Bickering

Liam1965 · Post by **Liam1965** » Mon Mar 07, 2005 5:36 pm

Yeah, I've never really liked the "number of events" as a measure for apnea.

Because all it takes is one or two events an hour where you stop breathing for a minute or two to lower your O2 levels dangerously.

On the other hand, I have lots of events, but my O2 levels never drop, it just wakes me and keeps me from getting restful sleep.

One disorder, two VERY different symptom sets.

Liam, counting an apnea everytime he switches from inhalation to exhalation, his AHI is REALLY high.

rested gal · Post by **rested gal** » Mon Mar 07, 2005 5:43 pm

Tying in with what Janelle said about her doctor having the good sense to look at the whole patient instead of an AHI number, SWS posted this great link once:

"an article in which Dr. Colin Sullivan (inventor of the CPAP) and others take issue with AHI as a suitable means of indicating OSA severity"

wading thru the muck! · Post by **wading thru the muck!** » Mon Mar 07, 2005 6:00 pm

RG,

Another interesting finding in the PowerPoint posted by mikesus was the statement that:

Measuring oxygen desaturation correlates best with outcomes and is more reliable and reproducable than measuring AHI.

Study posted by mikesus

Liam1965 · Post by **Liam1965** » Mon Mar 07, 2005 6:30 pm

wading thru the muck! wrote:Measuring oxygen desaturation correlates best with outcomes and is more reliable and reproducable than measuring AHI.

See, I still disagree with this. I'm serious they really are two different disorders with a similar cause...

In the one case, you may be getting some restful sleep, but you may be damaging your organs with hypo o2 saturation.

In the other case, you may be doing little organ damage, but suffer from severe sleep deprivation.

I think BOTH are important, for different reasons.

Liam, who can't afford to let his O2 drop, his brain is already pretty damaged.

Mikesus · Post by **Mikesus** » Mon Mar 07, 2005 8:54 pm

I think I would agree with Liam. Some folks don't desat that much but still have lousy sleep. Some Desat a lot, but sleep "ok", or like me, did a bit of both (desat to 90%, ahi 37). I think the truth lies somewhere in the middle.

wading thru the muck! · Post by **wading thru the muck!** » Mon Mar 07, 2005 9:20 pm

I wouldn't be so quick to disagree. I think high frequency, ultra precise recording of oxygen saturation is a much more accurate method of diagnosing SDB. I would say it needs to be coupled with repiratory effort monitoring to distinguish between obstructive events and neurological events.

Mikesus · Post by **Mikesus** » Mon Mar 07, 2005 9:38 pm

That is basically what they are saying here

Link Here

A third area of progress is in understanding
that the apnea-hypopnea index
(AHI, sometimes referred to as
RDI or respiratory disturbance index)
is not the only way to define
this disease, that in fact there is
wide variation in the degree of
symptoms for any given AHI (which
measures the number of apneas and
hypopneas during the sleep study).
The oxygen desaturation level, the
length of the apneas, the number of
clear arousals, and the presence of
EDS may become part of the definition.
In other words, one person
with an AHI of 20 may not have
other symptoms of sleep apnea, such
as EDS, while another person with
an AHI of 10 will have more symptoms
and require treatment. Hence it
is now believed arbitrary cutoffs for
the AHI cannot be made. Longitudinal
studies on asymptomatic patients
with high AHIs are needed, as well
as studies on interventions to reduce
health risks in this population. However,
at present, that step may be
premature because many patients
with symptomatic sleep apnea have
not been recognized.

littlebaddow · Post by **littlebaddow** » Tue Mar 08, 2005 5:37 am

wading thru the muck! wrote: Measuring oxygen desaturation correlates best with outcomes and is more reliable and reproducable than measuring AHI.

Can you and how do you measure your own oxygen desaturation level?

Mikesus · Post by **Mikesus** » Tue Mar 08, 2005 6:37 am

Requires pulse oximetry reader. Resmed and Respironics both offer modules that do that, but they are in the $900 range...

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