How to improve Snore Index?

Ergin · Post by **Ergin** » Sat Feb 18, 2006 11:55 pm

I have an average SI of about 12-13.

First of all is there a criteria about the reasonable level of SI?

How can SI be improved?

I am also using SomnoPlus mask which generates whistle like sounds, is
it possible that these sounds are misinterpreted as snore by Remstar?

rested gal · Post by **rested gal** » Sun Feb 19, 2006 12:51 am

I am also using SomnoPlus mask which generates whistle like sounds, is it possible that these sounds are misinterpreted as snore by Remstar?

I think that's very possible. I don't worry about the snore index on my REMstar. The other numbers are more useful.

Kemosabe · Post by **Kemosabe** » Sun Feb 19, 2006 10:17 am

Thanks to MyEncore, I know that I could reduce my snoring by bumping the pressure by about 2-3cm, but that'd get me into the pressure range that starts getting me centrals. I can live with a few snores.

Snoozie · Post by **Snoozie** » Sun Feb 19, 2006 10:25 am

Also, thanks to MyEncore I was able to take data to my Dr. and have my pressure upped. By doing this, I reduced my snore index to an average of around 100 to an average of 5. This is only an average - some days are a little higher and some are lower. Pretty good, I'd say.

Wulfman · Post by **Wulfman** » Sun Feb 19, 2006 11:39 am

I really don't take my Snore Index seriously. One thing that I HAVE noticed is that on the nights that my AHI is higher.....my Snore Index is usually very low.
Seems contradictory, but that's the way it is. On the other hand, with low AHIs, my Snore Index can be high or low or somewhere in between.

Den

PEELS · Post by **PEELS** » Sun Feb 19, 2006 12:02 pm

I found that using the Aura nasal interface my snores are practically zero but when I switch to a FF mask the snores jump up to about 8 per hour. Obviously with the FF mask one can breathe thru their mouth allowing snores. If you wand to reduce or eliminate snores then try to use a nasal interface.

Guest · Post by **Guest** » Sun Feb 19, 2006 12:10 pm

You might find this old thread interesting. Derek did some experiments to see the influence on the snore index:

Experiments on RemStar Snore Detection...

Snoozie · Post by **Snoozie** » Sun Feb 19, 2006 12:37 pm

Very interesting report that Derek did. I felt worse with my pressure lower and was getting returning headaches, and my snore index did definitely change for the better with the change in pressure and I have the paper to prove it, but I don't think that my now feeling better is really a result of less snores which I seriously doubt, but more so from the change in my pressure setting causing AHI's to be less. I believe the headaches were being caused from the "vibration" of snores (which incidentally I still manage to do with my mouth taped - just not as much) causing irritation and rattling on the nasal passage where I have a bone spur as a result of deviated septum, so the ENT states, since that is the area where the headaches start. I just haven't gotten up the nerve to have the surgery since legally, he has to say there are no guarantees. I just have come to the conclusion that if I don't have a headache I probably didn't snore much no matter what my AHI says, but on the other hand, if my AHI stays low regardless of snores, I will feel better.

Goofproof · Post by **Goofproof** » Sun Feb 19, 2006 4:13 pm

I raised my pressure from 14 to 15.5 in small jumps watching the software for increased centrals. I was able to get my AHI down and cut snore rate to less than half.

If you go slow and pay attention to the data progress can be made, and I use a FF Mask. The only one I've used. The secret is to find the sweet stop and stay there.

Ergin · Post by **Ergin** » Sun Feb 19, 2006 9:44 pm

I don't wanna play with the pressure at all, that's what the auto is for
and so far it did a great job, all my other indices are sub 1.0.
The SI index does not seem to be correlated with the pressure either,
sometimes it goes up with pressure and sometimes down.

Today, I took a nap in the afternoon and the SI was 3.4 and the variable
breathing fraction went up to 51%, so I guess SI might be something really
important.

Goofproof · Post by **Goofproof** » Sun Feb 19, 2006 10:04 pm

Even using APAP, adjusting your pressure for the maxium gain of treatment makes sense. By allowing the APAP to access a smaller range of pressure it can react faster to inprove your AHI and decrease Snores. Your high is best set 2 cm over your 90% rate and about 2 or 3 under the 90% rate. Then keep checking the data to see that centrals aren't increasing. The object is to get all the ducks in a row, and SLEEPING.

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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI, APAP

Kemosabe · Post by **Kemosabe** » Mon Feb 20, 2006 12:04 am

Here's are my MyEncore charts for SI vs pressure and AHI vs pressure:

Note that 9cm is the sweet spot for AHI, but SI would require me to raise the pressure to a worse spot for AHI.

Ric · Post by **Ric** » Mon Feb 20, 2006 1:09 am

Kemosabe wrote:Note that 9cm is the sweet spot for AHI, but SI would require me to raise the pressure to a worse spot for AHI.

Question for Kemosabe: I have been curious about staying in "the zone" where the OAs taper off, and the CAs begin, do you have "uncompensated" apneas whilst in that modest pressure range?

I too have noticed that there are two peaks in the OA curve, but with the AUTO set sufficiently high, the curve extinguishes around 12, with ZERO uncompensated OA events during the past 3 months. I worry about dropping the pressure to prevent those "centrals", but failing to deal with the occasional OA that would resolve with just a little more pressure. A few of those could ruin my whole night, or so I imagine.

Kemosabe · Post by **Kemosabe** » Mon Feb 20, 2006 7:57 am

I'm not entirely sure what you mean by "uncompensated apneas". With an AHI consistently averaging less than 1.0, I'm not sure I could kill off any more apneas. I'm sure most of the ones left on the record are not actually apneas. They're things like me holding my breath as I turn over, or the hose rapping on the headboard, or other non-apnea events that the machine reads as apneas..

My reading of the chart above is based on the NR line, which starts at 10cm at zero and increases slightly at 11cm. That says to me that I shouldn't go above 11cm or I'll end up in central land. Perhaps I should cap at 10cm, but some nights when I'm a bit congested or have had a few beers I need a little more than 10cm.

I had it set 8-14cm at first, but never got over 11.5cm ever. When I saw that the upper range started throwing me NRs, I tightened it to the current setting or 8-11cm. (I was titrated at 10cm)

I'm feeling great with this setting. Brighteyed and bushy tailed (or so my wife says). I'm not sure I've ever felt this good since I was a teen.

GLC · Post by **GLC** » Mon Feb 20, 2006 8:50 am

Could someone explain how "Centrals" are associated with increased pressure? I understand that Centrals Apneas are caused by the brain not giving instructions to breath, I believe. However I do not understand this relationship to increased pressure. Does the increase pressure at some point cause the brain to think it does not need to give instructions to breath? If so, how do you interpet this on the graphical analysis? Therefore, not increasing your upper range to eliminate snores, or what ever. Thanks

Mask