AHI Control

[Sheriff Buford]

Hello all: I've seen posts about folks trying to get their AHI down. Am I right in the only way to reduce you AHI is to:

- increase your machine pressure setting
- control mask leakage

Sheriff

[bayourest]

HI Sheriff,
I think you have succinctly articulated the $64k question for a lot of us...particularly relative newbies. "What can I do to impact my therapy towards improvement?" I am looking forward to the responses from the very experienced on the forum....It seems to me from what I have read here that using good sleep hygiene is probably an important factor too. Robysue has posted a lot about her battle with insomnia and I believe that those tools are important to incorporate as well. I had my personal best last night: ahi was 1.6 and a i was 0.7 I never ever thought I'd see a score in those ranges. I have no idea what I did differently (I wish I knew) but for the last couple of nights the scores have been getting better. I use a quattro FX with a padacheek liner. it's all relatively comfortable. I am trying to get to bed at the same time and I think I have tweaked my pressure to what may be the optimal level for me (apap 10-12.6). I just dont know if it's any of that or if it is the support and expertise available by reading the forum combined with some months now. probably all of the above....

[KimberlyM]

Another factor is sleep-onset centrals and those that occur upon awakening. Now that I have adjusted to the mask and I am sleeping more deeply my centrals have dropped significantly, reducing my total AHI down to less than 2.

[bkdraft]

I started out with really high centrals (no centrals in the sleep test), but over the last month they have got better and better. I am also now on O2 which has also helped. I think getting used to the cpap has helped a lot also, seems I sleep better now. Another thing I have done is taking 1000mg of Calcium and 1000 mg of Magnesium 2 hours before I go to bed. I started off with AHI's of over 10, 98% of them Centrals, but actually got down under 2 couple of nights this last week. Have not seen anything over 5 for last 2 weeks so looks like I have things going very well right now. I guess it just takes some time for your body to adjust to the new sleep style.

[Starlette]

@bkdraft - I have to take calcium. you make me wonder if I should be talking that pill in the late evening.
Also, I'm rather surprised that magnesium would have any influence on a person's sleep. Never heard of that before.

Starlette

[Pugsy]

Am I right in the only way to reduce you AHI is to:

- increase your machine pressure setting
- control mask leakage

Well those are the first ones to think of. Now with Resmed machines and use of EPR, we can redue EPR or turn if off an maybe get a bit of an increase in pressure.

Also if someone very strongly worse in Events supine it might be possible to significantly lower the AHI by sleeping on side and not allowing movement on the back.

[billbolton]

Am I right in the only way to reduce you AHI is to:

- increase your machine pressure setting
- control mask leakage

No, you are wrong. There are very few absolutes in SDB treatment, so trying to make simple definitive statements about indefinite quantities (what value of AHI?, what value of leakage?) is actually not of much help, and can easily lead to chasing shadows.

Simply increasing pressure may lead to an increase in AHI score for a number of reasons, and similarly if the current leakage is within the management capability of the xPAP machine in use, simply reducing it will not necessarily make any difference to AHI score.

Each patient is going to bring their own set of existing issues to xPAP treatment, and finding their sweet spot in terms of good sleep is a journey of discovery that may well involve changes to many other things besides xPAP settings and report gazing.

Cheers,

Bill

[avi123]

I agree with Bill Bolton from Australia.

Here is why:

Severity of OSA (hi or lo AHI) does not depend exclusively on treatment.

Check this:

http://emedicine.medscape.com/article/2 ... w2aab6b6b6

[Emilia]

I also agree with Bill. I found, from tinkering at first, that just moving my lower pressure point up a half notch made a big difference....not the high end pressure. So, it really is a case by case situation that requires patience and experimentation. Leaks, sleep position, other medical conditions or even seasonal things like allergies, can all influence your therapy. Attention to the data and adjusting things as needed based on good knowledge and understanding will help each user learn what their individual needs are.