Humidity and AHI

[MRH]

Hi everyone,
Been a while since I have been here, hope all are doing well. Things have been going pretty good for quite a while, with ahi keeping below that magic 5 number. Well this summer I have been having the numbers getting uglier, hanging around 7 or 8! Last week I turned down my humidifier from 2 where I had been running it to a 1 setting. Now my ahi numbers have dropped backed down below 5 again. Anybody else notice this? I have never had rain out trouble either.

Mark

[Wulfman]

It's been noted before.
More humidity can have the effect of causing more nasal congestion and have an adverse effect on therapy.

One reason I never use heated humidification.

Den

[Hawthorne]

With my current auto settings, I have lower numbers when I use my humidifier in passover mode. I had it up to 1 the last 4 or 5 nights because I have been congested with allergy problems. I thought it might help. It didn't really help I don't think. Last night I had it in passover mode again and numbers are down again.
I should say that my numbers never get very high. In passover mode I am most often below 1 AHI. With the humidifier set at 1, I got up to between 1 and 2 AHI those nights. I know those are still low numbers so, my therapy has not been affected much. It does appear, though, that heated humidity ups my AHI (and most of the AHI number is OAs with heated humidity). I see this with my software and smartcard.
I should mention that I use the Fisher Paykel stand alone humidifier and not the integrated humdifier with my M Series Auto. Don't know if that's what makes the difference or not.
I may be using some heated humidity in the winter months when it is colder and less humid. I'm not sure how high I will set it since I have not had the stand alone one for a winter yet.

[Captain_Midnight]

I get my lowest AHI readings (they bounce around from 0.3 to 0.7) when I either do not humidify, or if I humidify with no heat (passive). Heated humidity magnifies my AHI by roughly 3 fold.

I like to compare heated humidity to steaming your airway like a bucket of clams. (It swells.)

Humidity is important for keeping membranes from drying out, but I'm not aware of any reason to vulcanize them with excessive steam and heat. Consider what many folks do with sinus problems. They move to Arizona from (any soggy climate.)

I believe that one reason that many folks can't adapt to PAP therapy is over-humidification. One day, this unintended consequence will be better-known.

Giving full credit, BTW, I learned the perils of over-humidification from Wulfman's postings

Regards all - - Tom



.

[Billmanweh]

are you really getting much humidity without the heat?

this is kind of anecdotal, but it seems like when I use the passive humidty I hardly have to fill my tank once a week. when I use the heat and the heated hose it needs to be topped off pretty much every day.

[Wulfman]

are you really getting much humidity without the heat?

this is kind of anecdotal, but it seems like when I use the passive humidty I hardly have to fill my tank once a week. when I use the heat and the heated hose it needs to be topped off pretty much every day.

Part of the equation depends on the relative humidity in your area/house......in other words, how much moisture will the air going through the humidifier pick up. Another is the pressure that the machine is pushing.
Where I live, the humidity is very low and I have to top off my humidifier (Legacy model) about every third or fourth night.....a good 3/4".....so, I know I'm getting some humidity.

Den

[Hawthorne]

It is summer here right now and we are having a very hot and humid one! I guess that's why passover humidity is enough right now.
I top off my humidifier about every 3 or 4 nights when I am using it in passover mode. I don't let it get too low or I THINK I'm not getting any humidity. I know that's not true because on my old machine, my humdifier was one of the ones recalled by Respironics a few years back and I really missed getting some kind of humidity and felt the difference then between passover and none. I don't do well on none!

[ozij]

Yes, I've noticed that too much heated humidity can raise my AHI.

O.

[freepostg]

I had recently added the hc150 to my s8 vantage(on cpap mode) and found that my ahi went up quite a bit--both ai and hi. I had first incorrectly attributed this to the standalone causing friction and thusly lowering my "at mask pressure" - wrong! The hc150 is capable of such humidity, if turned up, that my nasal membrane was swelling and my nose felt somewhat plugged throughout the night. This had in turned changed my pressure requirements without my knowing it. - When I switched to auto set, my 95% pressure went up by 1cm...strictly due to "too much humidity" -(swelled membranes). I reduced humidity and voila, ahi came back down. My setting on hc150 is approx 1.75. You really don't need much.

[-SWS]

I'm also one of those people whose AHI goes up with heated humidity. I can't sleep well with CPAP humidification because my discomfort level goes up significantly with warm humid air.

So today's outdoor temperatures were in the mid-eighties Fahrenheit with a relative humidity above seventy percent. And I feel uncomfortable because of that warm humidity---as if I were using CPAP humidification once again. I can also notice an audible increase in airway turbulence because of today's warm "swampy" air. That slight increase in audible turbulence probably means decreased airway diameter, which in turn likely means increased airway resistance. My best guess: an ever so slight bronchospasm triggered by warm, humid air. Warm, dry air doesn't trigger that response in my airway. And cold air doesn't trigger that response either.

Warm, humid air is known to trigger bronchospasms in cases of asthma or COPD. If you happen to have asthmatic tendencies or even COPD, then heated CPAP humidification just might be one of your bronchospasm triggers. And if it is, then your AHI is probably going to elevate.

As a side note I have passed the asthma diagnostic challenges with no problem. But my doctor thinks I might be on track for COPD (I inhaled asbestos, coal, ore, and plenty of other particulate matter working my way through college).

[carbonman]

It's been noted before.
More humidity can have the effect of causing more nasal congestion and have an adverse effect on therapy.Den

When I started using the FFM, I turned my HH up to 3.
I was having dry, back of my throat problem.
Numbers were in the 2.5-3.5 range, w/some going to 7.5-10.
I think some of that was adjusting to the new mask.

After reading this thread, last night, I set the HH to 1.
AHI this am, 1.5, lowest I have ever had, leak rate steady at 39.
Still had abit of dry throat, but was much more comfortable.
Air felt ok and was cooler.

Once again, the wisdom of this forum, saved me many nights
of trial /error to discover this.
The FFM is really starting to work for me. Every night gets a little better,
and everyday a little brighter.

THANKS!!

[Wulfman]

It's been noted before.
More humidity can have the effect of causing more nasal congestion and have an adverse effect on therapy.Den

When I started using the FFM, I turned my HH up to 3.
I was having dry, back of my throat problem.
Numbers were in the 2.5-3.5 range, w/some going to 7.5-10.
I think some of that was adjusting to the new mask.

After reading this thread, last night, I set the HH to 1.
AHI this am, 1.5, lowest I have ever had, leak rate steady at 39.
Still had abit of dry throat, but was much more comfortable.
Air felt ok and was cooler.

Once again, the wisdom of this forum, saved me many nights
of trial /error to discover this.
The FFM is really starting to work for me. Every night gets a little better,
and everyday a little brighter.

THANKS!!

Glad to hear it worked for you. I haven't used heat in my humidifier since the first couple of nights of my therapy. I didn't like the warm, humid feeling and also had a snootfull of water from rainout......yuck. The cold humidity keeps my nasal passages open.

Den

[adrienneiii]

My mileage varied.

Yesterday I read this thread and decided to try turning the humidifier down a notch. I had been running at a humidifier setting of 3, quite comfortably, though a couple of hours before dawn I could generally count on having a stuffy nose. I have had allergies and a stuffy nose all my life. That's why I wear a full face mask. Actually, being on xPAP has helped in that line, possibly because of the air filter and possibly because of the humidifier; note that I live in the desert.

But since everyone in the thread, including Wulfman, whose profile says he's from equally dry Wyoming, recommended less humidity, I decided to try it. Big mistake. Two hours into the exercise I woke up -- snoring, which I haven't done with the cPAP running before -- inside this wonderful new mask that Just Doesn't Leak --with a stopped up nose. Worse, although I don't have software, the personal miner's canary that is my ring finger was quite swollen. I have trained myself to breathe through my nose as much as possible because the air stream just feels better that way, even with a full face mask, so evidently I didn't open my mouth until the A's and the H's were in full bloom.

I know it wasn't an allergen in the air, because after 30 minutes of sitting up without the mask my nose cleared up a bit. So I put the mask on, cranked the humidifier back up to 3, and finished the night.

This is puzzling, because everything in this thread makes excellent sense, at least on paper. It just didn't work for me.

Adrienne

[carbonman]

It is so interesting how subjective this entire process is for each person.

I tried no HH last night.
YIKES An hour after going to bed, my upper sinus hurt......like it was from cold.
I thought maybe it was just getting used to it, so I tried to maintain.
In another half hour, my entire forehead was starting to throub.

Turned HH to 1, and in less than half hour, all was well again.

Now I know where my HH needs to be.

[Wulfman]

It is so interesting how subjective this entire process is for each person.

I tried no HH last night.
YIKES An hour after going to bed, my upper sinus hurt......like it was from cold.
I thought maybe it was just getting used to it, so I tried to maintain.
In another half hour, my entire forehead was starting to throub.

Turned HH to 1, and in less than half hour, all was well again.

Now I know where my HH needs to be.

Each person needs to be willing to experiment with different settings (humidity, pressure, etc.) to optimize their therapy.
Doing what someone else says or does MAY or MAY NOT give you the same results......but in the process of experimenting, you might discover what works best for YOU.

I assure you, I've had my share of VERY cold nights of breathing the cold humidified air.....and I didn't become accustomed to it overnight, either......many nights of dried out sinuses. I found that clearing my nasal passages right before bed was a big help. I don't know if I could go without any humidity, but my setup gives me "some"......and most of the time it's enough.

Den