resmed higher HI ?

[sleepycomic]

Hi, I keep hearing that the resmeds give a higher HI score. Anyone know ? My AI is like 0.5 and my HI is like 6.0 or 7.0. getting the AHI over the goal of <5.0. any feedback is appreciated. Mike

[Wulfman]

Yeah, I keep reading that, too. Have never used one, so I can't speak from personal experience.
I guess, if you want to get better numbers, you could buy a Respironics machine.

Den

[dsm]

It has been my regular and constant experience that Respironics machines tend to score me as AI higher than HI while Resmed machines tend to score me as higher HI over AI.

Over the years and after lots of testing and research I have satisfied myself that one is generally more accurate than the other. But, as soon as anyone tries to make such a case it can and often does start brand wars. So my slant on this now is, treat your scores as relative to that brand & don't try to compare to others.

If a low HI score is a psychological need, then buy the brand that satisfies that need but the result is going to be no change to sleep nor the real score.



DSM

[Snoredog]

well since according to that mfg's website and documentation it only responds to the following events:

Flow Limitation
Snore
Apnea

I'd have to say it doesn't respond to HI at all. Those HI you are looking at on the LCD and in the reports are calculated

don't ask me WHY they would do that, not respond to them yet include them on the reports,

but they show they detect and respond to snore yet they don't report your snore on the LCD or on the reports unless you have the $1250+ Reslink module.

AI is the only one you need to worry about anyway, get it down as low as it will go and HI will begin to drop.

[ozij]

Conclusion
In the present study, we have confirmed the overall
titration effectiveness of two A-CPAP devices using dif-
ferent operational algorithms based on the detection of
f low limitation. It appeared that the AHI was significant-
ly lower with the use of the RR, in comparison with the
RS. This result was achieved at lower pressure levels.
Head-to-head comparison of A-CPAP devices in a cross-
over design, as in the current study, is a feasible method
to evaluate their relative titration efficacy with respect to
sleep quality and indexes of sleep-disordered breathing.

RR=Respironics Remstar
RS=Resmed Spirit

[alnhwrd]

This is purely anecdotal, no basis in science whatsoever, so take it for what it is worth.

I have your exact same machine. One night I went to bed, put on my mask and etc., laid down and could not get to sleep. I tossed and turned for about 45 min, flipped over on one side, the other, my back, but nothing worked. I know that I was awake the entire time. So, I got up, took off my gear and got out of bed. Out of habit or just for curiositie's sake, I don't remember which, I punched the buttons to see my data. Pressure was right, leak was 0.0 AI 0.0, HI 3.3!!

So, I don't worry about HI too much, unless it were to skyrocket for some reason. Give me a taped mouth, a chin strap and an AI of 0.0 and I am a happy man! YMMV

[Guest]

Ozij,

Thanks for the article citation.

RiverDave

[billbolton]

Conclusion
In the present study, we have confirmed the overall
titration effectiveness of two A-CPAP devices using dif-
ferent operational algorithms based on the detection of
f low limitation. It appeared that the AHI was significant-
ly lower with the use of the RR, in comparison with the
RS. This result was achieved at lower pressure levels.
Head-to-head comparison of A-CPAP devices in a cross-
over design, as in the current study, is a feasible method
to evaluate their relative titration efficacy with respect to
sleep quality and indexes of sleep-disordered breathing.

Background: Auto-adjustable continuous positive airway pressure devices are widely used in titration procedures to determine therapeutic pressure levels in obstructive sleep apnea patients. However, differences in operational characteristics may influence the effect on the apnea-hypopnea index (AHI). Objectives: We compared the titration performance of two devices based on detection of inspiratory flow limitation, i.e. the Respironics REMstar Auto (RR) and the ResMed Spirit (RS). Methods: Fifty obstructive sleep apnea patients were recruited for a double-blind randomized crossover trial. Both devices were employed overnight by means of split-night polysomnography. The primary outcome was the AHI. Secondary outcome measures were the snoring index, pressure profiles and subjective appraisal of sleep quality assessed the morning after the sleep study. The Wilcoxon signed rank test for matched pairs was applied to assess differences between treatment conditions. Results: No significant differences were found in sleep parameters, subjective sleep quality and snoring index. The use of the RR was associated with a significantly lower AHI in comparison with the RS [mean (SD) 6.9 (11.6)/h vs. 9.4 (9.2)/h, p = 0.004]. This result was obtained at significantly lower pressure levels [P95 9.2 (2.3) cm H2O vs. 10.2 (1.5) cm H2O, p = 0.001]. Conclusion: While the RR provided a lower AHI than the RS at lower pressure levels, it could not be assessed whether this difference was relevant for clinical outcomes. However, this face-to-face comparison of Auto-adjustable continuous positive airway pressure devices seems useful for the assessment of titration efficacy.

"No significant differences were found in sleep parameters, subjective sleep quality and snoring index."

"...it could not be assessed whether this difference was relevant for clinical outcomes."

[ozij]

[quote="sleepycomic"]Hi, I keep hearing that the resmeds give a higher HI score. Anyone know ? My AI is like 0.5 and my HI is like 6.0 or 7.0. getting the AHI over the goal of <5.0. any feedback is appreciated. Mike

[jnk]

Snoredog,

Is there a significant difference between "HI" and measurements of "Flow limitation"?

Just wondering.

Maybe because I use a Resmed and am feeling slightly defensive.

[Slinky]

D*mn, jnk! Don't you go feeling defensive about having a Resmed!! Console yourself you don't have that PITA integrated humidifier tank, bothersome blue lights, aren't losing data a couple of nights a month and don't have to carry your xPAP to your 'puter.

Yer getting good therapy, feeling good and have such easy access to your nightly data on the LCD and that data card to yer 'puter!

NE USA??? You a Maine-iac by any chance?

[track]

Last night my AI was .4 and my AHI 5.1 so my numbers are very similar to yours....sometimes it will bounce to .8 and 6 AHI. As long as the AI is fairly low, that's all I concern myself with at this time.

[Slinky]

Ditto here, Track.

[jnk]

I live in NYC, but was afraid to put that in my profile. Born and raised in KY, so that should count for something. Some of my best friends are from Maine, though. Love that state. Only one I like better in the UA is Alaska. For now, though, I'm in Brooklyn. Point for now is for me to keep on PAP therapy so I can remain on the planet for a while, though, right?!

I just didn't want Snoredog to believe that Respironics had some magical way of sensing hypopnea events that the Resmed lacks. I think masks have something to do with that, at times. Breeze nasal pillows have a designed leak rate of 25 LPM at 12 cm. The Ultra Mirage Full Face has a leak rate of 40 LPM at the same pressure! If Resmeds were designed with a higher leak rate in mind then the Respironics machines were designed to expect, I can see how the two machines would differ in their calculations or HI or flow limitations during the night. And there are more significant flow limitations and less significant ones, I would assume. It may be, just maybe, that the Resmeds record flow limitations that don't quite restrict the flow long enough to be technically classified as hypopneas. Maybe thats why the Resmeds give an AI report and an AHI report but just don't do the math for you to get your HI number, since it may have recorded events that weren'r really HIs. That's just a personal theory. And I'm not an expert, obviously. I just play one on the computer for my own amusement.

jnk

[jnk]

As a newbie, when I reread what I posted above, I would just like to say two things.

1. I would have been happy with either a Respironics or Resmed.

2. In the last two weeks or so, I've learned a lot that has been very helpful to me in the posts from people like Slinky, Snoredog, dsm, and a few others. They aren't just insightful and helpful. They show regular flashes of sheer brilliance. So, I just want to say that whatever people like them are getting paid in the way of gratitude from the rest of us, it ain't enough. This is my public thank you. If it weren't for your guys, I might very well have been one of those people who give up on PAP therapy in their first few weeks.