Improving AHI

Hey folks, I'm struggling to get my AHI any lower.despite being a pretty good healthcare area, it's really difficult to get in to see a sleep physician. My initial sleep tests had AHI = 102, ~45, and ~35. I do feel much better, but I think there is a lot of room to improve.
[*]Central apneas seem to dominate most nights.
[*]I have played around with different pressure settings. That can be seen in the final image.
[*]I do use a CPAP pillow which greatly reduced my leaks.

I would really appreciate any insights that anyone has. I can send more data if requested. I have about 100 days of therapy.

https://imgur.com/a/h2Y6P0A

If it's no too much trouble,
What do you mean by 102, -45, -35 ? I'm not understanding the minus numbers. What are they in reference to?

Also, Could you take screen shot of your Statistics tab from Oscar so you can see what your average AHI, OAI, HI and CAI has been over a longer period of time (like a week or 30 days), ASSUMING that you've been using the PAP daily.

BTW, many people would be jealous of a 2.0 AHI.

If you are not getting good rest with an 2.0 AHI, perhaps you need to examine other factors, but overall, a reduction from 102 to 2.0 is fantastic.

They are not minuses. The are the about symbol. The imgur link does already contain the statistics in the last two slides. I'm looking to address why my CA is still sometimes 4x my OSA. The trend has been downward for each parameter. In fact, in a statistically significant manner. I'm a researcher, so I can assess that the data are trending, just not how to interpret these trends---not my field. Thanks for taking a look!

Welcome! Could you let us know what the "45" and "35" refer to? Also, in your sleep study, what was the breakdown of events into obstructive apnea, hypopnea, and central apnea?

In general, the zoomed-in views show arousal breathing, which is deeper and messier-looking that regular asleep breathing. It isn't uncommon for that deeper arousal breathing to be followed by a pause in breathing, and if the pause is 10 seconds or more, it's scored as a CA, whether you're fast asleep or partly or fully awake. The issue that's probably of the most concern is the arousal rather than the CA itself.

CAs can be highly variable from one night to the next, so you want to focus less on the occasional uptick and more on overall trend lines.

I would suggest that you turn the ramp off or at least set the ramp pressure at your minimum.

Your pressures go up and down in response not just to OAs and Hs but also in response to flow limitations and snores. Do you have a stuffy nose? I ask because I'm curious whether your FLs originate in your nose or further down in your airway.

It may help you get more restful sleep if you follow these guidelines. I thought they didn't really apply to me until, out of desperation, I tried following them. They do help.

• Keep a consistent sleep schedule. Get up at the same time every day, even on weekends or during vacations.
• Set a bedtime that is early enough for you to get at least 7 hours of sleep.
• Don’t go to bed unless you are sleepy.
• If you don’t fall asleep after 20 minutes, get out of bed.
• Establish a relaxing bedtime routine.
• Use your bed only for sleep and sex.
• Make your bedroom quiet and relaxing. Keep the room at a comfortable, cool temperature.
• Limit exposure to bright light in the evenings.
• Turn off electronic devices at least 30 minutes before bedtime.
• Don’t eat a large meal before bedtime. If you are hungry at night, eat a light, healthy snack.
• Exercise regularly and maintain a healthy diet.
• Avoid consuming caffeine in the late afternoon or evening.
• Avoid consuming alcohol before bedtime.
• Reduce your fluid intake before bedtime.

AH, the math "similar to" which is also (incorrectly) the tilde- Thanks

So, you've had three sleep studies, am I understanding that correctly? What happened (if anything) between the 102 and the 45 & 35, (that is a rather dramatic drop) ?

Your AHI trends are more easily viewed in a screen shot of the OSCAR Overview tab.*
I agree with Miss E, that Clear airway events are highly variable night-to-night, so in that regard a bigger picture view is prudent. And more so, that a great many non-respiratory factors can result in clear airway events.

(BTW, is the imgur link you sent a composite of three separate images? It is very difficult to read the numbers, because it is so blurry. If so, one screenshot per imgur link would be much clearer -Thanks)

* as you are a researcher, you may want consider exporting OSCAR data to a CSV file, enabling you to graph CA events or Obstructive events versus time (by date)

Hey folks, it's awesome to get some feedback. Yeah, three sleep studies=three AHI values. The 102 was without any sleep aids and the other two were with drugs. I do have sinus issues and septal issues. I take pseudoephedrine most nights, wear a breath right strip and neti 2xdaily everyday. These issue require surgical improvement, however, I can't convince my insurance to handle it. I wonder if there's a way to use this data to imply that the airway issues are due to nasal flow limitations and encourage them to cover it. I will attach imgur images one by one in an additional reply. I have downloaded the csv, that's the dataset I have been using for stats.

Ah yes, the insurance company !
They won't accept your physician's assertion of medical necessity, or are you trying to develop data for your physician that will establish (in his records) medical necessity?

Insurance argues the surgery request lies too much in favor of improvement in quantity of life vs medical necessity.

Toxinman7791! wrote: ↑

Thu Jul 27, 2023 8:50 pm

Insurance argues the surgery request lies too much in favor of improvement in quantity of life vs medical necessity.

Buggers ! They are arguing that you shouldn't live so long !