AHI number - HELP

[Streaming Bob]

I have thought all along that my AHI number was 40. Yesterday I visited my ENT Dr. and he looked at the sleep study and said my AHI is 18.5.
Here is what my sleep study says
"The patient initially slept for a total of 133 minutes out of time in bed of 203 with a sleep efficiency of 66%. The patient was noted to have one central apnea, 25 obstructive apneas, 15 hypopneas for an apnea hypopneic index of 18.5. He also had significant respiratory effort related arousals of 47 with an index of 21 for an overall respiratory disturbance index of 39.7. These events were disruptive to sleep and triggered cycling oxygen desaturation that went as low as 79%."
On Monday I got the read out from the chip on my new machine and it showed a AHI on Thur. of 18.1, Fri 31.6 Sat 31.6 and Sun of 7.3.

Thur, Fri and Sat. I was sleeping on my back on an incline with pillows and on Sunday I slept on my side.
I think this is why my AHI was so much better on Sunday. Got prescripition for new sleeping pill yesterday and will try them tonight.
I still am feeling tire. Going to see my internal medicine Dr. today. I just start having shortness of breath.
Any suggestion would be welcome.

[Mary Z]

It can take awhile to feel better- for some of us it takes six months. See you Internal Medicine Doctor about the shortness of breath. I doubt it would be related to CPAP. You may have other medical issues. I see your AHI was much better sleeping on your side- you noted this yourself. Also, during your sleep study the machine does not know whether you're awake, but the EEG does. That's how they can tell how long you slept and in what sleep stages. Good Luck.

[avi123]

At the sleep study they know how much time you slept which was 133 min = 2.2 hr. The total Obstructive and Hypopneas events that you had was 25 + 15 =40

By dividing 2.2 into 40 I get 18.2 as an AHI

This is close enough to the AHI of 18.5

While you are on CPAP the machine does not know if you're asleep. So it divides those events into usage time.

This could explain the diff.

Shortness of breath could be related to the pressure set on your CPAP if it is hi. But you don't give details of it nor your age.

[Streaming Bob]

Shortness of breath could be related to the pressure set on your CPAP if it is hi. But you don't give details of it nor your age.

I am on BiPAP with the setting at 8 and 12. I will be 70 in Oct. and have been very healthy up until I started this BiPAP thing. Before I started BiPAP I would sleep 8 to 9 hours only waking once for a potty break. Now I wake up every 2 to 3 hours and only get about 6 hours sleep. Feel tired most of the day and now the shortness of breath has stated. The sleep Dr. now wants me on sleeping pill so I at least sleep 6 hr. without waking. I am starting some new sleeping pills tonight.
Thanks for your help

[70sSanO]

Something doesn't look right.

At a sleep study without any therapy you have an AHI of 18.5.

Now with therapy on your machine you are getting 18.1, 31.6, and 31.6.

Did you sleep on your side during the sleep study because you side sleep AHI at home is 7.3?

Do you have a breakdown of your AHI numbers?

Does you Dr know about your latest results?

John

[Janknitz]

Another consideration is that you only slept a little over 2 hours in the study, and probably did not reach REM sleep. So your actual AHI may be much higher than indicated by the limited parameters of your study. And what of your titration study--were they able to observe you in different positions and during REM sleep for that???

You do seem to have a positional component--what position were you in during the sleep study posted?

Your machine is not doing a good job of controlling your apneas, especially in supine but even in side lying it's not too good. There are some factors that may contribute--primarily incorrect pressure settings and mask leaks. Can you access your leak data as that would be the first place to look?

Please be sure to post what make and model machine you have so we will be able to tell you how to access the appropriate data. And we need to know what mask you are using to determine leak rates.

Right now the CPAP doesn't sound like it's set correctly for you, so you are having interrupted sleep. Your sleep can and will improve when the therapy is dialed in to what is optimal for you. Hang in there, and let your doctor know about your sleep issues and very high AHI's on the machine.

[avi123]

Bob, I am also going to see one of my internist next week. I been on CPAP since Nov 2010. For 3 months it helped me to overcome the sleep fragmentation that I had before because of a Peripheral Neuropathy that I come down with suddenly. While CPAPing at home my AHI never came down below 5/hour. They did come down during the sleep study from 6 months ago from 40 with No CPAP to about 3 with CPAP. I don't know how they did it to come so low.

See here my recent averages for AHI while on a plain CPAP:.......................................................................................................




During the last month I have realized that I have a residual daytime sleepiness in spite of my 8 hrs sleep during the night. The sleep is broken into three to go urinate. But I fall back asleep on the CPAP immediately. Two months ago I stopped taking the 10 mg of Zolpidem (for sleep) and now just take 1/2 mg Xanax 4 times daily.

During the last 2 months I have also been realizing some shortness of breath on exertion.

Currently, I have started to use an S9 Autoset, set at 8 to 13 cmH2O and I already see improvement in my AHI.

Hoping it helps you somewhat.

[ozij]

I have thought all along that my AHI number was 40. Yesterday I visited my ENT Dr. and he looked at the sleep study and said my AHI is 18.5.
Here is what my sleep study says
"The patient initially slept for a total of 133 minutes out of time in bed of 203 with a sleep efficiency of 66%. The patient was noted to have one central apnea, 25 obstructive apneas, 15 hypopneas for an apnea hypopneic index of 18.5. He also had significant respiratory effort related arousals of 47 with an index of 21 for an overall respiratory disturbance index of 39.7. These events were disruptive to sleep and triggered cycling oxygen desaturation that went as low as 79%."
On Monday I got the read out from the chip on my new machine and it showed a AHI on Thur. of 18.1, Fri 31.6 Sat 31.6 and Sun of 7.3.

The text I marked in red is where the number 40 comes from. You sleep was interrupted by efforts to breathe 40 times an hour. That's your RDI. Your ENT focused on the AHI alone, the sleep report looked at your overall sleep.
If I remember correctly, your readout, on a Respironics machine, is always a 7 day average. This would mean the effect of side sleeping on Sunday was even more dramatic.

[Streaming Bob]

Something doesn't look right.


Now with therapy on your machine you are getting 18.1, 31.6, and 31.6.

For 18.l I had 13.0 mins of large leak - For 31.6 had 9 mins of large leaks and for the other 31.6 had 145 mins of large leaks.
For the 7.3 had 12 mins of large leakss

Did you sleep on your side during the sleep study because you side sleep AHI at home is 7.3?

Yes.

Do you have a breakdown of your AHI numbers? No Where do I see that. I have CA, OA, H, FL, VS, RE. is the the breakdown????

Does you Dr know about your latest results?

Yes he is on vacation and I will talk to him next week.

I get my printouts for my DME. Take my chip to their office

John

[Streaming Bob]

Another consideration is that you only slept a little over 2 hours in the study, and probably did not reach REM sleep. So your actual AHI may be much higher than indicated by the limited parameters of your study. And what of your titration study--were they able to observe you in different positions and during REM sleep for that???

You do seem to have a positional component--what position were you in during the sleep study posted?

Your machine is not doing a good job of controlling your apneas, especially in supine but even in side lying it's not too good. There are some factors that may contribute--primarily incorrect pressure settings and mask leaks. Can you access your leak data as that would be the first place to look?
I added the leak data in the above message

Please be sure to post what make and model machine you have so we will be able to tell you how to access the appropriate data. And we need to know what mask you are using to determine leak rates.

My model machine is at the bottom of my post.

Right now the CPAP doesn't sound like it's set correctly for you, so you are having interrupted sleep. Your sleep can and will improve when the therapy is dialed in to what is optimal for you. Hang in there, and let your doctor know about your sleep issues and very high AHI's on the machine.

[Streaming Bob]

Can't get this quote thing figured out. I did add the leak in one of the above messages I sent.


I saw the Internal Dr. Wed. and he thought the shortness of breath was due to the fact that I had not gotten much excerise during the winter. Now that we are getting nice weather I will be more active. Suggested that I also lose some weight so my wife and myself our now on a diet. Great no more ice cream.

Dr. said to try and keep going with the BiPAP machine but he knew that some people just can't do it. Didn't know if he could do it.
Bob

[ozij]

[quote="Streaming Bob"]Can't get this quote thing figured out. I did add the leak in one of the above messages I sent.


I saw the Internal Dr. Wed. and he thought the shortness of breath was due to the fact that I had not gotten much excerise during the winter. Now that we are getting nice weather I will be more active. Suggested that I also lose some weight so my wife and myself our now on a diet. Great no more ice cream.

Dr. said to try and keep going with the BiPAP machine but he knew that some people just can't do it. Didn't know if he could do it.
Bob[/quote]

Hi Bob,
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