Does a sleep study HAVE to show AHI greater than 5 to warrant cpap use?

Pugsy wrote: ↑

Thu Feb 03, 2022 12:07 pm

zonker wrote: ↑

Thu Feb 03, 2022 11:58 am

interesting. when i click that link, it takes forever to load. then it only offers me a chance to reply, not read the thread.

Well that was weird.
I think I fixed that little boo boo.

fixed!

MMcG wrote: ↑

Thu Feb 03, 2022 8:16 am

Morbius wrote: ↑

Thu Feb 03, 2022 7:31 am

I think I'd have to look and see the raw data. You're assuming the machine is accurate, and IMO, with such few events, most oftenly it's not.

We don't know whether it was a lab or home sleep study, but it wasn't from a CPAP machine, based on what the original poster said.

No, we don't *KNOW*, and you're just ASS-U-MEing and blathering on about those assumptions.

MMcG wrote: ↑

Thu Feb 03, 2022 8:16 am

Sleep studies done in sleep labs are usually fairly conclusive and reliable to the best of my knowledge,

In lab sleep studies have false negatives often enough that we've read about them *MANY* times. False positives are rare, false negatives seem to happen fairly often.

MMcG wrote: ↑

Thu Feb 03, 2022 8:16 am

while home ones can underestimate the result (because they cannot tell for sure whether the person is awake or asleep during the period of the study).

Depends on the class of the home study, again, you're showing the limits of your knowledge.

MMcG wrote: ↑

Thu Feb 03, 2022 8:16 am

When it comes to CPAP machine results (the ones usually posted here), one has to be aware that not all machines are programmed the same way when it comes to recording and responding to events. For example, on my Devilbiss/Intellipap machine, the clinician menu allows one to redefine Hypopneas and Obstructive Apneas, both in terms of duration and percentage obstruction.

You've got a few months with ONE type of machine, and you think you've got the knowledge to HELP people...

MMcG wrote: ↑

Thu Feb 03, 2022 9:04 am

I'm done with commenting here anyway, Pugsy. So I reckon everyone will be happier. I honestly don't need the aggro. Peace.

PROMISE???

Because most yammerheads that say that don't actually do us the favor of GOING AWAY and polluting some other forum... or better yet in your case, 'so-called media' where they encourage you to spew your ignorance for the entertainment of others.

You know, a little civility costs nothing. You can tell a person you disagree with them in a polite and civilised manner without involving sarcasm or just plain unpleasantness.

Respirator99 wrote: ↑

Thu Feb 03, 2022 8:48 pm

You know, a little civility costs nothing. You can tell a person you disagree with them in a polite and civilised manner without involving sarcasm or just plain unpleasantness.

I politely disagree with you in the particular circumstances.

Dumbass newbies that know nothing but think they know everything cause trouble that has to be refuted because they mislead others.

Let them go and mislead people on facebook or somewhere else.

I say again - civility costs nothing. You can tell people they're wrong without being an arsehole about it. You should give it a try.

Then may I respectfully ask those blowing hot air, to PLEASE stop,
Before some innocent soul believes it and suffers the consequences.
Your ego is not more important than ANYBODY'S health!

Can we please get back on topic please and in case anyone has forgotten....the topic isn't the best way to correct someone without hurting someone's feelings.
If you guys want to go down that road...please start your own thread to discuss how to play with the other kids in the sandbox.

I already tried correction and being civil....didn't help....I still got the "I'm outta here" message sent to me.
Sometimes even being civil gets a person kicked in the teeth.
Some people just won't budge and don't really want to learn or look at things from someone else's perspective.
Time to cut bait and quit trying. I am done with that fishing trip.

Any other thoughts as to the original question???
Which was just how critical is that medical profession line in the sand of 5.0 AHI????
Is it set in stone from a symptomatic point of view along with the diagnosis criteria meeting thing....or is it a gray line in the sand where people really need to take a look at the much bigger overall picture before making black and white statements?

If no other constructive discussion is to be made and all we are going to talk about is how someone talks to someone...I will close out the thread and you guys can take it elsewhere and I won't be a part of it.

Thank you very much.

I've stated it many times that my *opinion* is that the 5ahi is crap.

it's 'good enough' for medical people, or insurance companies, who don't care about your health anyway.

But we've seen far too many people who had an AHI of 5, or 4, or even 3, that felt *better* when it was lower, and thus give lie to that '5 is good enough'.

Pugsy wrote:Any other thoughts as to the original question???
Which was just how critical is that medical profession line in the sand of 5.0 AHI????
Is it set in stone from a symptomatic point of view along with the diagnosis criteria meeting thing....or is it a gray line in the sand where people really need to take a look at the much bigger overall picture before making black and white statements?

In an ideal world the diagnosis would take into account a whole bunch of parameters, as you have described. AHI is just a start, and a pretty crude measure at that. We should consider the duration of apneas, clustering, central or obstructive, and so on. We should also consider the "almost apneas" that last less than 10 seconds but aren't recorded.

That's in an ideal world. But in a world where resources are limited, docs and techs are overworked and (often) under paid, and where the remedy is often paid for by a third party (insurance) we have to accept a more simplistic solution, which is AHI =>5.0. You could argue whether 5.0 is appropriate or whether it should be lower or higher. I think it is a reasonable compromise in an imperfect world.

Well I'll toss in a couple things!

Pugsy wrote: ↑

Thu Feb 03, 2022 11:15 pm

Which was just how critical is that medical profession line in the sand of 5.0 AHI????

IMO the "medical profession" as a whole, NEVER drew lines in the sand re: treatment for anything. Certainly, a good clinician wouldn't allow himself to be boxed in by insurance-driven criteria.

AHI has ALWAYS been under critical review. Even more so recently:

https://onlinelibrary.wiley.com/doi/ful ... /jsr.13066

That said, I'd really like to see some of these cases with <5.0 AHI with complete turnarounds in their lives. Were they HSTs? Self-diagnose and treat? "I feel great since starting CPAP, lowering my AHI from 3.1 to 2.5 and oh BTW stopped downing a bottle of Stoli every day!" Placebo?

So what is it that we're trying to do here anyway? Feel better? Live longer? Find something else to bitch about?

Respirator99 wrote: ↑

Fri Feb 04, 2022 1:29 am

We should consider the duration of apneas, clustering, central or obstructive, and so on. We should also consider the "almost apneas" that last less than 10 seconds but aren't recorded

Here's the problem tho, and I'm going under the ASS U ME perzumption that's it's "feeling" better" that's the goal. You aren't (and can't) measuring what you're actually trying to fix. It ain't the AHI, it's the AI (arousal index). And a few other things that relate to sleep continuity, total sleep time, sleep efficiency...

I realize tho that if the only tool in the toolbox is a hammer, then everything becomes a nail...

Morbius wrote: ↑

Fri Feb 04, 2022 4:37 am

I realize tho that if the only tool in the toolbox is a hammer, then everything becomes a nail...

There are lots of tools in the box, but many of them require too much skill or experience or time to wield. Our system in Australia (and perhaps even more so in the US) does not provide the money required to buy the time necessary to wield the more delicate tools. So the hammer - a blunt instrument like AHI - is the tool of choice.

Respirator99 wrote: ↑

Fri Feb 04, 2022 4:46 am

There are lots of tools in the box, but many of them require too much skill or experience or time to wield.

Like what?

Respirator99 wrote: ↑

Fri Feb 04, 2022 4:46 am

Our system in Australia (and perhaps even more so in the US) does not provide the money ...)

Seems to me, if something is ruining your health, it's worth ANY amount of money to get it fixed.

That said, there's plenty of ways to skin a cat (I never understood that expression. Why would one want to skin a cat anyway? Where's PETA when you need them?) that won't break the bank.