Question about my AHI, Hypopnea, etc.

[icemanbryan]

OK, I will try to explain the best I can.
Last Oct I got a cpap after a sleep study in Sept.
I found this site and became interested in finding out more I purchased the software and a card reader.
Just downloaded my information
Here goes.
My AHI is at 21.8, Hypopnea index is 18.3, apnea index is 3.5, % time in apnea is 1.2

My question is how / where do I stand with average?
I would just like to know.
BTW,
Saw the Dr. last month. He asked how did I feel? I said better, little more rested. He said good see you in 6 months.

Thanks in advanced

[amos]

If your AHI is 21.8, it is way too high. The doctors want it below 5.

amos

[KatieW]

I think you could be getting more effective therapy. Some things it might be:

1. Too high a leak rate. From the Clinical Guide: "Generally a leak rate of more than 0.4 L/s (24 L/min) is associated with patient discomfort, disturbed sleep and reduced efficacy of treatment. Leak values greater than .4L/s (24 L/min) affect the accuracy of other measurements." It could be a leak from poor mask fit, leak in hose or fittings, or mouth breathing.

2. Pressure was not set correctly for you, or perhaps your needs have changed. What pressure were you titrated at? Do you have a copy of your sleep/titration reports? What pressure are you currently using? Are you using ramp or EPR? Were your apneas higher when sleeping on your back?

3. Or it could be other factors like: sleep hygiene, stress, pain, medications, or other health issues.

Come back, with more information, and copies of your reports, and perhaps you'll get some suggestions.

Here is a link on how to post a report:

viewtopic/t47041/viewtopic.php?f=1&t=46 ... ot#p413222

[icemanbryan]

Thanks I dont have the sleep study report.
I am at 8.6 and I dont use the ramp feature.
I just have a nasal mask I may breath out my mouth.
I feel the pressure might be a little high but Dr said It is OK.
I even thought about going down a bit pressure wise.
I would really like to make this work better for me

Although Since I have had it I feel much more rested and not tired in the daytime

Thanks

[Julie]

Hi, 8.6 is quite a modest pressure, certainly below average, but your AHI is way high, not therapeutic at all, so you might want to try 1-2 nights of mouth taping to see if a full face mask is needed. Raising your pressure might be in order regardless of what mask you use, but if you're mouth breathing, without a FF mask, you'll only make things worse by raising it now.

[KatieW]

Thanks I dont have the sleep study report.
I am at 8.6 and I dont use the ramp feature.
I just have a nasal mask I may breath out my mouth.
I feel the pressure might be a little high but Dr said It is OK.
I even thought about going down a bit pressure wise.
I would really like to make this work better for me

Although Since I have had it I feel much more rested and not tired in the daytime

Thanks

I suggest you get a copy of your sleep report, as part of your medical records. It will tell you how many events you were having, and at what pressure that stopped--that may be why your doctor says 8.6 is your pressure. Also, if it was worse when sleeping on your back, and if you were mouth breathing. All useful information to have, when you are trying to improve your therapy.

If you feel the pressure is too high, you could try the Ramp feature, with a minimum of 6, and ramp up to 8.6 in 5 or 10 minutes. It will give you time to get used to it, and also time to adjust your mask for leaks as the pressure increases.

Taping is a good way to find out if you are having mouth leaks, because if you were, you will see your leaks go down. Then you might prefer to change to a full face mask instead. Many use blue painter's tape, make a little tab at each end, so it's easy to pull off quickly if you need to.

[kcarlee]

Use a chin strap. works well for me.

[icemanbryan]

Thanks so much for the comments, I really appreciate it.
I adjusted my mask last night and got 11.9 AHI and .20 AI
I am reading some say to 1/2 the AHI cause it is a resmed??
Is that what you do?
I will try the tape tonight over my mouth.
Also, I sometimes feel the mask gets half cocked on my face because of the pillow pressure (I most sleep on my left side).

Anyone have the same problem?
Can anyone reccommend a pillow or mask that seems to fit well?
I know it is personal but.....
Maybe someone has some ideas

Thanks Bryan

[icemanbryan]

Thanks again for all the information.
Last night I read that lanolin lotion ( It is for breast feeding mothers) works well to seal the mask.
I purchased some last night and got a AHI of 9.5 and an AI of 1.2
Best so far, just wanted to share the lotion trick

[amos]

Bryan,

This post is in answer to your question about pillows...especially pillows for side sleepers. Yes, a comfortable and useful pillow is a very personal choice. Here are some choices to help you decide:

(1) Take some masking tape and tape up the edges of your pillow. This will allow your mask to hang over the sides.

(2) Buy a shapeable pillow from Target. This pillow type stays the way that you shape it.

(3) Some people prefer a foam or memory type pillow such as the tempur-pedic.

(4) Some people prefer the papillow - a horse shoe shaped pillow.

(5) Some people prefer the buck wheat hulls pillow such as the regnesis.

Hope this helpd.

amos

[icemanbryan]

Hi, thanks. I do have a memory foam pillow. I think I will go for the CPAP Pillow
with the cut outs. That may be better.
I sometimes wake and find the mask has been pushed off by my pillow so maybe a cut out pillow will help.
I forgot about the buckwheat ones I may check that out as well.

I really would like to thank everyone, it is so nice to speak with people who know or have ideas on what works
The Dr's are on such a time frame it is hard to ask general questions.

[kwikwater]

Katie,
How did you perceive leak rate from the data Bryan gave. I'm pretty sure I don't understand hypopnea and wonder if that's tied to mouth/mask leaks.
Thanks,
Kelvin

[KatieW]

Katie,
How did you perceive leak rate from the data Bryan gave. I'm pretty sure I don't understand hypopnea and wonder if that's tied to mouth/mask leaks.
Thanks,
Kelvin

Kelvin, it was just a guess, since it's a very common problem for beginners. Though you're right, I never specifically asked what his leak rate was.

Hypopneas, as measured by xpap is different than what is measured in a sleep lab. On xpap, it's a partial drop in ventilation. Resmed's definition is different from Respironics. I have a Resmed, and from the Clinical Guide it says: "A hypopnea is defined as a 50 to 75% drop in ventilation." Respironics uses different percentage markers.

This is from Sleep Apnea: the Phantom of the Night (an excellent book by the way): "Hypopneas are partial obstructions, most laboratories also count hypopneas, particularly if they cause arousal from sleep or have an associated fall in blood oxygen saturation."

If leaks (mask or mouth) are too high (on a Resmed too high is .4 liters/second), then the xcap can't compensate, and so then both therapy and data are compromised. From the Clinical Guide:

"When assessing results, check the leak data first. Leak values greater than 0.4 liters/second affect the accuracy of other measurements. A Leak rate of more than 0.4 liters/second is associated with patient discomfort, disturbed sleep, and reduced efficacy of treatment."

[icemanbryan]

Great news group!

Last night after readjusting my mask (who knows how many times since I have had it), I did a great job.
My AHI is at 5.8 and my AI is at 0.30
Apnea index is 0.3
% time in Apnea 0.1
Leak Median 0.0
95th percentile 0.0
Hypopnea index is at 5.5 (not sure where I stand on this one).

Also, I am a idiot, my cpap is set for 11.2
My ramp start which is off is set to start at 8.6
I really think I have it down. But, if I didn't find the group to discuss my lack of knowledge I would not be where I am.

Thanks so much for all the help and suggestions

[KatieW]

Great news group!

Last night after readjusting my mask (who knows how many times since I have had it), I did a great job.
My AHI is at 5.8 and my AI is at 0.30

Also, I am a idiot, my cpap is set for 11.2
My ramp start which is off is set to start at 8.6
I really think I have it down. But, if I didn't find the group to discuss my lack of knowledge I would not be where I am.

Thanks so much for all the help and suggestions

That is very good news. Thanks for the update.

What was your leak rate before, and what is it now?