Sleepy study AHI vs ODI

DizzyAmoeba · Post by **DizzyAmoeba** » Sun Jun 09, 2019 3:38 pm

I wonder if anyone can help me as I am getting a bit desperate!
For background, I am a reasonably healthy 38yr old male with a BMI of 28.
I strongly suspect I have sleep apnea, as I have many symptoms (loud snoring, pauses in breathing in sleep, tired all the time, unrefreshing sleep etc. etc.) and have been checked for thryroid problems and so on. After waiting five months (NHS delays unfortunately) I had a home sleep study and an appointment with a consultant. He told me that my sleep study was normal, and I "shouldn't let the snoring worry me". He said a AHI of 8 had been recorded and this was fine, not a problem, no treatment needed.
However, using a recording pulse oximeter at home I have an Oxygen Desaturation Index of 20.6. This is constantly over 20 many nights of my own testing, sometimes as high as 27.
One of my typical charts is here : https://imgur.com/a/jbWfcGM
Whats going on here? I am very tired (epworth scale score of 15) and I don't feel the SP02 results are normal given that my SP02 is 98-99% during the day!
Any ideas or hints?
Specifically, I don't understand how my ODI is so different to the doc's measured AHI...

zoocrewphoto · Post by **zoocrewphoto** » Sun Jun 09, 2019 3:54 pm

An ahi of 8 is considered mild, and many insurance companies will not pay for treatment unless there are other health issues. It sounds like teh NHS is similar. Most people don't feel good unless it is less than 2, so so most of us here will recommend treatment. You are just stuck paying for it yourself.

As for the ODI, it looks like most of your events fall into the 90-94%, which would be noted in a sleep study, but probably not counted for apnea events. I believe they count thembelow 92 or 88. I can't remember. So, it looks like you are suffering from sleep apnea, but you are just on the wrong side of getting it officially treated.

I would like for an apap machine. The best one is the Resmed Airsense Autoset for her. It has a few different modes, and we can help you with some settings to start and then dial it better once we see data. Other people will post their ideas as well. And those local toyou cangive you options of where to buy a new or lightly used machine at a decent price.

palerider · Post by **palerider** » Sun Jun 09, 2019 4:10 pm

DizzyAmoeba wrote: ↑
Sun Jun 09, 2019 3:38 pm
Specifically, I don't understand how my ODI is so different to the doc's measured AHI...

Because there's no correlation between the two.

You can have a fairly low AHI and severe ODI, or, conversely, a bad AHI and insignificant ODI.

All depends on how quickly your body arouses and starts breathing again.

Jas_williams · Post by **Jas_williams** » Mon Jun 10, 2019 12:59 am

DizzyAmoeba wrote: ↑
Sun Jun 09, 2019 3:38 pm
I wonder if anyone can help me as I am getting a bit desperate!
For background, I am a reasonably healthy 38yr old male with a BMI of 28.
I strongly suspect I have sleep apnea, as I have many symptoms (loud snoring, pauses in breathing in sleep, tired all the time, unrefreshing sleep etc. etc.) and have been checked for thryroid problems and so on. After waiting five months (NHS delays unfortunately) I had a home sleep study and an appointment with a consultant. He told me that my sleep study was normal, and I "shouldn't let the snoring worry me". He said a AHI of 8 had been recorded and this was fine, not a problem, no treatment needed.
However, using a recording pulse oximeter at home I have an Oxygen Desaturation Index of 20.6. This is constantly over 20 many nights of my own testing, sometimes as high as 27.
One of my typical charts is here : https://imgur.com/a/jbWfcGM
Whats going on here? I am very tired (epworth scale score of 15) and I don't feel the SP02 results are normal given that my SP02 is 98-99% during the day!
Any ideas or hints?
Specifically, I don't understand how my ODI is so different to the doc's measured AHI...

With your graph there were no significant desaturation (less than 89) that is more important than the fluctuations in your graph. Typically the NHS won’t treat an AHI of less than 10

DizzyAmoeba · Post by **DizzyAmoeba** » Mon Jun 10, 2019 2:39 am

Aren't the fluctuations though a sign of disturbance in sleep though? I agree a lower desaturation would be even worse, but it I certainly have very disturbed sleep and resulting tiredness.

I have also found some research that suggests AHI and ODI are closely correlated (https://erj.ersjournals.com/content/24/6/987 : "A good correlation was found between the apnoea–hypopnoea index and the ODI").

Since I have an ODI of around 20 (tested with two different devices across several nights) I suspect the sleep study AHI is incorrectly low. Possibly because in general my greatest disturbances are in the final 2hrs of sleep and I only slept around 6 of my normal 8 during the test due to the discomfort of the equipment.

Has anyone seen this sort of thing before? Or am I barking up the wrong tree entirely?

Julie · Post by **Julie** » Mon Jun 10, 2019 4:21 am

You cited one study, from 2004, where the conclusion (of your theory) is all about 'maybe' if read carefully. If you look hard enough, you can probably find lots of research to back up anything you come up with re any med or psych issue out there... and one 15 yr old study just doesn't prove anything... doesn't mean there aren't some good thoughts in it, but I wouldn't base your present medical treatment around it.

Miss Emerita · Post by **Miss Emerita** » Mon Jun 10, 2019 9:11 am

Dizzyamoeba, best not to get too hung up on correlation between AHI and O2 data. You have an abnormal AHI, and you are experiencing symptoms that need to be addressed. Even without desaturations, obstructive events may be trashing your sleep architecture and your ability to sustain restful sleep.

Under my health plan, anything over 5 would result in coverage of treatment. I’m sorry the same is not true for you.

As zoocrewphoto suggests, your next step would be to buy a machine. I think many people would agree with his recommendation of which machine to get.

DizzyAmoeba · Post by **DizzyAmoeba** » Mon Jun 10, 2019 9:29 am

Thank you all for your advice, I will get a machine and sort this problem out!

Jas_williams · Post by **Jas_williams** » Mon Jun 10, 2019 11:57 am

DizzyAmoeba wrote: ↑
Mon Jun 10, 2019 9:29 am
Thank you all for your advice, I will get a machine and sort this problem out!

If your interested I have a US imported Resmed Autoset 10 availiable with only 209 hrs I would want £200 + Postage PM if you want to follow this up.

Jason

Diamon98 · Post by **Diamon98** » Sat Apr 25, 2020 10:26 am

Hi there,

Im a third year respiratory and sleep physiologist studying in the UK. There is a possibility in which your OSA could be positional and the night you performed the sleep study you had slept in the correct position therefore making your sleep study appear normal in that case. So possibly you could bring this up.

Isaac

zonker · Post by **zonker** » Sat Apr 25, 2020 11:06 am

Diamon98 wrote: ↑
Sat Apr 25, 2020 10:26 am
Hi there,

Im a third year respiratory and sleep physiologist studying in the UK. There is a possibility in which your OSA could be positional and the night you performed the sleep study you had slept in the correct position therefore making your sleep study appear normal in that case. So possibly you could bring this up.

Isaac

welcome to the forum. pls be advised you are responding to someone who hasn't been logged in here for almost a year.

Sleepy study AHI vs ODI

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