AHI - Putting all eggs in one basket

DreamStalker · Post by **DreamStalker** » Fri Jul 11, 2008 7:04 am

jnk wrote:My understanding (probably flawed, certainly not "expert") is that an AHI below 5 is generally considered "normal" (whatever that word is supposed to mean) and that if it is that low without using something to GET it that low, you do not have obstructive sleep apnea (as far as the doctors are concerned, anyway) even if you still have some apneas overnight.

If a person has been diagnosed OSA and is being treated, I don't think there is any need for that person to worry too much about trying to get a zero AHI, although it is always cool to try to get it as low as one can--just for the principle of the thing.

If a person can get the AHI consistantly below 5, I hear that that is cause for that person to do a little snoopy happy-feet dance every morning from that point on. But minor flow restrictions can be counted by some machines in figuring the AHI, which may make the AHI number misleadingly high now and then.

Just stuff I think I've read in other posts somewhere.

jnk

If your focus is on eliminating daytime sleepiness and/or snoring (I'm pretty sure that is what the AHI of 5 statistic is based on), then you and your sleep doc have succeeded and a happy-feet dance is in order.

If your focus is on eliminating O2 desaturations, then AHI of zero is your goal.

jnk · Post by **jnk** » Fri Jul 11, 2008 7:45 am

Well said, dreamstalker. As Carney, Berry, and Geyer said in
Clinical Sleep Disorders, 2005: “The end point (goal) of titration varies somewhat, but ideally includes elimination (or near elimination) of obstructive apnea, hypopnea, snoring, arterial oxygen desaturation, and respiratory effort-related arousals (RERAs), which are those events associated with arousals secondary to increased respiratory effort that do not meet criteria for obstructive hypopneas. . . . Central apneas and mild airflow limitation may be acceptable as long as there is no associated sleep disturbance or significant oxygen desatruration. The goal of most centers is to have an AHI < 5 per hour in all body positions and sleep stages.”

Gerald · Post by **Gerald** » Fri Jul 11, 2008 10:45 am

I think DreamStalker is correct.

My sleep study showed my AHI to be just under 5.0.....and for that reason, Medicare wouldn't pay for any of my equipment.

I knew, however, that I was in DEEP trouble. I was getting blood pressure spikes (in the middle of the night) of over 200 systolic....and I was well on my way to becoming a stroke induced vegetable.

I suspect that the idea of an AHI score below 5.0 being "OK" might have evolved as a way to reduce insurance company costs. If they can lull their customers into a false assemption that they're OK so long as their AHI is under 5.0, the insurance companies get to keep more of our hard-earned bucks.

By experimenting on myself, I've found that my nightly O2 levels cannot be maintained at 93% or better...unless...my AHI scores stay below 2.5.

O2 saturation is the ball game........unless all one is trying to do is reduce snoring noise....so that someone else can sleep.

For me, snoring noise isn't a factor. Getting enough O2 so that I can reach my 90's is the goal.....and I've learned that I can't pull that off unless my AHI is consistently below 2.5.

Gerald