Giving up on good AHI

[Portageegal]

I checked my study results and my AHI was 58.7, so I guess todays 17.8 was a lot better than that. I am tired of trying to get it below 5 or even below 10. Enough already !!

[jnk]

I checked my study results and my AHI was 58.7, so I guess todays 17.8 was a lot better than that. I am tired of trying to get it below 5 or even below 10. Enough already !!

Here is my take, which may be nonstandard:

Getting AHI down can be a fun game, if it is not too goal-oriented. The trick is to see how low you can get it, in your personal case, not necessarily to get it to some arbitrary number. The information from the machine is there to help you, not discourage you, after all. So try not to get discouraged about it if you can help it--there are always other things to try. Sometimes rigging something to stay off your back helps, for example.

How is your AI? Personally, I would ignore my AHI number until my AI was as low as I could get it, on a ResMed. But that's just me.

Anyway, if that is as low as you can get it for now, find some joy, as you are, in the fact that it is so much lower than it was at the study. But the future may hold surprises in what you might think of doing in the lifelong game of tweaking for AHI.

Your doc may have useful info on how to view the numbers, if he/she is on board.

[DreamStalker]

Here is a post from about a month ago ...

Okay ..... I put the pressure range back to where the dr. recommended in the start. 6 -14 Last night my usage was 8.36 hrs, which is pretty normal for me.

Pressure 13.4
LEAK 0.0
AHI 19.6 (highest ever)
AI 9.
HI 10.6

My monthly figures are:

Pressure 11.6
Leak 0.6
AHI 14.4
AI 5.3
HI 8.8


Last night was the first time I woke myself up snoring since being on APAP. I used to be the champion snorer in a house with 36 people.
I'm stumped. It seems whatever advice I follow I can't improve the numbers. I feel better than before, but the #'s suck.

What are your current machine settings? ... and other numbers?

[kteague]

Hi. Was reading thru some of your prior posts and have a couple questions - did you try raising the the lower end of your range, and if so, what were your results? if you sometimes need a pressure over 13, that's a long climb from 6. I'm wondering what your numbers would look like with that lower number at 9 or 10.

I agree that too much concern can be counter productive. Just make sure before adopting a hands-off policy that you've exhausted options for improvement before you "settle". What has been done since those numbers above?

[Portageegal]

I haven't really "given up", I'm just pissed that I can't get better numbers.
No, I do not sleep on my back.
Yes, I have highered my #'s from 6-9 and highered the max a little, too.
Leaks are pretty good. Last couple of nights was 0.0
AND I am back to being tired all the time.


I really appreciate the responses. I am glad I found this site.

[ozij]

Portageegal,
You've tried so many things with this ResMed machine - maybe you're just one of the people who will do much better with another machine's algorithm.

An AHI of 17 is a lot - and being tired all the time it not what should happen to you on therapy.

Can you at least rent another auto for month, to see if it makes a difference?

You know. you really should complain and complain and complain to your doctor - at your high pressure you're close to where BPAPs are tried - and insurance will pay if there's proof fixed (or auto) pressure isn't doing the job. You've got data to prove this machine isn't working for you.

Some people simply cant' tolerate one machine's algorithm, and do great on another.

(typos edited)

[andy88488]

I checked my study results and my AHI was 58.7, so I guess todays 17.8 was a lot better than that. I am tired of trying to get it below 5 or even below 10. Enough already !!

AHI is not the be-all and end-all. l recently had an interesting experience. I changed my APAP settings from 11-20 to 11-13. My AHI dropped from about 2-3 to 0.5 or so. But l didn't feel as well-rested.

Admittedly, an AHI of 17 worries me for you. I just wanted to share with you my somewhat surprising experience with lower AHI not necessarily being better.

Andy

[spookydoo]

I agree with the post that says go see your doc again. And if you don't have someone who is taking this seriously find another doc.

[Portageegal]

A doctor ???? You mean the guy who sends a bill that I never laid eyes on. THAT doctor? I'll have to find out how often Medicare will pay for a sleep study and get re-titrated.

[ww]

A doctor ???? You mean the guy who sends a bill that I never laid eyes on. THAT doctor? I'll have to find out how often Medicare will pay for a sleep study and get re-titrated.

I am an engineer, not a doctor, but these machines work when given a chance.

I presume you don't have the software, so you must simply take down the numbers off your lcd readout each morning.

This is a very poor machine for the combination of high AI and high pressure and it does not respond to it.

As I recall from reading your previous posts, you have gotten very little relief up to now and that is a real problem. So far now set the machine to CPAP (Constant pressure mode) and if you know your titrated pressure, set the CPAP machine to that pressure (not auto mode). If you don't, then set it to 13 cm if that is the 90% point when using it in APAP mode, and record the data for 7 days in a notebook or a Excel spreadsheet for later use.

If your AI is still high, up the CPAP pressure to 14 cm for one week, then repeat at 15 cm for one week. This should give you a good indication whether the change in pressure is helping your condition.

Don't give up as we all had lots of problems when we started out. I started off with an AHI=14.1 and now consistently less than 2. See this thread: viewtopic.php?f=1&t=29565&p=254533#p254533

It also takes a lot of work to get the right size mask as I take a small in the UMFF and a medium in others. I understand the Quattro runs even smaller. The mask is a little hard to fit, that is why they give you a movie to show you how. You need to run your fingers around your mask and feel for any leaks and resolve them. The Quattro also seems to leak around the swivel and many have used plumbers teflon tape to seal that big leak. I have to use a piece of moleskin on my nose bridge to eliminate a bad leak there. You really have to work at this, but you can see real improvements. Unfortunately, most DME's and sleep doctors don't seem to have a clue as to the real problems that their patients go through to get their AHI to a respectively low number for their therapy to work.

Start a thread on the CPAP mode and post to it daily for comments, but DON'T make changes more often than 5-7 days! Good Luck.

[ozij]

A doctor ???? You mean the guy who sends a bill that I never laid eyes on. THAT doctor? I'll have to find out how often Medicare will pay for a sleep study and get re-titrated.

No, I mean your primary care physician, your treating physician - or whoever it was that referred you to the first sleep study.

Medicare Coverage Database: Decision Memo for Sleep Testing for Obstructive Sleep Apnea (OSA) (CAG-00405N)

CMS finds that the evidence is sufficient to determine that the results of the sleep tests identified below can be used by a beneficiary’s treating physician to diagnose OSA, that the use of such sleep testing technologies demonstrates improved health outcomes in Medicare beneficiaries who have OSA and receive the appropriate treatment, and that these tests are thus reasonable and necessary under section 1862(a)(1)(A) of the Social Security Act.

O.