Got my test results

[dynamite]

Yesterday I saw the sleep doctor. I was pleased that a copy of my sleep study was printed out for me without my even needing to ask for it. I reported on my qualitative results after 45 days of therapy--reduced daytime sleepiness, no more awakening with horrible headaches (this makes a huge difference to my well-being) and dry mouth, no more trips to the bathroom during the night, and general, hard to describe feeling that I am actually breathing when sleeping. Who knew what what we were missing before CPAP! All together great results, right? However, when the doctor went over my test results and the report from the Smart Card (based on only 4 nights it appears) I have an average AHI of 9.4. (My original AHI during sleep study was a whopping 102.) The average leak rate was 39.24. My CPAP pressure is set at 11.0. When I expressed concerned about the 9.4 AHI average, the doctor said that given my report of improvement, I shouldn't mess with the CPAP pressure or be concerned with my AHI of 9.4. I hate to mess with a good thing but from following the discussions on this forum, this number seems too high to accept. What do you experts think?

[Georgio]

I'm not an expert, but I have identical equipment as yours, and I haven't had a leak rate as high as 39.25. I think 38 was the worst I ever had on a bad night. I believe excessive leaks will throw your therapy and AHI number off. You need to look at your AHI for more than one night.
Are you using Ayer Gel? It seems to reduce leaks for me.
Georgio

[jules]

you need to look at the actual leak graphs to know if the leak is or isn't an issue

as far as your AHI, was there any indications of centrals during the original diagnostic or during titration?

more information is needed for many sources

[dynamite]

The answer to central apnea occurrence is yes. I had a split night study. Baseline data showed AHI of 102 with Central Apnea Index of 48.42 p/h. During CPAP phase, Central Apnea Index of 35.83 p/h and AHI of 36.07. During titration, Central Apnea was 8 at pressure of 11 and jumped to 123 at pressure of 13. Thus, treatment set at pressure of 11. Does this change the picture?

[jules]

if you had centrals at the rate of 8/hour at your titrated pressure, wouldn't you expect to maintain that rate during treatment?

the APAP you are using doesn't distinguish those in the reported AHI (the 9.4 would include those too)

Hence without going to a fancier machine, this might be a great result

I think these would be great questions to ask the doctor

[dynamite]

Thanks Jules for the explanation. The sleep study notes conclude: "Findings suggest Complex Sleep Apnea. CPAP treatment should be attempted at 11 cm H2O. CPAP adherence will be monitored for at least one month. Nocturnal home monitoring of oxygen saturation for 2 day will be orderd, patient should be seen in OP Clinic for evaluation of clinical benefits, and if no perceptible change, will schedule for VPAP servovenatilation study." Is VPAP the fancier machine you reference?

[jules]

It is one of them yes

You might want to look at (and all the threads linked off it)

viewtopic.php?f=1&t=37242&p=325462

[aranpolk]

Do you sell banner ads here?
If yes, CPM or clicks?

[Mary Z]

Yes, normally AHI should be under 5. But if you have complete subjective improvement of symptoms I'd probably stick with the prescription and ask the doc next time I see him about the AHI. If you are having a number of centrals he has decided not to treat that could account for the high AHI. The VPAP servoventilator is a totally different machine and unfortunately I can't explain how it works except that it senses centrals and gives you a breath or two or however many you need until you start breathing again. I would go in that direction if I still didn't feel good with my current therapy. I know how you feel chasing that sometimes elusive AHI< 5. I have never, between two doctors, gotten titrated correctly, or well enough to meet that magic number. Although I don't have centrals I do have excessive daytime sleepiness and am now in the process of self titrating and seeing some improvement. Again though, if you really do feel 100% I'd stay with things as they are.
Good luck, sounds like you're off to a good start and numbers can improve over time.