Averages and Index

breathright · Post by **breathright** » Sat Nov 24, 2007 1:36 pm

I have the Encore Pro software and I'm looking for ranges for the diffrent reports. Understand 0:0 is preferd but what should the goal be eg. average Apeneas should be less than < 3.9 etc.

EdAPAP · Post by **EdAPAP** » Sat Nov 24, 2007 1:56 pm

You are correct - <5 is acceptable. Many are able to get well below that using Encore software. What was your AHI during your sleep test?

mindy · Post by **mindy** » Sat Nov 24, 2007 2:07 pm

breathright wrote:I have the Encore Pro software and I'm looking for ranges for the diffrent reports. Understand 0:0 is preferd but what should the goal be eg. average Apeneas should be less than < 3.9 etc.

Hi breathright,

I gather that there are somewhat differing opinions on the desirability of AHI being 0. Since it's only as accurate as the machine can measure and that's not likely to be perfect, I've been told that anything <5 is the goal. That said, some say they feel better at a lower AHI, some don't. I don't know if it depends on whether the events are many in a short period of time Vs. the same number spread out over 8 hours. In any case, if you're under 5, I would go by how you feel.

Mindy

breathright · Post by **breathright** » Sat Nov 24, 2007 3:06 pm

EdAPAP and Mindy Thanks for your reply. During the test I was at 21.1.

I'm trying diffrent pressures and I'm kind of looking for a sweet spot, I do not want to spend too much effort trying to tweak it if I'm within a good range.

EdAPAP · Post by **EdAPAP** » Sat Nov 24, 2007 3:14 pm

You are doing great. I hope that my last pressure increae will get mine down to an acceptable range.

sleepie · Post by **sleepie** » Mon Nov 26, 2007 10:29 am

hi breathright,

i too have asked this question--because i struggle with the fact that all the indexes need to be zero---i'm sure there is room for each index --where you are getting the best therapy---the less than 5 for ahi --is all thats out there----so now ,,i use how i feel---although ,,i don't think this is the way to go---i will keep searching untill i get the answers to the other indexes,,,if you find them first please let me know----thanks pat

Guest · Post by **Guest** » Mon Nov 26, 2007 1:04 pm

Sleepie, Thanks for your reply and if I get an answer I'll let you know.

What I plan to do is to go a week and review my events/averages, then I'm going to adjust pressure both up and down for a week at a time to see if I can get lower results. Of course how I feel and sleep will be the real test. I've gone from moderate (sleep study) to mild I would just like to get as close to perfect as possible.

rested gal · Post by **rested gal** » Tue Nov 27, 2007 4:30 am

sleepie wrote:hi breathright,

i too have asked this question--because i struggle with the fact that all the indexes need to be zero---i'm sure there is room for each index --where you are getting the best therapy

The indices don't need to all be zero. It's normal for people without OSA to have a few "events" (obstructive apneas/hypopneas -- and yes, even central apneas) while they sleep. A few events. That means few enough to result in an AHI less than 5.0. So, if treatment gives us an AHI less than 5.0, we're doing fine. Doesn't have to hit zero at all to get restful, refreshing sleep.

The leak rate index depends on what brand of machine a person is using, what mask, what pressure. Generally speaking, a leak rate that doesn't exceed 40 L/m (liters per minute) is ok with a Respironics machine at the pressures most people are prescribed.

There is never a "zero" leak rate with a Respironics machine because the leak rate will always include the normal vent exhaust air flow from the mask. You can look at the vent flow rate on the package insert of your mask to see what is normal leak at various pressures for that mask.

Leak rate should not exceed 0.4 L/s (liters per second) with a resmed machine, and a zero leak rate is obtainable on those machines since the mask leak rate is already calculated in.

That's a start for the two most important (imho) indices to take notice of on software data. AHI and leak.

sleepie · Post by **sleepie** » Tue Nov 27, 2007 7:52 am

breathright,,,, rested is absolutly right--ahi less than 5---as far as leaks,, if rested is right than 24lpm over your mask leak rate for respironics machine is the play----this is info to me --so if my mask has a leak rate of 30 then in encore pro as long as its 54 or less then i'm good--this is what i was looking for---now there are many other indexes in encore pro that we need to have the "within good therapy" numbers---lets keep looking--looks like leaks are solved-----pat

mindy · Post by **mindy** » Tue Nov 27, 2007 8:00 am

For Respironics (leak rate not adjusted), I was told that in general, leak rate in the 30's and 40's if fine; if it gets into the 80's and 90's that's not good.

Unless leak rates get high, machine adjusts for leak rates.

Since I've quit stressing about leak rates, I'm sleeping much better. The main leaks that bother me now are leaking into eyes and large leaks.

Mindy

track · Post by **track** » Tue Nov 27, 2007 11:26 am

I think a person has to be careful on evaluating AHI. From my limited experience an AHI of 4.9 with 4.9 AI lasting an average of 40+ seconds each is not giving you very effective treatment. On the other hand an AHI of 7 with all the apnea events being hypoapneas, would seem to be a much better treatment....especially if the machine doing the recording is a resmed.

gasp · Post by **gasp** » Tue Nov 27, 2007 1:58 pm

I was happy with under 5.0 as my RT said this was my goal. Then I saw people posting that they were able to get their numbers much lower.

I changed masks, added Pur Sleep scents that worked for me to rest peacefully, changed my pressure range, tweaked my headgear, and I now have an AHI regularly under 1.

The lower number is only meaningful to me if I feel more rested. I can tell little difference in how rested I feel in the 0-3ish range, but as the AHI average reaches near and over 5 I can tell I do not feel as rested.

More or at least as important, are the reports I get from Encore Pro Analyzer by James Skinner. I keep watch on my trend. I can tell over time if my mask, pressure, etc is right.
-----------------------
Here is my trend (average) over 30 days/6 months

Average Minutes in Apnea: 1.8/2.7
Average Seconds of Apnea Duration: 17.9/12.6
Average Apneas: 9.6/15.6
Average Hypopneas: 13.9/17.5
-------------------------
We can see that all has improved except the number of seconds of apnea duration which declined by 5.3. So, I look at the reports to see when the average seconds of apnea duration increased.
1 week: 10.9 seconds
2 weeks: 15.3 seconds
3 weeks: 19.1 seconds
1 month: 17.9 seconds
2 months: 13.9 seconds
3 months: 13.1 seconds
6 months: 12.6 seconds

By this, I see that the past week shows my time in apnea is lower than in the past 6 months and that 2 to 4 weeks ago when my asthma was bad, my average time in apnea was increased. That makes sense so I will change nothing in my current set up.

Hope this makes sense and helps.

rested gal · Post by **rested gal** » Tue Nov 27, 2007 2:06 pm

track wrote:I think a person has to be careful on evaluating AHI. From my limited experience an AHI of 4.9 with 4.9 AI lasting an average of 40+ seconds each is not giving you very effective treatment. On the other hand an AHI of 7 with all the apnea events being hypoapneas, would seem to be a much better treatment....especially if the machine doing the recording is a resmed.

Good point, track.

The original poster is using Encore Pro software, which means using a Respironics machine, so my comments were about only that brand of machine's index reports regarding "AHI."

I agree that resmed machines do report higher hypopnea numbers than the other brands of machines I've used. Or did for me, anyway..about double on the hypopnea index, yet my treatment results (feeling well rested) were the same using any of the three major brands.

track · Post by **track** » Tue Nov 27, 2007 2:36 pm

Thanks rested gal.....another thing I have learned from my software. Not alll AHI are equal even if the numbers are equal. Sleeping on my back versus side might give me the same AHI on a particularly good night on the back but generally speaking the length of the AI on my back is going to be double the length or more in duration. Therefore my time in apnea while on my back can be double what it is on my side, even with the same AHI. It's important to know the duration as well as the frequency of your apneas.

mindy · Post by **mindy** » Tue Nov 27, 2007 5:10 pm

Agreed, Track!

That also speaks to the issue of relying too much on numbers. These machines are not perfect in identifying apneas vs. hypopneas and other measures. There is always some amount of error in measurement and it is probably higher for these home machines than for sleep lab equipment.

I'm learning more and more that how I feel is what matters. Large leaks or increasing leaks matter, the pattern of apneas and hypopneas may matter, as you noted the length could certainly make a big difference in oxygen saturation, and so on.

So I look at the data about once a week to make sure things are staying in a reasonable range. I'm feeling so much better than before that I'm very grateful!

Mindy

Mask	Humidifier

Additional Comments: Pursleep, Padacheek, Regenesis™ Pillow, Neti Pot, Travel Buddy hose hanger

Machine	Mask

Machine	Mask

Averages and Index

Averages and Index

Re: Averages and Index