Zero AHI the goal?

Swordz · Post by **Swordz** » Wed Sep 19, 2007 5:47 am

Obviously sleep and rest are the overall goal of all of our struggles. But, does anyone really notice a major difference between 0 AHI and say mild apnea (~5)?

I know that limiting event/hour is important, but will one feel much better from eliminating all apneas, or it is all just purely subjective?

ozij · Post by **ozij** » Wed Sep 19, 2007 6:06 am

[quote="Swordz"]Obviously sleep and rest are the overall goal of all of our struggles. But, does anyone really notice a major difference between 0 AHI and say mild apnea (~5)?

I know that limiting event/hour is important, but will one feel much better from eliminating all apneas, or it is all just purely subjective?

tillymarigold · Post by **tillymarigold** » Wed Sep 19, 2007 7:12 am

I have UARS and it hit me particularly hard (you know how they say AHI is unrelated to how you feel, especially in women?). My normal AHI, without CPAP, is 4.7.

So yes, there's a heck of a difference between that and 0. Not that I've ever had a 0, but there's a heck of a difference between that and 1. It's the difference between staying awake and living my life from 6am to 10 pm, and needing four cups of coffee, two cans of Monster Energy, and a three-hour nap to do so.

track · Post by **track** » Wed Sep 19, 2007 11:03 am

No noticeable difference to me. Never been close to zero but have had a few nights with the AI at .3 which means only a couple of ten second AI in the entire night. No difference than when my AI is 1 or 2. I don't know why someone would even use Cpap if their AHI is below 5 without treatment....but that's just me.
I have had some nights where I have had long AIs. I have found by sleeping on my side and staying off my back there is a big difference in the number and duration of the AIs. Therefore I sleep with a couple of soft balls taped to the back of my tee shirt. That usually keeps my AI under 1 and my AHI under 5...and most importantly I can turn the pressure down considerably from what it would need to be if I was on my back.

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP, AHI

Snoredog · Post by **Snoredog** » Wed Sep 19, 2007 12:12 pm

I've gone many nights on the machine with Zero apnea seen across that session, only having a few hypopnea and flow limitations and felt really no better than a night of having a dozen.

Goofproof · Post by **Goofproof** » Wed Sep 19, 2007 1:11 pm

A few days at over AHI 3, and I feel it. So I do what I need to and for most nights keep it under AHI 1. Machines and masks do make the difference.

Resmed's seem to score higher, so my remarks only apply to what I use Jim

tillymarigold · Post by **tillymarigold** » Wed Sep 19, 2007 2:48 pm

track wrote:I don't know why someone would even use Cpap if their AHI is below 5 without treatment....but that's just me.

You know, I really hate it when people say "I don't know why" when what they mean is "I disagree." I JUST EXPLAINED IN THE POST DIRECTLY BEFORE YOURS why I use CPAP.

Since you apparently didn't read what I wrote, I said: "It's the difference between staying awake and living my life from 6am to 10 pm, and needing four cups of coffee, two cans of Monster Energy, and a three-hour nap to do so."

It's also the difference between walking my dog and being too tired to feed the cats; between eating dinner with my husband and sleeping through it; between normal blood pressure and hypertension; between steady weight loss and uncontrollable weight gain; between getting regular exercise and doing my joints serious damage; between having a clean house and living in a pigsty.

Now, do you still "not know" why someone would prefer the life I have now over the life I led for the last 17 years? Or do you honestly believe my old life was good enough? I'm so glad that I have a real, qualified sleep doctor in charge of my health, instead of you.

Snoredog · Post by **Snoredog** » Wed Sep 19, 2007 3:06 pm

tillymarigold wrote:
track wrote:I don't know why someone would even use Cpap if their AHI is below 5 without treatment....but that's just me.
You know, I really hate it when people say "I don't know why" when what they mean is "I disagree." I JUST EXPLAINED IN THE POST DIRECTLY BEFORE YOURS why I use CPAP.

Since you apparently didn't read what I wrote, I said: "It's the difference between staying awake and living my life from 6am to 10 pm, and needing four cups of coffee, two cans of Monster Energy, and a three-hour nap to do so."

It's also the difference between walking my dog and being too tired to feed the cats; between eating dinner with my husband and sleeping through it; between normal blood pressure and hypertension; between steady weight loss and uncontrollable weight gain; between getting regular exercise and doing my joints serious damage; between having a clean house and living in a pigsty.

Now, do you still "not know" why someone would prefer the life I have now over the life I led for the last 17 years? Or do you honestly believe my old life was good enough? I'm so glad that I have a real, qualified sleep doctor in charge of my health, instead of you.

magpie · Post by **magpie** » Wed Sep 19, 2007 3:11 pm

Couldn't say. I've never had a night below a 5. but can say there is a huge difference between 15 and 5 LOL

track · Post by **track** » Wed Sep 19, 2007 3:32 pm

Hi Tillymarigold

Nothing personal that's why I said.."but that's just me"...meaning from my perspective. If you have something going on that I don't have, then my perspective would not be valid for you.

tillymarigold · Post by **tillymarigold** » Wed Sep 19, 2007 5:01 pm

Snoredog wrote: Most people have NO clue as to what UARS is, insurance doesn't either, reason they won't pay for it. What is UARS?

(you know this but most others don't) Upper Airway Resistance Syndrome

Why it continues to be classified as a "Syndrome" when the cause is KNOWN is beyond me. BUT many factors can contribute to UARS such as:

Nasal blockages due to:

Deviated Septum
Bony Turbinate overgrowth
Flabby Soft Palate
Overly large Uvula

OR anything that causes a "Resistance" to nasal airflow.

So using CPAP makes perfect sense or WHY one would use the machine with a AHI less than 5. But I would also consider "some" surgery procedures to eliminate those effects.

Worst thing one could do with a deviated septum is use a nasal pillow style mask, this makes ones nose look like Miss Piggy and can contribute to complete blockage of the nasal valve. An incorrectly fitted nasal mask that places too much physical pressure on the outside of the nose can also contribute to it.

Now, Insurance WILL cover UARS if you use a different name for it, such as a deviated septum, turbinate reduction etc. When you think about it if you fix those items and resolve chronic congestion you are addressing UARS.

Actually, in my case, UARS is caused by exactly the same thing as causes sleep apnea ("upper airway" includes the throat), and as such, there *is* no other way to treat it besides the standard OSA treatments. I do not have a deviated septum, chronic congestion, or any of those other things.

The way my sleep doctor explained it is that with OSA, your airway narrows, you can't breathe, your body realizes you can't breathe, and you have an arousal. With UARS, your airway narrows, your body realizes your airway is narrowing and you'll soon be unable to breathe, and you have an arousal.

It is particularly common for premenopausal women to have UARS due to the same physical conditions that lead to OSA in men and postmenopausal women, and in fact many young women with UARS have it develop into OSA when they get older. Also, studies have shown that the day-to-day symptoms of UARS in women are every bit as severe as the symptoms of OSA (the difference is in the long-term symptoms like heart and kidney damage).

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CPAPopedia Keywords Contained In This Post (Click For Definition): nasal pillow, Arousal, CPAP, AHI

sleepyred · Post by **sleepyred** » Wed Sep 19, 2007 5:09 pm

Snoredog wrote:
OR anything that causes a "Resistance" to nasal airflow.

So using CPAP makes perfect sense or WHY one would use the machine with a AHI less than 5. But I would also consider "some" surgery procedures to eliminate those effects.

That would be me - had the deviated septum surgery - successful and none of the other issues you described, Snoredog.

Being on cpap/apap has made the world of difference for me. My AHI is between .3 and .7 - and that is the point when I feel the best. If it goes over that - I usually have another issue (stuffy nose, leaking mask, etc) which is causing my AHI to rise.

I was a lucky one whose insurance company recognized the dx of UARS and I got a basic cpap machine. Bought an apap from a forum member and that has made my treatment even more successful.

I made the mistake of taking a nap yesterday without my apap and awoke enough times to kick myself for not using the apap. How many times did my UARS kick in, once a hour, twice, 25? - don't know - but I do know that it would not have been that way on apap and I would have had the nap I needed after a 6 hour iron infusion for a low ferritin level.

UARS, IMHO, is under diagnosed and unrecognized by most insurance companies, and even the medical profession. That in itself is another story which I won't bore you with now.

darthlucy · Post by **darthlucy** » Wed Sep 19, 2007 8:28 pm

Snoredog wrote:Why it continues to be classified as a "Syndrome" when the cause is KNOWN is beyond me.

It's because the term "syndrome" doesn't mean unknown cause. A syndrome is not one disease or condition, but a collection of several clinically recognizable features, signs, symptoms, phenomena or characteristics which often occur together. When an individual has a syndrome such as UARS, the person may or may not have all of the characteristic features, but will have at least some of them. A perfect example is AIDS, acquired immunodeficiency syndrome. It can present itself in many different ways in different people, but the cause, the HIV virus, is well known.

Incidentally, the most common term for a disease or condition of unknown origin is idiopathic.

RosemaryB · Post by **RosemaryB** » Thu Sep 20, 2007 4:28 am

I do notice a difference when my AHI gets higher than 2. That's way better than it was untreated (I have moderate sleep apnea). But the difference is there. I do notice it in how I feel.

One other difference appears to be measurable. Every morning, I work out using a heart rate monitor. Here's an apparent correlation I've begun to notice: On the mornings when my AHI is low (say 0.3) I have a very hard time getting my heart rate up to areobic level. IOW, I have to work much harder to get my heart rate up. (Think of someone fit, who doesn't get out of breath very easily).

When my AHI is higher, say over 2.0, my heartrate goes up with very little effort. (Think of someone out of shape who gets out of breath easily). Not getting enough sleep will also result in my heartrate going up more quickly.

jasper · Post by **jasper** » Thu Sep 20, 2007 9:49 am

Not sure whether the AHI is making a difference for me. The best the sleep lab could do was to get mine from 65 down to 15, and yes, I felt better at 15. They attributed the higher number to centrals, and put me at 14 cm on straight CPAP. Sent me home with an M-Series Plus.

Well, two weeks ago, I got an APAP with Aflex, and it has been reporting AHI between 7 to 8. Once again, I feel better, but is it just because of the numbers or are there many other factors involved with using Aflex? My 90% pressure is around 11 cm, and I generally feel that I sleep better. I set the APAP at 8 to 18 as a start and haven't changed anything in 2 weeks. I wanted a good baseline.

Just got a card reader, so now I can see what the daily data looks like, and decide where to make any other tweaks. All in all I'm pretty pleased with how I feel, even though the numbers are still in the "mild" range.

Mask

Additional Comments: Aussie Heated hose for rain out/PapCap Headgear and chin strap

Zero AHI the goal?

Zero AHI the goal?

Re: Zero AHI the goal?