Help a Newbie out? AHI Question

When I went for my initial sleep study, they said my AHI was at 63.7. (I knew what to ask because of all of you). When I went in for my second study my AHI dropped to 19.8 treated. I was prescribed 17 cm on a CPAP. Some of you out here are seeing numbers consistently below 1. Am I untreatable to this level? Is my pressure still too low? Does it get better over time? Unfortunately I only have a Remstar Plus without all of the bells and whistles (you know the one the DME makes the most money on). With this I can only gauge my success to my level of "tiredness". What do I do? My sleep doc seemed excited with 19.8. I, however, am not.

May I ask how you are feeling? Do you think you are seeing improvement? Ideally, your AHI should be 5 or less to be considered normal (whatever that is). A pressure of 17 is pretty high already. There are a lot of things you may be able to do to improve your AHI, just read the boards for more info than you can probably digest initially. But to be hones it's going to be hard for you to know if any tweaks that you make are working except for how you feel. Without a machine capable of recording events, you'll be guessing relative to your AHI.

Hi ajraih1,

I agree with Sleepless in St Louis: "it's going to be hard for you to know if any tweaks that you make are working except for how you feel. Without a machine capable of recording events, you'll be guessing relative to your AHI."

The REMstar Plus machine you have listed in your profile, ajraih, can't give any info except "hours of use" -- just "compliance."

I can't imagine a sleep doctor being excited (pleased?) about a titration night that reduced your AHI from 63 untreated to almost 20 treated. But maybe there were other circumstances that he felt made that as good as you can get.

I'd suggest you do this -- gather up all the information you can from your sleep study. Especially graphs from the titration night. Post them on the Sleep Studies forum at apneasupport.org:
http://www.apneasupport.org/forum-4.html

Hopefully, a guy nicknamed "sleepydave" will take a look at it. You realllllly need to have graphs from the titration (sleep architecture, pressures used, etc.) - not just a summary report, although that's better than no info at all - for him to get a good idea of what went on in the titration.

sleepydave manages an accredited sleep lab and is an RPSGT, RRT. Very knowledgable guy, and very helpful. I'd definitely want him to look at a titration that did no better than leave me with an AHI of almost 20 and put me on a pressure of 17.

In the meantime, I'd ask the doctor to let me have a trial on a Respironics REMstar Auto with C-Flex.

If the doctor balked about ordering a trial on autopap, I'd just get a copy of my prescription and go online to buy myself that autopap (or the new small "M" version of the same machine - Respironics Auto with C-flex.) All that the original prescription has to say somewhere on it is the word "cpap" -- to let you buy an autopap from cpap.com.

I'd get the Encore Pro software and card reader so I could see for myself, on my own computer, how the nightly treatment was going.

[quote="ajraih1"]When I went for my initial sleep study, they said my AHI was at 63.7. (I knew what to ask because of all of you). When I went in for my second study my AHI dropped to 19.8 treated. I was prescribed 17 cm on a CPAP. Some of you out here are seeing numbers consistently below 1. Am I untreatable to this level? Is my pressure still too low? Does it get better over time? Unfortunately I only have a Remstar Plus without all of the bells and whistles (you know the one the DME makes the most money on). With this I can only gauge my success to my level of "tiredness". What do I do? My sleep doc seemed excited with 19.8. I, however, am not.

A pressure of 17 cm H2O is pretty high. For those who need that much pressure, I think Bi-PAP’s are often prescribed.

My first sleep study showed an AHI of 31. My second (titration) study, resulted in an AHI of 7.5 at 13 cm H2O. Better, but still not “normal.”

My insurance required that I first rent a CPAP to see if it produced good results before they would pay for buying one. The DME to which my doctor referred me rented me a Resmed S8 straight CPAP with humidifier. It helped, but the pressure of 13 cm was bothersome and would often wake me in the night. (I had mask issues, too, but that’s another story.)

Long story short, I soon purchased a REMstar Auto with C-flex, plus heated humidifier, from cpap.com. After some experimenting (I have the card reader and Encore Pro software), I’ve settled on a range of 10-14 cm in Auto mode, with C-flex. 10 cm is enough to eliminate most of my snoring and I find this pressure perfectly comfortable. When it gets to 13 to 14 cm, it sometimes wakes me, but I just hit the ramp button, change sleeping positions, and go back to sleep. Many nights, it doesn’t go above 11 or 12 cm and I often sleep through the night.

MyEncore shows that I’m at 10 cm almost 60% of the time, and I’m at 13 or 14 cm less than 5% of the time in the aggregate. My 90% pressure is usually under 12 cm and some nights under 11 cm. Some nights it is over 12 cm and, rarely, 13 and a fraction.

Most nights, my AHI is under 5, better than the titration study result of 7.5 at 13 cm. And because the Auto keeps the pressure at a more comfortable level most of the time, I feel I sleep better. I’m very happy with my REMstar Auto.

Wayne