What is an acceptable AHI for CPAP patients?

EdAPAP · Post by **EdAPAP** » Thu Nov 29, 2007 1:10 pm

The sleep lab guy said that AHI of 10-12 might be as good as it will get for me. What strategies should I consider to get my AHI down to 5 or below?

I have been on APAP at 9-17 cm for one month for auto titration purposes. The first two weeks of data indicate that even with CPAP therapy and 90% pressure = 17 cm, I have an average AHI of 11-13. The sleep lab is changing my Rx to 15-20 cm. I will start using Encore Viewer next week to monitor my data and manage my therapy.

I am encountering exhalation difficulties at 17-18 cm even with A-Flex on highest setting. Would a BiPAP be helpful at these pressures?

ED

tangents · Post by **tangents** » Thu Nov 29, 2007 2:55 pm

Ed,

I have heard it said that a Bi-pap at the higher pressures helps, but I wouldn't know. Maybe others can chime in with their experience.

My experience with the auto-paps is that the closer my lower pressure is to the effective (90%) pressure, the lower my AHI is. I think it's because the APAP keeps trying to lower the pressure until it senses an apnea, then it bumps the pressure until the blockage is cleared. The key thing is that it doesn't start raising the pressure until an apnea has already occurred. So by definition you'll have lots of apneas if your pressure range goes too low. If you find that your AHI is lower with the setting at 15-20, then your experience will be similar to mine.

Good Luck, Ed,
Cathy

EdAPAP · Post by **EdAPAP** » Thu Nov 29, 2007 3:17 pm

Thanks for your reply. I have read that a narrower APAP setting range is better. Your explanation is very helpful. ED

cflame1 · Post by **cflame1** » Thu Nov 29, 2007 3:41 pm

Ed,
Yes, a Bipap would be better at those pressures... you can even get an auto Bipap if that's what you'd like.

Goofproof · Post by **Goofproof** » Thu Nov 29, 2007 3:52 pm

If you truly need the higher pressures the Auto Bi-PAP is the way to go.

Taking the sets to get the software and reader are the most important. You may find that you are mouthbreathing, if you are, No pressure will be correct, even with software use. You will not know for certain if you leak out your mouth, as it happens in your deepest sleep.

The goal is under AHI 5, for me that's not good enough, I am desturbed if I'm over AHI 3.

If you take steps to prevent mouthbreathing, the software can help you find the correct range, your AHI should fall in line. Jim

DreamStalker · Post by **DreamStalker** » Thu Nov 29, 2007 6:13 pm

Assuming you are certain you have leaks under control, your strategy should include:

1) collection of a week or more of efficacy data before making any changes to treatment parameters (machine settings or mask).
2) not change more than one parameter at a time (be it a machine setting or mask).
3) with the software you will be able to plot pressure vs AHI
4) patience patience patience.

track · Post by **track** » Thu Nov 29, 2007 9:06 pm

If I were you I would try limiting myself to side sleeping to see if that helps. It dropped my pressure and Rooster dropped his pressure almost in half. He was at a pressure of 19 and went to 9 and I get better treatment at 10 on my side than I do at 16 on my back. It doesn't work for everyone but it works for a lot of people. For many people with apnea, sleeping on ones back is like throwing gas on a fire.

EdAPAP · Post by **EdAPAP** » Fri Nov 30, 2007 3:00 am

Thank you one and all for your replies.

Why do you think the sleep lab tech would tell me that 10-12 AHI is as good as its going to get?

ozij · Post by **ozij** » Fri Nov 30, 2007 4:15 am

[quote="EdAPAP"]Thank you one and all for your replies.

Why do you think the sleep lab tech would tell me that 10-12 AHI is as good as its going to get?

Mask

Additional Comments: Strictly a side sleeper