On days that your numbers are high...

[joeljjk11]

Everybody has bad days where for whatever reason your AHI numbers are high. Do you notice that you feel different? I've noticed that I am more anxious on these days and feel the need to relieve this anxiety by exercising or doing some sort of physical activity. This isn't necessarily a bad thing though except for the anxiety. I have also noticed that my thoughts aren't as clear on these bad days and more 'clouded' if you will.

How do you feel when your numbers are high?

Joel

[Wulfman...]

Everybody has bad days where for whatever reason your AHI numbers are high. Do you notice that you feel different? I've noticed that I am more anxious on these days and feel the need to relieve this anxiety by exercising or doing some sort of physical activity. This isn't necessarily a bad thing though except for the anxiety. I have also noticed that my thoughts aren't as clear on these bad days and more 'clouded' if you will.

How do you feel when your numbers are high?

Joel

What is your qualification for "high"? I have to go back "YEARS" to find a nightly AHI of 2.0 or more.......and there haven't been many of them in the last 10 years, either.

But, my opinion is that this is a therapy of "averages" and trying to achieve the best in that regard. All of my annual AHI averages have been at or below 1.0.
During the early years, it seemed like there was a delayed reaction to "higher" nights in that I may not actually feel it until a couple of days later. Another way I looked at slightly higher AHIs is that I was sleeping deeper during those nights. And, since I've always used straight pressures, that factor has been a "constant" when reviewing my therapy results.


Den

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[joeljjk11]

My numbers fluctuate greatly and I have never had a night under 4.0 AHI. Pretty much the best I have ever had is 4.1 which was a few nights ago. Last night it was 8.4 for example and there is a noticeable difference in how I feel. My doctor is convinced that I don't need a bipap or asv machine even though I have tried everything with my current machine and can't seem to get the numbers real low. I had a sleep study a month ago and she seemed to be confused about the results. The only thing that lowers my AHI is more pressure but she still says I don't need a bipap. Who knows at this point.

[RogerSC]

Not really any difference. I purposely have enough physical activity normally, so that's not an issue for me. The only way that I know that I've had a "higher than normal" AHI is by looking at the numbers. Which I do every day, so I get a pretty good sense of it. On the other hand, for me a high AHI is > 2, never get an AHI > 3. My "normal" AHI is around 1, mostly due to the centrals that I have for some reason. If I get a "high" AHI, it's always because of extra centrals...whatever that tells me *smile*. Good dreams, maybe?

[Wulfman...]

My numbers fluctuate greatly and I have never had a night under 4.0 AHI. Pretty much the best I have ever had is 4.1 which was a few nights ago. Last night it was 8.4 for example and there is a noticeable difference in how I feel. My doctor is convinced that I don't need a bipap or asv machine even though I have tried everything with my current machine and can't seem to get the numbers real low. I had a sleep study a month ago and she seemed to be confused about the results. The only thing that lowers my AHI is more pressure but she still says I don't need a bipap. Who knows at this point.

What are your settings (all of them)?


Den

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[joeljjk11]

My numbers fluctuate greatly and I have never had a night under 4.0 AHI. Pretty much the best I have ever had is 4.1 which was a few nights ago. Last night it was 8.4 for example and there is a noticeable difference in how I feel. My doctor is convinced that I don't need a bipap or asv machine even though I have tried everything with my current machine and can't seem to get the numbers real low. I had a sleep study a month ago and she seemed to be confused about the results. The only thing that lowers my AHI is more pressure but she still says I don't need a bipap. Who knows at this point.

What are your settings (all of them)?


Den

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Minimum 18 - Maximum 20 for pressure. No EPR, auto humidity, the maximum my machine goes is 20. My doctor said to keep the pressure in a small range like this.

Joel

[Pugsy]

I don't know that you need ASV but I still feel strongly that you would benefit from a bilevel trial (plain bilevel and not the ASV bilevel). Your doc thinks you have centrals but the machine you are using doesn't think those are centrals and wants to go higher than the 20 cm.

Might be time to get a second opinion since your doc is so inflexible and not willing to at least try a bilevel.
Most docs when patients need pressures like you need will see the need for bilevel.

In answer to your question...I can't really ever tell much of a difference in how I feel when AHI is good or not so good. I can always tell based on how I slept though (don't even need to look at the numbers)...if I tossed and turned a lot and had a lot of wake ups...I will feel like crap no matter what the AHI might be and some nights my AHI is 8ish..and I feel great.

[Wulfman...]

I agree with Pugsy. Your pressures are in the "BiPAP/VPAP/Bi-Level" range.

On the other hand, my sleep doctor wrote my prescription for 18 cm. and I found out I could do quite well at 10 - 12 cm.

What is your typical sleeping position? Supine (back), side, stomach, some of all of the aforementioned?

Are you studying your nightly data with software? ( like Sleepyhead )


Den

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[acabgd]

Reading this thread I now fear my AHI numbers are way too high. Rarely do I see numbers below 2 (if at all), the usual range is between 2.5 - 4.5, but last night was 6.5, many nights during a month it's 4.5 or 5.0...

Should I be worried? My pressure is set from 8 to 15, humidity 4. I'm not studying my numbers with Sleepyhead as I don't really know what all the graphs mean, I just look in the morning at my machine and the hours slept.

Should I maybe increase max pressure?

[Wulfman...]

Reading this thread I now fear my AHI numbers are way too high. Rarely do I see numbers below 2 (if at all), the usual range is between 2.5 - 4.5, but last night was 6.5, many nights during a month it's 4.5 or 5.0...

Should I be worried? My pressure is set from 8 to 15, humidity 4. I'm not studying my numbers with Sleepyhead as I don't really know what all the graphs mean, I just look in the morning at my machine and the hours slept.

Should I maybe increase max pressure?

You REALLY need to study your data with software. It will show you what's happening throughout the night instead of the summaries in the LCD.
Your minimum pressure could be too low and it's taking too much time to get to where it can be of advantage to head off other events. You also may have apneas that don't have preceding events (Flow Limitations and Snores) that typically increase the pressures to where they need to be.

The more you look at the reports, the better you'll understand them. To be honest, I had always used Encore Pro with my Respironics machines and the first Sleepyhead reports I saw looked like gibberish to me. But, the longer I've studied them, the better I've come to understand them. I still can't use it as my machines are too old, but I get to see quite a few posted reports on the forum.

I encourage you to get the software and study what's going on while you're sleeping.


Den

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[Pugsy]

Should I be worried? My pressure is set from 8 to 15, humidity 4. I'm not studying my numbers with Sleepyhead as I don't really know what all the graphs mean, I just look in the morning at my machine and the hours slept.

Should I maybe increase max pressure?

IF (that's a big if) the pressure needs to be adjusted most likely it is the minimum pressure unless you are going to15 and staying there all night.
You really need to at least learn to evaluate the event categories in SleepyHead...if the bulk of your AHI is Clear Airway events (centrals) more pressure won't fix those type of events and potentially make them worse.
You don't have to zero in on all the graphs in SleepyHead...just learn the AHI and event category breakdown and maybe what the pressure is doing and leak graph (confirm that leaks aren't so big they are allowing events to happen).

[hegel]

I often find that my AHI score is higher on nights that I've slept more soundly. I'm still always under 5, usually below 2, but on nights when I dream heavily, I may be up around 3.5-4 or a bit more. My pressure average will often be higher as well.

[Sheriff Buford]

Reading this thread I now fear my AHI numbers are way too high. Rarely do I see numbers below 2 (if at all), the usual range is between 2.5 - 4.5, but last night was 6.5, many nights during a month it's 4.5 or 5.0...

Should I be worried? My pressure is set from 8 to 15, humidity 4. I'm not studying my numbers with Sleepyhead as I don't really know what all the graphs mean, I just look in the morning at my machine and the hours slept.

Should I maybe increase max pressure?

First off, don't worry about numbers. What's "normal" for me may be bad for you. In the autoset mode, the max pressure is not as important as the low pressure setting. The machine will only use what it needs to treat an event... then "back down". I'd try bumping it up and see if it makes a difference.

The lower setting provides comfort and determines how fast/long it takes to ramp up and treat the event. While is moving up, you are experiencing an event. In theory, the quicker.. is the least amount of time experiencing the event OR allowing an event to become worse.

Sheriff

[acabgd]

In the autoset mode, the max pressure is not as important as the low pressure setting. The machine will only use what it needs to treat an event... then "back down". I'd try bumping it up and see if it makes a difference.

Bump up both the min and max settings, or just the min pressure?

[Sheriff Buford]

In the autoset mode, the max pressure is not as important as the low pressure setting. The machine will only use what it needs to treat an event... then "back down". I'd try bumping it up and see if it makes a difference.

Bump up both the min and max settings, or just the min pressure?

For now, I'd just bump the max pressure up... to see how high it needs to go to keep your airway open. Sheriff