Humidity and AHI

I wish there was a way for me to get a little more humidity. With it just running on '0', which I guess is the passive humidity, my AHI+FLI has been around 1.0 all week. I've been sleeping better than I can remember in years. Then I tried bumping the humidifier to '2' and my AHI went right up to 5 or so. So I went back down to a setting of '1' and my AHI went down to 1.5.

I'm also using the heated hose to deal with the rainout. I just wish there was a way to get a little more humidity without the warm feeling and also keep my AHI down. I guess it's not going to happen. I might just keep it on the passive setting and get a little humidity and just deal with the dry nose some other way.

Wulfman wrote: Each person needs to be willing to experiment with different settings (humidity, pressure, etc.) to optimize their therapy.
Doing what someone else says or does MAY or MAY NOT give you the same results......but in the process of experimenting, you might discover what works best for YOU.Den

..and this is why this forum and people like you, that come here and share
your aquired knowledge and experience, is invaluable to people like me.
I am so far ahead in my therapy, by reading and trying things that I have learned here.
Some work, some don't, but I knew of and had those options.
Who knows how many miserable nights I have been
spared by all the things I have learned here.

THANKS!!

Billmanweh - with a Fisher& Paykel stand alone HC150 Heated Humidfier you can "fine tune" your humidity better than with the integrated humidifier. It is available at cpap.com at a good price. It works with virtually all xpaps. I use one with my M Series Auto with A-Flex and it works great. Right now I am using it in passover mode because it is hot and humid in my part of Canada (Summer). It does take up a little more room but you remove your integrated humdifier and attach it to your machine with the small hose that comes with it. You need to put that little adapter piece that came separately with your machine after you remove the integrated one. Check it out on cpap.com. It might be worthwhile for you too.

carbonman wrote:

Wulfman wrote: Each person needs to be willing to experiment with different settings (humidity, pressure, etc.) to optimize their therapy.
Doing what someone else says or does MAY or MAY NOT give you the same results......but in the process of experimenting, you might discover what works best for YOU.Den

..and this is why this forum and people like you, that come here and share
your aquired knowledge and experience, is invaluable to people like me.
I am so far ahead in my therapy, by reading and trying things that I have learned here.
Some work, some don't, but I knew of and had those options.
Who knows how many miserable nights I have been
spared by all the things I have learned here.

THANKS!!

You betcha!

What makes me sad is knowing there are the "uninformed" XPAP users out there who didn't/haven't questioned why their therapy isn't working even though they obediently followed the instructions of their "medical professionals" and haven't found the support groups on the Internet. Most can't even tell you what makes/models of equipment they're using (or not using because it's in the closet or was sold in a yard sale).
It also makes me sad (actually MAD) that there are those "guests" (probably DMEs or RTs) who frequent the forum and admonish us for giving "medical" advice. Those folks are part of the problem and not the solution. If they don't like us doing this, then my advice is for them to get their segment of the industry to clean up their acts......or shut the Hell up!

I'm sure I can speak for everyone who hangs out on these forums trying to help others with getting the kinks worked out of their therapy......in what a great feeling it is for us........when those people come back and proclaim their "successes".

Best wishes,

Den

As a rule of thumb it seems as if most people using CPAP machines report that they strongly prefer or even need heated humidification. Then, it seems of the minority who have difficulty tolerating CPAP humidification, most of those exacerbate some type of nasal issues (eg. vasomotor rhinitis). And I'm also under the impression that far fewer trigger some type of reactive bronchospasm by using heated CPAP humidification.

I tried once without a humidifier and my throat got unbearably dry. But a couple times I inadvertantly used passover mode since I forgot to turn on my humidifier and didn't notice much (this was in the summer which is humid here). I never associated it with a lower AHI, but I think I'll try it.

Just out of curiousity: Is there a difference between a formal "passover humidifier" and a regular one used without heat, iow, is there somehow more surface area in the passover ones? I might like to try this in the winter to see if using a passover prevents rainout. I don't have rainout in the summer and don't even use the heated hose, just a snuggle hose cover. However in spring, fall, and winter I do use the Aussie heated hose and sometimes still get some rainout. Maybe passover mode is the way to make this better. I'd still use the heated hose, but not the heated humidifier.

Poster SWS writes...As a rule of thumb it seems as if most people using CPAP machines report that they strongly prefer or even need heated humidification. (Bolding added)

I think that there is a comforting sensation to heated humidification (the "prefer" part) that belies the actual "need" for many.

The current state of research offers conflicting opinions as to whether heated humidification is a good practice to routinely recommend, or not. Here's a paper abstract that says "nah" http://tinyurl.com/6jvgoe (There are others that are more recommending of the practice.) What is needed are some scientific studies in which a large number of (otherwise successfully optimized) xPAP subjects are given (randomly changing before each night, and blinded) levels of heated humidification (from 0-5) and the AHI and patient comfort observations recorded. A 30 day test might do it. I would prefer to see 90 days.

I suspect that many of the folks who just never seem to respond to PAP therapy (even when leaks and pressures are optimized) need to look at humidification, specifically the possibility of over-humidification.




.

It only took one night for me to know not to use the heated humidification. One reason my titration study night went so bad was because they started me out with the HH running. The first time I woke up, no air was getting through because my nasal passages were so swollen. They switched it to passover, and my sinuses slowly recovered. My house is heated with a forced hot air system, and in past years its been so dry once I started using the furnace that I've had to use a humidifier. I don't think I'm going to automatically start using the HH once I start using the furnace, though. I'll see how things go with the passover humidity and take it from there. At $5/gallon for fuel oil, I don't expect to overwork the furnace anyhow.

Marsha

I used passover (no heat) on my integrated last summer and had decent numbers, however, this summer I have generally left it on 1 (no real reason why, just kept forgetting to turn it off) and in looking back at my numbers in comparison to this summer, my AHI is lower by about .5 to .6. (on average over the past three months 0.9AHI). So for some reason I seem to prefer low heated humidification even in the summer (at least for this year, will probably change next year).

TM

Wulfman wrote:
You betcha!

What makes me sad is knowing there are the "uninformed" XPAP users out there who didn't/haven't questioned why their therapy isn't working even though they obediently followed the instructions of their "medical professionals" and haven't found the support groups on the Internet. Most can't even tell you what makes/models of equipment they're using (or not using because it's in the closet or was sold in a yard sale).
It also makes me sad (actually MAD) that there are those "guests" (probably DMEs or RTs) who frequent the forum and admonish us for giving "medical" advice. Those folks are part of the problem and not the solution. If they don't like us doing this, then my advice is for them to get their segment of the industry to clean up their acts......or shut the Hell up!

I'm sure I can speak for everyone who hangs out on these forums trying to help others with getting the kinks worked out of their therapy......in what a great feeling it is for us........when those people come back and proclaim their "successes".

Best wishes,

Den

I think that most of us are bright enough to distinguish between "medical advice" and pointers from experienced people about how to live happily with the remedy we've been given.

Were it not for the collective advice of many people who have been here before, I'm sure I would still be struggling with a setup that was not right for me at all. As it is, thirty days into the exercise, things are beginning to work out quite nicely. Many, many thanks to everyone on this forum.

Adrienne

I attended an AWAKE meeting once and the topic was CPAP humidification. The speaker was a very experienced RT and a CPAP patient. He cited a lot of research related to this . Here are some relevant things he said:
> Passive humidifiers basically don't do anything. They are not worth using. (his words, note mine!)
> Heated humidifiers have been shown to increase compliance, which is why they are commonly prescribed and insurance companies pay for them. They do not necessarily improve efficacy.
> Rainout caused by too much humidity can actually decrease delivered pressure at the mask, and therefore could, in theory, decrease efficacy.

My sleep doc says that most nasal congestion is more often caused by too little CPAP humidity, rather than too much, but of course, every patient is different.

What I take from all this is that if you do well with less humidity, or more humidity, you should go with what works for you. Unlike changes in pressure, the sleep medicine medical establishment leaves humidity completely up to the patient, as it should be.

Of course, I think the pressure thing should be that way also, and I take control of my own therapy, but that's another discussion!

carbonman wrote:

Wulfman wrote: Each person needs to be willing to experiment with different settings (humidity, pressure, etc.) to optimize their therapy.
Doing what someone else says or does MAY or MAY NOT give you the same results......but in the process of experimenting, you might discover what works best for YOU.Den

..and this is why this forum and people like you, that come here and share
your aquired knowledge and experience, is invaluable to people like me.
I am so far ahead in my therapy, by reading and trying things that I have learned here.
Some work, some don't, but I knew of and had those options.
Who knows how many miserable nights I have been
spared by all the things I have learned here.

THANKS!!

BIG DITTO!!!.. i just got back from a double appt at the VA. one with my primary & one with my rheumatologist . it baffles them to no end when i start spewing cpap jargon .....we are soo far ahead of the curve ...& yes my ahi seems to be affected by the HH . my #'s seem to be best when mochine is set to( 1).... i have some Sjogren's Syndrome to deal with. ....Tim

If you are using an auto, you may want to check the manual to be sure it is OK to use an external humidifier.

My VPAP Auto's manual warns that it is not compatible with any external humidifier. I assume it must have something to do with how it senses events and reacts to them. Either that, or it has something to do with an attempt by the company to sell more integrated humidifiers. Not sure which. Just thought I'd throw that out there.

Great discussion on humidity here, by the way. I'm with carbonman--still in awe of how much can be learned in this forum.

jnk

This thread got me to thinking -- and to finding out what the relative humidity actually is where I live. So I checked the National Weather Service web site. The night that turning down the humidifier didn't work for me, we were bumping along at our usual summer teens/low twenties for per cent relative humidity.

The last couple of days have been rainy and damp. Night before last I actually had rainout when I hadn't for a while, so last night before bed I checked the NWS web site. Sure enough, humidity around here was up in the high 80's. So I cranked the humidifier back from its usual 3 to a 1, and my nose didn't get stuffy at all, nor did I get that scratchy, dried-out feeling. Slept all night, quite well.

Looks like there's one more variable to keep up with. Not sure how I'd be handling this if I wasn't a nerd.

Adrienne

This is one of the most interesting and helpful discussions I have read in a while. I stopped using HH when the heat was turned off and the relative humidity started going up. I had severe breathing problems day and night, even went to the doctor for allergy medication. I found out that I needed passover mode and have used it every night throughout the summer. I was planning to increase to a 1 for HH when the heating season starts. But, since I am new to xpap, and after reading this thread, I am now armed with valuable info. This group is great. Hearing many of you that have a machine that supports a smart card makes me jealous. I have no idea what my AHI is.
I will keep reading and learning. Thanks for all the help.
Bill