dynamic

and highly variable process that will likely catch up with you eventually.


Dr. Barbara Phillips, M.D., M.S.P.H.,a past president of the National Sleep

Foundation, among others. Has made the point, with supportive evidence,(11,12) that

one apnea per hour can be “deadly” and therefore, all obstructions must be eliminated.

This message has been slow to get out into the medical community.

[jdm2857]

[quote="mars"]
I just knew that my clean and upright living had to be rewarded eventually
[quote]

That may have something to do with your sleep difficulties.

[roster]

The main purpose of the whole exercise is to eliminate obstructions that decrease the 02 level. Good AHI figures is only an indicator that there is lesser obstruction but this doesn't demonstrate that 02 levels are better. We should not focused on intermediary objectives and forget the main goal.

......

If by "exercise" you mean the CPAP process, then I disagree with your statement. Certainly maintaing an appropriate blood/oxygen level is important, but an uninterrupted sleep is right up there in importance. A good blood/oxygen level can be achieved with a very high and deadly respiratory disturbance index.

[DoriC]

Mars, I envy you your sleep specialist. I can't imagine a doctor spending 90minutes with a patient and giving such a good description of OSA and what it all means. Your clean living really did pay off!

[mars]

I just knew that my clean and upright living had to be rewarded eventually

That may have something to do with your sleep difficulties.

Doesn't everyone sleep standing up How else can you live an upright life?

New post by DoriC on 13 Aug 2009, 21:19
Mars, I envy you your sleep specialist. I can't imagine a doctor spending 90minutes with a patient and giving such a good description of OSA and what it all means. Your clean living really did pay off!

I know. As the time went by I kept on wondering - how much longer is he going to spend with me. I had spent nearly 2 hours waiting after my appointed time before I saw him, but somehow did not get angry. I knew he was with someone, and was obviously attending to them. And he did the same with me. As well as going through my sleep study line by line, he took my history and gave me a physical examination, looked at my nose bleed problem, and my throat closing problem etc. I was amazed. He is the Doctor at the sleep centre I did my overnight with, and who gave me my original prescription. He was not in the least concerned that I had all the reports to show him, or that I was deciding what pressure range to use. He made helpful suggestions for fine-tuning that I had not thought of, and was 100% supportive. When I sacked my original sleep doctor I thought of him, and yes, he does see a few patients apart from his sleep clinic patients.

Isn't it good to have our faith in the goodness of human nature affirmed every now and then, what with so much evidence to the contrary. Mind you, I think most Forum members have that goodness, and continually show it, even though they are often ignored.

cheers

Mars

PS - of course, my clean living may have some thing to do with multiple lower back fractures, and no energy

[Brian OReilly]

I agree with all the great comments here. I think all the data are really indicators.

1. AHI is an indicator that you are not waking up and you are getting a restful sleep (no adrenaline pumping in to keep you breathing)
2. Hours of continuous CPAP use is another indicator that you are doing things well.
3. Oxygen saturation is an indicator that you are getting good oxygen levels in your blood

Taken together, these indicate good oxygen, low waking periods (restful sleep) and time in a good place.

My AHI was originally 100 but is now consistently in the 2.4 range week over week. I had originally used epap, but it was not getting my oxygen where it needed to be; cpap (resmed) has certainly helped me have more restful nights and is keeping my indicators where they need to be (95% O2,7.9 hours and 2.4). I have resmed on my smartphone so I can see each day at a glance. I also keep a sleep log where I record any drinks I've had, sickness (colds, etc al), number of times up at night and general feeling on waking up; I replicate the resmed data in the spreadsheet to get a better idea of whether I am improving over time.

[DeadlySleep]

You will probably be criticized by a few forum rats for resurrecting a thread from 2009. But don't worry about it. The stuff is still relevant.