data for a "normal" person

[jayjp04]

I am 23 years old, physically fit (BMI 21), exercise a few days a week, eat a mostly vegan diet with small amounts of fish, meat and diary weekly. I sleep 9 hours if at all possible, and use my CPAP religiously. As a student in the healthcare field, my health is invaluable to me, and I am trying to perfect my numbers. I use the resmed elite II with H3i humidifier and a swift LT facemask.

My numbers last night were typical: Leak 0.32 Liters/second, AHI: 5.7, AI: 0.5, HI: 5.2

Because I am sooo young, and will be using this thing forever I have been tweaking my cm pressure (which went from 6 to 7) and then returning to my DME a month or two later to see exactly where my numbers are best. My question is, do I already have what I am chasing, or is there still a lot of room for improvement? Is anyone able to achieve a lot better numbers with a resmed elite II? Does anyone have any idea what a "normal" person without sleep apnea would get for numbers if they could sleep through a night with a cpap on with a resmed elite II (which i hear may be more sensitive in reporting increased numbers in comparison to other machines)?

thanks!

[Julie]

Hi - I sent you a PM, but sort of forgot to remind you that it's highly unlikely you'll be using Cpap as we know it today for very long, let alone your lifetime, not because you'll necessarily be magically cured in a short time (unfortunately that doesn't really happen, especially if your problems are anatomical rather than weight related), but because technology is moving very fast now and the 'fixes' available to you within a few years I'm sure should be hopefully easier to live with than Cpap.

[kolchak]

That is an interesting question and one i asked my sleep Dr just yesterday. I asked the question from the perspective of someone with central apnea and my Dr. looked like he had never thought about it before & couldn't answer it. I like the answer you got from Julie - gives me hope we won't be wearing masks forever. GL

[gasp]

I am 23 years old, physically fit (BMI 21), exercise a few days a week, eat a mostly vegan diet with small amounts of fish, meat and diary weekly. I sleep 9 hours if at all possible, and use my CPAP religiously. As a student in the healthcare field, my health is invaluable to me, and I am trying to perfect my numbers. I use the resmed elite II with H3i humidifier and a swift LT facemask.

My numbers last night were typical: Leak 0.32 Liters/second, AHI: 5.7, AI: 0.5, HI: 5.2

Because I am sooo young, and will be using this thing forever I have been tweaking my cm pressure (which went from 6 to 7) and then returning to my DME a month or two later to see exactly where my numbers are best. My question is, do I already have what I am chasing, or is there still a lot of room for improvement? Is anyone able to achieve a lot better numbers with a resmed elite II? Does anyone have any idea what a "normal" person without sleep apnea would get for numbers if they could sleep through a night with a cpap on with a resmed elite II (which i hear may be more sensitive in reporting increased numbers in comparison to other machines)?

thanks!

Great questions! I've always wondered what someone without OSA would show for numbers. If I didn't have to go without it, I'd love to strap my CL2 mask on my hubby and use my AFLEX to see what his numbers looked like.

How do you feel? Do you feel refreshed and rested? How long have you been on therapy? I ask because it took me months for my body to recuperate from years of undiagnosed or untreated OSA.

By the way, I'm happy to see you doing this therapy and that you found this forum. It really helped me at first and all along the way.

[DreamStalker]

I didn't think there was such a thing as a normal person. I assumed everyone was weird like me.

When I had a ResMed machine I was able to get my AHI under 2.0 fairly consistently. But ResMeds are a bit more sensitive and therefore more dificult to get under AHI 1.0 than say Respironics machines.

If you work on getting the leak rate down before tweaking pressure(s), you will go a lot further and a lot faster towards optimizing your treatment.

Best of health!

[el_zorro]

Your numbers are really good. Wow, 9 hours of sleep for a 23 year old, you will live a long life with that good habit.

The Resmed AHI and HI numbers are so sensitive that you are almost always going to have some HI. If you are 5.0 or lower, that might be as good as your ever will get. I tested my Autoset II the other day just relaxing watching TV for 30 mins and had an HI of 3.4. On my Respirononics machine, I have never been above 1.4.
On a Resmed, if you are consistently above 5 or you have significant (over 1 AI), then you might want to tweak things.

[jayjp04]

thanks for the responses!

My average for this month, which is fairly typical, is AI: 1.0 and HI: 6.0 leak 0.3L/s. What is fairly constant looking through my data on my machine is the leak, which has always been 0.3L/s. I used to tape, now I don't, I just use a chin strap. Maybe I will try taping again for a couple weeks and see if I feel any different or if I get different data. My leak is below the level of being a problem according to the swift LT manual, so I guess I was not sure, and am still not sure, if the reason I cannot achieve lower numbers this far is due to not having the perfect pressure yet or not getting my leak low enough yet. The swift LT fits my face and nose perfectly, and I have tried the Quattro with no success; I have a very narrow face and jaw, and most FFM are just too darn wide to form an adequate seal on my face!

As far as how I feel.....I am attending graduate school at Mayo Clinic, so I am in class anywhere from 5-8 hours per day, I work out after class, then I study until I go to bed....almost always at 9:30. I fall asleep within 5 minutes (no joke...often within just a couple minutes), and wake up at 6:30 or 6:45 am. I am 100% better compared to last year (I kept falling asleep in class, it was just a constant struggle....even driving was a struggle) but I know I am not 100% for me! I just have that feeling that I am running on three quarters of a tank of gas, and just need to find that extra 1/4. I have complete access to all my medical records, including my sleep study and data numbers....so I guess I expect to achieve "perfection" as far as getting the most out of sleep. I don't want to wreck havok on my body for the next 50+ years of my life by not getting restorative sleep at night!!!

[Julie]

You might want to just call Cpap.com and ask them if they're aware of any masks that are particularly suited to your type of face, though they may or may not want to say .

[tattooyu]

I say tackle the leaks. Once you figure out what works for you, report back to us on your numbers. I use a PAPcap with my Swift and Resmed S8 Autoset II. My leaks are usually 0.0 L/s and never reach 0.1 L/s if I have any at all. The PAPcap doesn't work for everyone, but it saved my butt.

What kind of chinstrap do you have?

PAPcap - http://www.pur-sleep.com/products/prodD ... rch=&page=

(Is the PAPcap Plus no longer available?)

[jayjp04]

sounds like I will plan on tackling the leak for now. I used to have a chinstrap that looks like this:

http://ecx.images-amazon.com/images/I/4 ... AA280_.jpg

It made my face sweat and was wayyy too big. This is the main problem I have; I have a very small head. When I wear a hat, I wear a flexfit size small. It seems like all these straps, even the adjustable ones, are for people with big heads!!!! Anyone find a chinstrap that works for someone with a small head let me know. For now, I will use my old one and tape my mouth shut. I will post my numbers over the next couple days and see if anything improves. Again, thanks for the help.

As far as the papcap-looks great, but again, I have a small head. Think it would be too huge?

[billbolton]

Does anyone have any idea what a "normal" person without sleep apnea would get...

"Normal" sleep is generally regarded as an AHI of 5.0 or less.

If you are in that range, you are not regarded as having an OSA related SDB (Sleep Disordered Breathing) problem..... that is OSA is being satisfactorily treated.

However, keep in mind that you could have other SDB, or sleep related, problems which are not being treated by xPAP, so you could still end up not feeling well rested even while in the the normal sleep zone as far as OSA is concerned.

Generally, for OSA treatment, a good strategy is to aim to get the AI (apnea) component below 1.0 and while maintaining that, work on getting the HI (hypopnea) compenent as low as you reasonably can.

There is no absolute "perfect".

Cheers,

Bill

[SleepingUgly]

I have asked this question many times (and actually have this question posed right now waiting for a response on another thread): What would normals look like on Auto-PAP? Would the pressure start at 4 and stay there all night with very little variability? What would the AHI be? It seems this study has not been done, despite the fact that it would be easy to do. Perhaps we can all donate a spouse and between us all get a sufficient sample size to do our own study?! Only problem is that without PSGs, we wouldn't really know if our "normals" are "normal".

I did ask my doctor about what the AHI on CPAP should be and he said it should be below 5, and ideally as low as possible; however, we don't know whether there is any difference between 1 and 4 or whatever. Keep in mind that below 5 was somewhat arbitrarily chosen as the cutoff (basically two big wigs had different opinions about what it should be and they compromised on 5!). That said, below 5 is deemed "normal" so is there such a thing as "more normal", "less normal"? There is error in measurement, as well as variability from night to night, so really every AHI should come with a confidence interval that describes how certain we are that it falls within a particular range (e.g., "My AHI is 6 +/- 4, with 95% confidence", or whatever).

I also have a small head, but I have a long, narrow face. I am trying the Hybrid right now. I'm having to do a "fix" to keep the pillows in my nose while I'm sleeping, and I can't say whether this will be the mask for me or not. I hope so as I love nothing on the bridge of my nose, and it does not leak around the cheeks like the Quattro did (although my main issue with the Quattro was that it pulverized the bridge of my nose).

As far as a chin strap, my doctor said that some people use athletic headbands/sweatbands like the kind people wear on their forehead to keep from dripping sweat when they workout. Maybe this would work for you? If the size is about right, but the tension is too high, perhaps you could try the soft headbands made for little girls (look in the hair accessories section of Target or Walmart or whatever for these soft, colored headbands that tend to come several in a package and are about an inch or so wide).

[terrydk]

SleepingUgly,

I see that the full face Quattro worked the bridge of your nose over as well, I had to stop using it even though I liked it in all other respects. I am now using a F&P Forma and it doesn't bother the bridge of my nose but the seal is different enough, I don't think its as soft, that I have to wear the mask tighter than I like to keep the leaks down. I also don't like the strap release on the Forma as well as the Quattro. They also gave me a Mirage Liberty but I feel like the air on exhale is being restricted too much with the pillows...that was my first eval anyway, I haven't tried it for a night yet. I would love to not have my nose completely covered but not sure that I can find a pillow that doesn't feel restrictive and still seals. I finally got my AHI down to 3.8 last night with an AI of 1.1, thats pretty decent considering my sleep study last November recorded and AHI of 126.

I have asked this question many times (and actually have this question posed right now waiting for a response on another thread): What would normals look like on Auto-PAP? Would the pressure start at 4 and stay there all night with very little variability? What would the AHI be? It seems this study has not been done, despite the fact that it would be easy to do. Perhaps we can all donate a spouse and between us all get a sufficient sample size to do our own study?! Only problem is that without PSGs, we wouldn't really know if our "normals" are "normal".

I did ask my doctor about what the AHI on CPAP should be and he said it should be below 5, and ideally as low as possible; however, we don't know whether there is any difference between 1 and 4 or whatever. Keep in mind that below 5 was somewhat arbitrarily chosen as the cutoff (basically two big wigs had different opinions about what it should be and they compromised on 5!). That said, below 5 is deemed "normal" so is there such a thing as "more normal", "less normal"? There is error in measurement, as well as variability from night to night, so really every AHI should come with a confidence interval that describes how certain we are that it falls within a particular range (e.g., "My AHI is 6 +/- 4, with 95% confidence", or whatever).

I also have a small head, but I have a long, narrow face. I am trying the Hybrid right now. I'm having to do a "fix" to keep the pillows in my nose while I'm sleeping, and I can't say whether this will be the mask for me or not. I hope so as I love nothing on the bridge of my nose, and it does not leak around the cheeks like the Quattro did (although my main issue with the Quattro was that it pulverized the bridge of my nose).

As far as a chin strap, my doctor said that some people use athletic headbands/sweatbands like the kind people wear on their forehead to keep from dripping sweat when they workout. Maybe this would work for you? If the size is about right, but the tension is too high, perhaps you could try the soft headbands made for little girls (look in the hair accessories section of Target or Walmart or whatever for these soft, colored headbands that tend to come several in a package and are about an inch or so wide).