AHI 40, but no Apneas?

[ellabella777]

Hi. I am new to all of this and am trying to understand. I had 2 sleep studies, on with and one without the mask. I was put on the Resmed S9 with humidifier and after some back and forth, settled on the Swift FX for her pillows. I have had some trouble with rainout, so I have turned the humidifier down (our room is cold), although I am not sure that is a good idea. I have called the DME and asked for the climate controlled hose. They told me that they would contact my pulmonologist for a prescription, but have yet to do it. I did buy a barrel cozy from Pad a Cheek and plan on using it tonight to see if it helps with the rainout in the pillows.

My Pulmonologist's office just sent me the paperwork from my study and I noticed that it says: The overall respiratory distrubance index (RDI) was 45.0 per hour, and the overall apnea/hypopnea index (AHI) during sleep was 40.0 per hour. There were 0 total apneas, including 0 central and 0 mixed. RDI during Stage R sleep was 35.1 per hour, and RDI while supine was 102.0 per hour. The maximum waking oxygen was 100%. The average SpO2 in sleep was 94.1%, the minimum during sleep was 80.%, and the Sp02 was under 90% for 1.8% of the sleep time. There was frequent loud snoring.

The thing about the snoring is that they made me sleep on my back and that is the only time people have said that I snore. Also, I was sick and I had taken Ambien 10 mg to get to sleep (I also have delayed sleep phase syndrome).

Anyway, do I still say I have sleep apnea with 0 apneas? Or do I have sleep hypopnea? I am getting testing so that I can have the gastric sleeve surgery. My surgeon is alarmed by these results, also because I have mild pulmonary hypertension due to the sleep apnea, while the pulmonologist, felt like losing the weight could fix the sleep apnea. They surgeon wants to sit down and talk about putting in a filter so I don't get clots. My pressure during the sleep study was 10, but the Dr. prescribed 12. He showed me that with the cpap, I had 0 events.

I just found out that I have to have a 30 compliance report before surgery. I just got on the machine 2/11. I have been trying to get used to it, but have only been compliant (over 4 hours the last 5 days). My circadian sleep disorder throws a whole monkey wrench into the whole thing because I can't get to sleep until 3-4 AM and have to get up to get my daughter to school at 7:45 AM. Some days I do take naps, and on the weekends I sleep in.

Anyway, is it normal to hypopneas and not apneas? Does that effect the severity of sleep apnea? I downloaded Sleepyhead (I am not sure how to upload pictures yet). Everyday I have been under 5 AHI events. Most days 0. My leaks seem good. My respiratory rate is not low--if anything it can be high at times (peak at 40), which looks like a pattern--is that REM? This whole CPAP thing is definitely overwhelming!

[BlackSpinner]

Yes you still have OSA even if you have no actually apneas. What you have is called "sleep disordered breathing" - hypopneas are apnea wannabees.

[sleepstar]

Hypopneas and apneas are pretty much the same thing. Both cause oxygen desaturation and arousals.
Apneas aren't "worse" than hypopneas. You can desaturate just as often (sometimes worse) with hypopneas.

[jweeks]

Anyway, do I still say I have sleep apnea with 0 apneas? Or do I have sleep hypopnea? I am getting testing so that I can have the gastric sleeve surgery. My surgeon is alarmed by these results, also because I have mild pulmonary hypertension due to the sleep apnea, while the pulmonologist, felt like losing the weight could fix the sleep apnea. They surgeon wants to sit down and talk about putting in a filter so I don't get clots. My pressure during the sleep study was 10, but the Dr. prescribed 12. He showed me that with the cpap, I had 0 events.

Hi,

There is good news in here. If CPAP results in 0 events, then you have a treatment that is going to help get you back on track. One of the side effects of OSA is that it can make you gain weight, and it makes it extremely hard to lose weight. I know because I was through that, having weighed 330 lbs at my peak (I am currently bouncing between 175 and 180). Finding a way to make CPAP work for you is one of the biggest things you can do to help your quality of life now, and to ensure that you stick around to enjoy many more years of life.

There are a number of components to OSA. An actual obstructive apnea event is when you stop breathing for 10 seconds or more due to your airway collapsing. If this happens for less than 10 seconds, you get most of the same effects, but it is called a hypo. If you stop breathing but your airway has not collapsed, then it is a central event, possibly caused by your brain. Obstructive events are usually pretty easy to treat, hypos are a little harder to tame, and central events keep the doctors and engineers scratching their heads and trying new things. I also notice that your RDI is higher than your AHI. The difference is something called RERA breathing. That is a new kind of sleep disorder that was only recently discovered, and there still isn't a good treatment for it yet other than very high CPAP pressure. It is most often given the name UARS. Since your RDI was 45 and your AHI was 40, the difference of 5 is RERA. That actually isn't a lot, so hopefully that doesn't become a major issue in your treatment.

There are 1,000 reasons for losing weight. However, curing OSA is not one of them. It will certainly help. However, speaking from personal experience, while my OSA changed considerably, I ended up with other sleep issues hiding behind the OSA, then RERA became my primary issue. Please be happy if your OSA improves, but don't go into this with your hopes and dreams set on curing OSA. Rather, put your hopes and dreams on creating a new self, one that is able to be more active and enjoy more that life has to offer. Once you get started down that path, every day can be better than the previous day.

-john-

[sleepstar]

Anyway, do I still say I have sleep apnea with 0 apneas? Or do I have sleep hypopnea? I am getting testing so that I can have the gastric sleeve surgery. My surgeon is alarmed by these results, also because I have mild pulmonary hypertension due to the sleep apnea, while the pulmonologist, felt like losing the weight could fix the sleep apnea. They surgeon wants to sit down and talk about putting in a filter so I don't get clots. My pressure during the sleep study was 10, but the Dr. prescribed 12. He showed me that with the cpap, I had 0 events.

Hi,

There is good news in here. If CPAP results in 0 events, then you have a treatment that is going to help get you back on track. One of the side effects of OSA is that it can make you gain weight, and it makes it extremely hard to lose weight. I know because I was through that, having weighed 330 lbs at my peak (I am currently bouncing between 175 and 180). Finding a way to make CPAP work for you is one of the biggest things you can do to help your quality of life now, and to ensure that you stick around to enjoy many more years of life.

There are a number of components to OSA. An actual obstructive apnea event is when you stop breathing for 10 seconds or more due to your airway collapsing. If this happens for less than 10 seconds, you get most of the same effects, but it is called a hypo. If you stop breathing but your airway has not collapsed, then it is a central event, possibly caused by your brain. Obstructive events are usually pretty easy to treat, hypos are a little harder to tame, and central events keep the doctors and engineers scratching their heads and trying new things. I also notice that your RDI is higher than your AHI. The difference is something called RERA breathing. That is a new kind of sleep disorder that was only recently discovered, and there still isn't a good treatment for it yet other than very high CPAP pressure. It is most often given the name UARS. Since your RDI was 45 and your AHI was 40, the difference of 5 is RERA. That actually isn't a lot, so hopefully that doesn't become a major issue in your treatment.

There are 1,000 reasons for losing weight. However, curing OSA is not one of them. It will certainly help. However, speaking from personal experience, while my OSA changed considerably, I ended up with other sleep issues hiding behind the OSA, then RERA became my primary issue. Please be happy if your OSA improves, but don't go into this with your hopes and dreams set on curing OSA. Rather, put your hopes and dreams on creating a new self, one that is able to be more active and enjoy more that life has to offer. Once you get started down that path, every day can be better than the previous day.

-john-

Hi John, a hypopnea needs to be over 10 seconds.
All respiratory events need to be more than 10 seconds or they aren't counted as anything.

[zoocrewphoto]

I just wanted to add that compliance counts the number of hours in a 24 hour period, so naps will count toward your 4 hour minumum each "night".

As a fellow DSPS person, I would recommend that you go into the clinician mode and change the time on your machine. It is set to change 24 hour period at noon each day, but odds are you sleep pas noon when you can, and that will break up your sleep. If you check the screen after noon, it will only show your hours and ahi for the time used after noon. I set mine so that it thinks noon happens at 3 or 4pm. Currently 3pm, but once the time change happens this week, it will go back to 4. I normally get up between 2 and 3pm on days off, so that allows me to sleep a full night and still see the data and graph as one night. If I take a nap later, it counts toward the next night's data.

You can get the manual and directions for the clinician mode by going here:

http://www.apneaboard.com/adjust-cpap-p ... tup-manual

Then pick the Resmed S9, and it will be emailed to you.

[ellabella777]

Thank you all so much! That was very helpful!