AHI of 5 -- would you CPAP?

[kteague]

I would also wonder if her sleep studies captured her worst case scenarios. That AHI of 5 may or may not be the full picture. At any rate, if she was symptomatic I'd say she should be treated, if for no other reason that to rule out OSA as the cause. Is she wasting her time? Well, without addressing any mouth breathing, she may be. But if she addresses that and after a while still has symptoms, delving further might be needed. Would she receive the discussion any better if it came from your hubby? Or be direct with her, and tell her you are struggling with honoring her desire for privacy when you have some concerns and some insights into cpap use that you think she might find helpful. Let her know she controls the depth of discussion.

JNK - You are one smart funny man.

[Gerryk]

Numbers numbers numbers.
How does she feel? If she feels fine and has no symptoms then why did she have the sleep study done? If she has symptoms which is probably why she had the sleep study done then she should be on cpap.
A 4 untreated could be more problems then someone who is being treated but still has 10 an hour. It all depends on how the person feels and other symptoms.

For some people 5 events is nothing for others it can completley ruin a nights sleep.

Gerry

[ozij]

Yes, I would treat an AHI that low *if* my sleep doctor said he thought CPAP would improve my symptoms. (He did, I do, and it has.)

If she snores *continuously*, without stopping every 10 minutes or so, then that doesn't sound like apnea. (I'm basing the "10 minutes" thing on her AHI.) It could be UARS, though. Could also be something else entirely.

Ditto.
O.

[LinkC]

I read thru this entire thread thinking "With AHI of 5 I would base my decision on how I feel", and wondering why no one mentioned that.

Then I finally got to Gerry's post. Amen, brother!

[Wulfman]

I read thru this entire thread thinking "With AHI of 5 I would base my decision on how I feel", and wondering why no one mentioned that.

Then I finally got to Gerry's post. Amen, brother!

I did.
My third post on the first page.


Den

[jnk]

. . . on how I felt not treating it versus how I felt when I did treat it. . . .

. . . I would base my judgment on how a person felt. . . .

I read thru this entire thread thinking "With AHI of 5 I would base my decision on how I feel", and wondering why no one mentioned that.

Then I finally got to Gerry's post. Amen, brother!

Would someone please copy this and tell LinkC to take me and Den off his blocked-posters list.



You crack me up, LinkC. VERY funny!!

jeff

[MoneyGal]

You guys are great.

I wholeheartedly agree with the comment that if it were me, I'd base my decision to treat with CPAP or not based on how I felt with CPAP and without.

The problem is, when I ask my mother-in-law those kinds of questions, I get a series of complaints about ... everything in life, pretty much. You may recall I said that she is estranged from everyone in her family (her other children, for example; her brother, her mother, etc.) -- there's a reason for that: she is very very hard to be around.

I am probably going to mail her a copy of the link suggested earlier...I will continue to promote her health and well-being, within the constraints I'm facing. Thanks!

[Muse-Inc]

...I am probably going to mail her a copy of the link suggested earlier...

Might add this one, it might help explain her estrangement: http://sleep.lovetoknow.com/Sleep_Apnea_Mood_Swings...I gave it to all my friends and loved ones saying I am working on this but I know I can be very difficult so this might explain some of the problem I am dealing with. My bipolar friend's mood were often more stable than mine during the first year...even now into my 3rd yr, my mood is still pretty volatile.

[onesight1]

Not me, my mother-in-law.

She has an untreated AHI of 5.

She got a CPAP machine with a non-full-face mask (I am unclear on the terminology here! and I don't know what mask.) She says that "sometimes" her mouth must be open when she's sleeping, because she wakes up with a dry mouth. She also said she is unwilling to try a FFM.

She was visiting this week and slept in the room next to ours. Apparently she has snored for decades and the last three nights were no exception -- loud, continuous snoring throughout the night.

Here are my questions:

If you had an AHI of 5, would you treat it with CPAP?
and, based on what I've written, do you think it's possible she's getting any benefit from CPAP?

as a sleep technician, CERTAINLY.

although her AHI JUST meets the criteria for a diagnosis.... what was her AHI in REM?

also, what was her RDI?

theres more to it than AHI, because if she is having a shitload of respiratory effort related arousals.... even marked, wont affect the total AHI..... sures theres no hypoxemia involved, but RERA's cause sleep fragmentation..... so obviously treatment would be advised.

thats why RDI, should not be overlooked..


now... if you mean to ask... is there a BETTER solution to CPAP? .... ummm, other than surgery, probably not.

even then, its not certain surgery works, does she still have her tonsils/adenoids?


EDIT: ALSO! if she is having trouble with the nasal mask.... ( those cover the entire nose ) try PILLOWS.... women normally prefer it anyways... smaller, lighter, ect....

and add a chin strap.

see how it goes, what does she have to lose?

[foxhunter]

I am assuming that your Mother-in law is a Medicare recipient? If so and if you are expecting Medicare to cover the treatment, you are most likely going to be disappointed. Medicare at least until recently would only cover conditions at AHI30 or over. I believe that that number may be changed to 15 or 20 but she is a long way from there.
The advice you have got here is good advice but AHI 5 is not dramatic. Should she wish to pay for it herself (or,of course, you) then the world is her oyster. Just get a prescription from her sleep doc and BUY ON LINE, not from your local DME. You will definitely notice the cost difference.

[LSAT]

Foxhunter...You said..." Medicare at least until recently would only cover conditions at AHI30 or over. I believe that that number may be changed to 15 or 20 but she is a long way from there."

NOT CORRECT......I had an AHI of 14 on my titration in mid 2008 and everything was covered by Medicare.

[Gerryk]

This is an excerpt from a letter dated March 3rd 2009 from Director of coverage and analysis group to administrative file for the US department of health and human services center for medicade and medicare services.

The TA reported that the reference standard for the diagnosis of OSAHS is facility-based PSG, a comprehensive sleep study that records and evaluates a variety of cardiorespiratory and neurophysiologic signals during sleep time. It quantifies the severity of disturbances with the Apnea-Hypopnea Index (AHI). Higher AHI values imply more severe sleep disturbances. Typically, a value of 15 or more events/hour of sleep is considered to be suggestive of OSAHS. An AHI suggestive of OSAHS is neither sufficient nor necessary for the diagnosis of the condition, as the severity of symptoms has to be accounted for, and other conditions affecting sleep may need to be excluded. Baseline AHI is only modestly associated with response to CPAP use among people with high (pre-test) probability for OSAHS. The same is true for other indices obtained from sleep studies such as the mean or minimum O2 saturation, apnea index, hypopnea index, frequency of arousals and other quantities.

So again as I and others have said in these forums numbers are only a small part.

Gerry

[Gerald]

Moneygal....

As I see it, the only way you're going to make any progress on your "puzzle" is to measure her O2 levels with a recording Oximeter....every night for a couple of weeks.

Sleep apnea is simply slow motion suffocation.....waterboard torture while asleep......low levels of O2 in the bloodstream. For good health, the O2 should be at 93% or better all night....evey night.

Purchase a SPO-7500 Oximeter from Turnermedical.com and run nighttime tests on her.

If she doesn't want to bother with testing herself, then drop it. She doesn't have the will to live a healthy life....and no amount of "pushing" on your part will help.

Finally, my honey and I have found that we can have AHI scores well below 5.0 and still not get sufficient O2 for good health. We have to get the AHI below 2.5 before we start seeing an improvement in our O2 blood saturation levels. Just because it's "common knowledge" that anything below 5.0 is "OK"....doesn't mean that the idea is correct. My testing has found the medical establishment to be wrong on the "5.0 mark" as being OK..

Just remember....you can't manage what you can't measure. O2 levels are the bottom line......and trying to guess what they are by looking at your AHI scores....or trying to guess what they are by how you "feel" is haphazard at best.

Gerald

[jnk]

Purchase a SPO-7500 Oximeter from Turnermedical.com

Here's a screaming good deal on a recording pulse-ox w/software, in my opinion, right now:

http://www.semedicalsupply.com/cms-50d_plus.htm

Get it without a case, and it is less than 90 bucks total if you use the code "HOLIDAY09." Free shipping.

It doesn't have alarms, but it does record overnight and come with software. (Note that only the "+" [Plus] model,CMS-50D+, records and has software.)

I assume from what others have said that it is a good-quality product, but I have no first-hand experience with it so I don't know for sure.

I bought from semedicalsupply one time about a year ago and had a good experience, as I recall, but that is all I know about them.

jeff

ps-Man. The more I thought about it, the more I wanted one. So I just ordered one myself. I HATE when I talk myself into unplanned purchases like that!

[MoneyGal]

Crap. I've been wanting an oximeter myself.

We're in Canada, guys; there's no Medicare here. I'm not sure what my next steps are, because she's gone back home to her house and we will likely not see her for another year. I'll keep you posted on any news. My first step, if I'm able to arrange this, is to get a copy of her polysomnograph.