Effective therapy AHI=5+ ?

[bemused]

Just completed 4th week of therapy (S9 Adapt). Average AHI=5.58 (been fairly consistent over last 2 weeks).
Is this sufficient for effective therapy re insurance reimbursement? I thought I saw a clause that therapy has to be 'effective' but now I can't find it (although I'm guessing its a non-issue as some machines don't even report AHI).

I know we are all different when it comes to AHI but I'm curious if anyone here has a long term average of 5+ and their Doc is happy with it.

I had AHI=83 on sleep study so 5+ is WAY better already.

[LSAT]

Insurance reimbursement is normally based on compliance...using the CPAP at least 4 hours per night for 30 days(?). I don't believe they ever look at therapy numbers.

[Mary Z]

Bemused, insurance authorization is based solely on compliance. You need to use the machine for > 4 hour for either 30 or 90 days (not sure which) for insurance. Your AHI is a little bit high and your pressure may be tweaked just a tad.

[LinkC]

It's not a specific rule, but most sources say UNDER 5 AHI is effective therapy. You are a bit above that, but tweaking and sleep hygiene will probably bring it down.

I've never heard of an Ins Co requiring an AHI level for compliance. What you are getting is WAY better than without CPAP.

[bemused]

All,
you are right of course, ineffective therapy is an insurance factor in me getting ASV rather than bipap. My mind is clearing slowly today, I should not post after a rough night

[hades161]

Haha, post away its no big thing we all have been "foggy" =) When ever anyone asks me how I am feeling I always reply, 'Fair to partly Cloudy"

Under 5.0 is considered successful by Doctor standards yes. This helps with the big issues like O2 levels and bathroom trips at night. For me though I don't feel "good"? at 5.0 I feel just meh ok. Now on the nights I get under 2.0 I normally wake feeling like I can get out of bed, make coffee, have a light breakfast, go for a walk, maybe later hit the Dog Park with my friend and her husky. So for me anyway 2.0 to 5.0 I am looking for issues and trying to improve, under 2.0 AHI I am doing it right. YMMV

Never heard of insurance wanting anything more then Compliance though.

[Pugsy]

Your slightly greater than 5 AHI....what is the breakdown in event category indexes?
In other words...what is the central apnea hourly average?...the hyponea hourly average and the obstructive apnea hourly index? Before considering tweaking of the pressure (should you ever decide to go down that road) consider that if the AHI is predominately central in nature, increasing the pressure is not the way to go and may make things worse.
When look at AHI on these new machines that score centrals we need to look at the individual categories as part of the evaluation.

And yes, agree with the others...your insurance will consider hours of use only when it is requiring "effective" treatment.

[yrnkrn]

I now usually get AHI of 4-5 but with no de-saturations as measured by a recording oxyimeter. To try and understand better what's happening for two nights I videotaped myself at night using an IR camera and found out I change sleep positions about four times an hour on average. This is considered normal. While I did not matched the time exactly (my CPAP does not report exact time of events) I do believe that every time I change sleep position the CPAP records a breathing event. It means nothing.
For me there is no relation between quality of sleep and the AHI number the CPAP reports.

[SleepyToo2]

I do believe that every time I change sleep position the CPAP records a breathing event. It means nothing.

Intrigued by this - what kind of events get recorded? Any consistency in the type? You say there is no correlation between number of events and how you feel? I seem to feel worse when there are more CAs, but I have not been able to entirely eliminate them. Reducing leaks helps. Turning off the C-Flex+ helped quite a bit. Using a cervical collar seems to help a bit, too - but that is taking a bit of getting used to. I tried reducing my pressure by 0.5 cm a while ago, but only left it there for 4 days because the numbers were going in the wrong direction. I am thinking it is time to try that experiment again for a week or two. Challenge is that my AHI is really quite good (1.8 for the last year, with about half of that being CAs), so what difference am I likely to see?

I have not used a video camera to record my sleep position, but my wife tells me that sometimes my legs are "quite active" during the night. Probably a combination of many things will contribute to the events.

[yrnkrn]

Leaks should be as low as possible. Even if the machine can push more air and keep the correct pressure, leaks out of your mouth or around the nose can disturb your sleep. Everything that disturbs your sleep is a problem.

Events are highly individual. For me, after lots of experimenting with different CPAP and BiPAP machines I am now sure that just about any pressure is good enough. The events happen just the same with any pressure and they confuse any Auto machine into raising pressure. Therefore I now use fixed pressure of 6.

A very good advice I got on this board, change things slowly. Very slowly. Most times the nightly changes you observe has nothing to do with what you changed last night. Don't change more than once a week or two. Go slowly and you'll get reliable results and solid conclusions.

Moving legs may be PLMS but for many people PLMS is not a problem.

Intrigued by this - what kind of events get recorded? Any consistency in the type? You say there is no correlation between number of events and how you feel? I seem to feel worse when there are more CAs, but I have not been able to entirely eliminate them. Reducing leaks helps. Turning off the C-Flex+ helped quite a bit. Using a cervical collar seems to help a bit, too - but that is taking a bit of getting used to. I tried reducing my pressure by 0.5 cm a while ago, but only left it there for 4 days because the numbers were going in the wrong direction. I am thinking it is time to try that experiment again for a week or two. Challenge is that my AHI is really quite good (1.8 for the last year, with about half of that being CAs), so what difference am I likely to see?

I have not used a video camera to record my sleep position, but my wife tells me that sometimes my legs are "quite active" during the night. Probably a combination of many things will contribute to the events.