Can you ever get to zero events?

[jlklinko]

Hi there
1) I have been getting between 4 and 10 events a night.
2) I am on a straight CPAP pressure setting of 11 with 5 minute ramp.
3) Will I ever expect to get zero events? Is that the goal?

[barker109]

I don't know but I'd like to....LOL! I get about 1.6 per hour.

[archangle]

It happens, but don't go out of your way to eliminate the last few events.

Get it below 5, look at the events on the computer to see how bad it is, consider how you feel, etc. There's definitely a point of diminishing returns.

[edm_msu]

In the last two weeks I've had three nights with an AHI of 0.0. Resmed S9 Auto, 6 to 10 cm H2O. Usually the pressure is at 6, and two or three times a night it will go up to 8 or 9. I'm still feeling tired with low energy, but I don't think it is from over-doing my treatment. I doubt if reducing my pressures would give me more energy. The end of my 3 month compliance period is June 14.

[avi123]

Yesterday, I had one event:





In my computer the Stats may get the evening date and the Detail Graphs the after 12 a. m. date.

Note above that I had to get up twice during the night and go to pee. This Nocturia, signals that my OSA treatment is yet to be optimized.

And here is my zero events night from 20 nights ago:







Yes, it does not pay to make too many efforts to reach a zero events result. Look at me. I still suffer from Residual Excessive Sleepiness during the mornings from after breakfast till noon. Luckily I am retired and don't need to go to work. But it still effects me and I don't set any appointments before noon.

[nanwilson]

Yes, you can.... previous to last week I managed to get 2 or 3 zero ahi nights a week. Last week I had the whole week at zero....thought there had to be a problem with my machine, so Monday night i did a test, went to bed at 10, waited until about 10 past and then held my breath for as long as I could, then waited another 15 minutes and did it again. Tuesday morning when I looked at my stats...there threy were, the 2 times I held my breath, plus one other at about 2am......that I hadn't planned My pressure is between 10 and 15, usually sits around 10.2 to 11 or 12, I really didn't believe I could go a whole week with zero ahi's as I do know that an ahi of 4 to 5 is normal for most people. I would not keep working at it until I got zero ahis, as I feel anything below 5 is wonderful. My ahi's at my sleep test were an average of 29 per hour plus desat to 72.....not great.
Don't stress yourself out trying to get that low, some patients never even get to 5. All that proves is that my therapy is doing more than it should...and I am a happy camper.
Cheers
Nan

[jweeks]

3) Will I ever expect to get zero events? Is that the goal?

Hi,

As low of number of events as practical is a good goal. Keep in mind that everyone has events from time to time, even folks who do not have OSA. For example, a few centrals when falling asleep is pretty common. I think a better goal is to feel good as much as you can, and keeping the events down can be a major contributor to feeling good. So does having good sleep habits and setting aside enough time to sleep.

-john-

[Sheriff Buford]

I get a 0 AHI, 0 apnea events and 0 central events two or 3 times a month. I average a .3 AHI on a daily basis, so yes it can happen, but I feel blessed and feel I am an exception. You should work at getting you events as low as possible for you and manage your leaks. For what its worth, when I get zeros... I feel worse...

Sheriff

[pats]

I get a 0 AHI, 0 apnea events and 0 central events two or 3 times a month. I average a .3 AHI on a daily basis, so yes it can happen, but I feel blessed and feel I am an exception. You should work at getting you events as low as possible for you and manage your leaks. For what its worth, when I get zeros... I feel worse...

Sheriff

I'm not sure about "work at getting your events as low as possible". I'm a retired computer scientist, and a strong believer in "If it ain't broke, don't fix it.". With my current settings, mask, hose management etc. I consistently have AHI under 2, with about 0.3 obstructive events per hour. My sleep doctor looked at my data, and told me that my OSA is well controlled, and it is normal to have a few pauses in breathing during the night. I would rather concentrate on getting used to the equipment the way it is, than change things to see if I can get my AHI lower.

[-tim]

The AHI numbers are sort of odd. You can have 5 events per hour of 10 seconds or 5 events per hours for 2 minutes and the machine would report the same number. Once would have your O2 levels much lower than the other.

CPAP fixes low O2 (Oxygen) levels. The fact that you're breathing or not is somewhat immaterial but breathing does keep the O2 level up and that is what CPAP does. Since we don't know if your stopping for 3 seconds or 40, that is where you should look.

When you download your data, you will find that your events increase around leaks. This seems to be true for nearly all new users. Focuus on decreasing the leaks and you will drop your AHI.

If you want know how effective your treatment is, you needs to start looking at SpO2 (blood oxygen saturation). There is a device that cost about $75 that will record O2 levels and you can use the free sleepyhead program to look at that data. Others list it in their equipment list.

[Sheriff Buford]

I get a 0 AHI, 0 apnea events and 0 central events two or 3 times a month. I average a .3 AHI on a daily basis, so yes it can happen, but I feel blessed and feel I am an exception. You should work at getting you events as low as possible for you and manage your leaks. For what its worth, when I get zeros... I feel worse...

Sheriff

I'm not sure about "work at getting your events as low as possible". I'm a retired computer scientist, and a strong believer in "If it ain't broke, don't fix it.". With my current settings, mask, hose management etc. I consistently have AHI under 2, with about 0.3 obstructive events per hour. My sleep doctor looked at my data, and told me that my OSA is well controlled, and it is normal to have a few pauses in breathing during the night. I would rather concentrate on getting used to the equipment the way it is, than change things to see if I can get my AHI lower.

There are little things you can do to get your numbers low or lower. I agree, the most important aspect to successful cpap therapy is to get used to using the equipment on a nightly basis.... to the point of being comfortable and adjusted. Once that occurs, you should find your "sweet-spot". That is the pressure setting that provides the lowest numbers. You can also see if autopap or straight cpap is for you. Some folks find autopap provides the best comfort, and some prefer straight cpap. I found that cpap mode offers me most comfort and lowest numbers. Also, different masks can provide lower or higher numbers. Don't get me wrong, I think the most important part of successful cpap therapy is how you feel. By all means, don't chase numbers... You may never find your "sweet-spot". I feel worse with no apnea incidents, so I am satisfied with a few incidents.

By the way... I ain't no scientist...

Sheriff

[archangle]

You need to be reasonable.

Assume you had AHI=40 without CPAP.

With CPAP at 10, it drops to 2. You look at the airflow graphs and they are 15 seconds long. You feel fine, and have no trouble sleeping.

If you increase the pressure to 20, it drops to 0.5.

At 20, your ears pop, you get gas, you have a hard time getting to sleep, your mask leaks, your mouth pops open and you wake up with dry mouth.

In this case, you'd be a fool to increase the pressure.

It's a judgment call.

Even more importantly, if you look at the airflow diagrams, you may very well find out that the "apneas" that get reported don't look like "real" apneas, just some sort of irregularity in your breathing.

[Catnapper]

Using my bipap, I tweaked the pressures until I had AHI 0.0 most of the time. I then lowered the low pressure so I still have them frequently to see how I felt like that. From the data I could see that I stayed at the lower pressure most of the time so I left it there because I could not really tell much difference in the way I reacted either way. Since I did so well at lower pressures, I saw no reason to increase the pressure.

I agree that feeling well is the goal, not the AHI reading, assuming it is relatively low, at least under 5, but preferably 2 or 3. Some people may be able to tell the difference. I very seldom have an apnea event, so if my AHI is above 0.0, it is likely to be hypopneas which worry me less than actually stoppiong breathing completely. Surely other people have other opinions.

Catnapper - Joanie

[LSAT]

Hi there
1) I have been getting between 4 and 10 events a night.
2) I am on a straight CPAP pressure setting of 11 with 5 minute ramp.
3) Will I ever expect to get zero events? Is that the goal?

4-10 events a night average out to an ahi of less than 1 per hour. In my 3+ years on CPAP the lowest I have ever recorded (When I check) is about 2.5 AHI...but I sleep well and I feel great. I don't care about the numbers.

pats has it right..."If it ain't broke...don't fix it"

[jlklinko]

Hi there
1) Thanks for the great responses everyone!!
2) I will focus for now on getting the leaks down and keeping the lowest number I can.
3) I do feel so much better than I ever have so maybe I shouldn't rock the boat by changing my pressure....?