Request for help

Hello! My name's Kim and I've been diagnosed as suffering from severe complex sleep apnea. My sleep test gave me an index of 70 pauses per hour with the longest lasting 75 seconds. I was given a Sandman Auto HC but, as I live in a non-English-speaking country, I have difficulty in understanding the significance of the information panel, particularly the event index. Since I discovered that the events were actually recorded, which only occurred some three months after I was given the machine, I've noticed that the highest reading on the panel was around 7, whereas the normal nights ranged from 0.5 to 2.5. In view of my original diagnosis can someone please tell me what kind of scale the Sandman uses so I can see whether my condition is improving, worsening or remaining constant? Many thanks for any help you can give.

I think what you are seeing is the AHI (apnea-hypopnea index).

It is the average of all breathing events PER HOUR. It is a measure of how well your therapy is doing.
Generally, the AHI number should be less than 5, and the lower the number the better the treatment.

7 is not good.
2.5 is ok, but you should try to make it lower.
.5 is very good.

Sleep apnea is not something that usually gets better or worse. You will probably need CPAP the rest of your life.

Thanks Linkc. I'm very much in the dark over here.

kimw wrote:Thanks Linkc. I'm very much in the dark over here.

To turn on the light, go to this blog, http://www.smart-sleep-apnea.blogspot.com/ , and spend much time reading and be sure to follow the many links back to cpaptalk.com. It's an excellent education that will help to empower you.

I have to disagree a little bit with the above. In general, yes, you want that number to be below 5 and lower is better, but:

I have the Sandman Auto also, and one thing I've noticed is that a very low number often happens when I feel the *worst* in the morning. I feel better when it records an AHI between 1-3 than when it records an AHI below 1. I suspect that a very low number means that it missed some apneas (perhaps because my mask had pulled away from my face and was leaking most of the night), not that there weren't any. I don't know if that is particular to the Sandman or not (I can't remember ever having had the problem with my previous machine, which was the GoodKnight 420E, the precursor to the Sandman Auto) but I wanted to mention it.

The Sandman separates your sleep into "sessions" (periods of time when the machine was running), so you might have more than one "session" per night if you turn the machine off for some reason. There should also be a reading for what time the session started and how long it lasted. Obviously the numbers in very short sessions can look much more dramatic--much higher or much lower--than in sessions that last all night.

There is also a "leak" reading that only says "OK" or "POOR" (I think the other option is "poor," I've never seen it). The leak reading means how much air pressure was lost from the mask vs. ending up in your nose/mouth. A little bit of leak is necessary for the mask to vent, but if it's too high, it's usually because the mask doesn't fit right or you've moved so it has pulled away from your face. But since the machine only calculates an average leak over the course of the night, an OK reading could either mean that you had no leaks (other than what is normal for your mask), or that you did have leaks but they weren't long enough/bad enough to make the average leak too high (especially if your mask's "normal" leak rate is very low, which is the case with mine).

7 is not good.
2.5 is ok, but you should try to make it lower.
.5 is very good.

This is an extreme generalization. Any number under 5 is considered NORMAL for an adult. Obviously, one strives for the best possible AHI, but to say" 2.5 is ok, but you should try to make it better" is far too generalized. What was the original Apnea and Hypopnea index? Are some of the events "centrals," or are they obstructive? There are so many questions in what constitutes an optimum AHI--most notably, are the events mostly Apneas (full airway obstruction), or Hypopneas (where the airway is partially obstructed)? Some folks after years of successful xpap therapy cannot get their AHI down to less than 2 or so, no matter what they do. Others will achieve AHI results close to zero. It depends on how the respiratory distress was in the first place, based on the specifics of the sleep study. Also, it depends on how the structure of sleep is presently, as opposed to pre-therapy. We all strive for the lowest AHI, but those generalizations you made are simply not accurate enough for successful therapy, without more information.

Thanks for all your help and advice. Whatever your problem it feels good to be part of a community.

I just wanted to welcome you, kimw! I'm glad you found this forum, as it is an excellent place to find information and support.

~ DreamOn

kimw wrote:Thanks for all your help and advice. Whatever your problem it feels good to be part of a community.

If you are going to hang around, you need to register as a member and fill out your equipment profile in text not images.

It is not necessary to reveal any other personal information.