I saw my DME yesterday and we discussed my 1st sleep study and then my 2nd (titration) study. My AHI was 5.5 which she said is very mild and that I should investigate other avenues for treating my OSA. She seemed to be implying that a CPAP was "overkill" in my case. I've been reading other posts and am wondering if she's crazy. I would love to have an AHI of 0....I think we all would but now I'm wondering if just being under 5 is good enough. I certainly don't feel well rested yet. I also asked her about an APAP but she didn't think it was necessary in my case.
Somebody mentioned RLS (restless leg syndrome I presume)..I've been meaning to ask about this. In my 1st study, I was recorded as having 145 leg movements and the Dr. recommended taking medicine for this IF I didn't feel well rested with the CPAP. I really don't want to take any more medication...I take enough already. So, does anybody else out there move their legs too much. Are you taking medication for it? Also, any opinions out there on whether I should be doing CPAP with an AHI of 5.5.
Thanks! Amy
A couple of questions...AHI and RLS
Shoot, I'd kill for an AHI of 5. My current is 57 without CPAP, and around 5 with. Are you still feeling tired? I would say with such a low AHI, that you shouldn't feel that tired from apneas, but other possible causes. I'm no expert by any means, and you may want to ask or PM Rested Gal. (She is the unofficial CPAP God of the internet).
Sleep: Did I ever know you?
Soccer: The beautiful game.
2006 Advertising Graduate: Any1 got a job?!
Soccer: The beautiful game.
2006 Advertising Graduate: Any1 got a job?!
Hi all,
My AHI was only 12 and my sleep doctor says that is borderline. He put me on CPAP to help other health issues.
I have had RLS while awake for over 30 years. On my titration study I was found to have periodic leg movements while asleep. During a 5 hour period I had 100 leg movements, and 36 of those WOKE ME UP! I had been aware of frequent awakenings but had no idea it was due to leg movements.
I was put on Mirapex, and have not had any RLS while awake since the very first night. I gradually titrated up to 0.5 mg and am awakening less. It's difficult to tell what awakenings are due to turning with the stupid hose, or if it is from the leg movements. So in my case the jury is still out! If you are not rested but have an AHI that is low, you might consider taking the MIrapex or Requip for the RLS. That could make all the difference in the world for your sleep. Good luck!
My AHI was only 12 and my sleep doctor says that is borderline. He put me on CPAP to help other health issues.
I have had RLS while awake for over 30 years. On my titration study I was found to have periodic leg movements while asleep. During a 5 hour period I had 100 leg movements, and 36 of those WOKE ME UP! I had been aware of frequent awakenings but had no idea it was due to leg movements.
I was put on Mirapex, and have not had any RLS while awake since the very first night. I gradually titrated up to 0.5 mg and am awakening less. It's difficult to tell what awakenings are due to turning with the stupid hose, or if it is from the leg movements. So in my case the jury is still out! If you are not rested but have an AHI that is low, you might consider taking the MIrapex or Requip for the RLS. That could make all the difference in the world for your sleep. Good luck!
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I am EXHAUSTED!!! No matter how many hours I "sleep" I'm always exhausted. It's really interferring with my ability to function during the day. There are times when I'm afraid to drive my car because I'm so tired and I don't trust my judgement. I guess I better give my doctor a call....should I continue using the cpap?
Thanks! Amy
Thanks! Amy
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sir_cumference
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My OSA was also considered mild/borderline and yet because symptomatically I was a wreck - they tried APAP titration to see if it would work - and the difference it made was beyond my wildest imagination.
The expert who fixed me up (not the numpty who's in charge of giving me a machine etc.) told me that when someone is mild the deciding factor for him is symptoms, because he has found that there are people with really bad OSA who seem to have little or no symptoms, and there are people who seem to have very mild OSA, whose symptoms are so bad they ruin their lives!
As for being restless (leg and otherwise) I have two observations in my experience.
1) When on APAP and getting exactly what my body needs when I need it my restlessness overall vanished! Instead of always turing over and moving about and never being comfortable, I lay so still that my wife started prodding me to make sure I was still alive!!
2) I also suffer from IBS, and if I am not very careful with my diet, I become disturbed because my tummy is uncomfortable. This in turn means I move around a lot, and then have problems with my mask. The best thing to do in this case is take something to settle your tummy, sit up out of bed for half an hour and then go back - after that I sleep really well again.
The reason I mention APAP is that when I was put on CPAP I had two problems. Firstly, they accidently set the pressure to high and although I had few symptoms, I swallowed air and got very uncomftable!! And then, when they set the pressure at what they said was 95% of my max. all my symptoms returned very quickly. I needed APAP because I am so sensitive to the problems of OSA and it keeps me symptomatically free.
I hope this helps. Maybe one, or a few night on an APAP will help you find out if its what you really need. I paid to have my study etc done privately and to be honest, that was the best decision I could have made as they were far less concerned about cost, and far more concerned about treatment.
sir_cumference
The expert who fixed me up (not the numpty who's in charge of giving me a machine etc.) told me that when someone is mild the deciding factor for him is symptoms, because he has found that there are people with really bad OSA who seem to have little or no symptoms, and there are people who seem to have very mild OSA, whose symptoms are so bad they ruin their lives!
As for being restless (leg and otherwise) I have two observations in my experience.
1) When on APAP and getting exactly what my body needs when I need it my restlessness overall vanished! Instead of always turing over and moving about and never being comfortable, I lay so still that my wife started prodding me to make sure I was still alive!!
2) I also suffer from IBS, and if I am not very careful with my diet, I become disturbed because my tummy is uncomfortable. This in turn means I move around a lot, and then have problems with my mask. The best thing to do in this case is take something to settle your tummy, sit up out of bed for half an hour and then go back - after that I sleep really well again.
The reason I mention APAP is that when I was put on CPAP I had two problems. Firstly, they accidently set the pressure to high and although I had few symptoms, I swallowed air and got very uncomftable!! And then, when they set the pressure at what they said was 95% of my max. all my symptoms returned very quickly. I needed APAP because I am so sensitive to the problems of OSA and it keeps me symptomatically free.
I hope this helps. Maybe one, or a few night on an APAP will help you find out if its what you really need. I paid to have my study etc done privately and to be honest, that was the best decision I could have made as they were far less concerned about cost, and far more concerned about treatment.
sir_cumference
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littlebaddow
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Re: A couple of questions...AHI and RLS
I can't comment on RLS and I'm not a doc, but I do think an AHI of 5.5 is worth treating.yawn wrote:My AHI was 5.5 which she said is very mild and that I should investigate other avenues for treating my OSA. She seemed to be implying that a CPAP was "overkill" in my case.
I've been using an APAP successfully for 7 months and have used 2 different types of mask (well, technically one is a mask and the other nasal pillow).
With one (mirage vista) I get an average AHI of 1.2 and with the other (breeze) an average of 3.5
In theory, both are acceptable scores and suggest that I am being treated successfully. However, I do notice the difference. If I use the breeze for more than a few days, i start to feel tired again. Not the brain fog of pre-treatment days, but noticably more tired.
I find the breeze more comfortable to sleep in and I therefore switch between the 2 every few days.
IMHO an AHI of 5.5 is well worth treating with APAP.
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Airsense 10 & Airfit N20
That makes sense to me. I am really really tired and can't fully function because of it. I'm very willing to try treating the OSA (even though it's clinically considered 'mild) to alleviate my exhaustion. I tried a new mask (Activa) the last 2 nights and I probably slept better than my previous efforts with other masks (I'm still new to this). Even with the "better" sleep, I'm still exhausted and fuzzy headed. Littlebaddow mentioned his AHI is better when he uses his "mirage vista" vs. his "breeze". I never thought a mask could make such a difference. My DME wasn't encouraging about using an APAP so I'm wondering how I can find out what my statistics are with different masks if I don't have access to an APAP. Do I just wait and see if I start feeling better?sir_cumference wrote:
The expert who fixed me up (not the numpty who's in charge of giving me a machine etc.) told me that when someone is mild the deciding factor for him is symptoms, because he has found that there are people with really bad OSA who seem to have little or no symptoms, and there are people who seem to have very mild OSA, whose symptoms are so bad they ruin their lives!
Thanks..Amy
Yawn....you make me tired just reading your name...
You sound so confused.
I have been on cpap for about 50 days now and I still feel tired and sometimes fall asleep if I relax during the day....but I am sleeping better ( but not all the time...I just had three bad nights ) and I still have hope that someday I will have that full of energy feeling. I haven't sleep for about 20 years ( since in my 20's) so I don't think I can expect to feel perfect after only 50 days. I know it will take time and I will not give up. It can be very frustrating because I still have good days and bad but I always have hope and know someday I will get there. Keep trying...it will get better.
You sound so confused.
I have been on cpap for about 50 days now and I still feel tired and sometimes fall asleep if I relax during the day....but I am sleeping better ( but not all the time...I just had three bad nights ) and I still have hope that someday I will have that full of energy feeling. I haven't sleep for about 20 years ( since in my 20's) so I don't think I can expect to feel perfect after only 50 days. I know it will take time and I will not give up. It can be very frustrating because I still have good days and bad but I always have hope and know someday I will get there. Keep trying...it will get better.
*** Linda ***
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Guest
Dear Yawn
The only way I know of to get the information you need is by using APAP. I use a Resmed autoset spirit and I look at my AHI every day, and what I have noticed is that it varies night to night. Sometimes I have almost nothing sometimes it's up in the 4 - 5 region.
Is there any way you can hire an APAP for a period of time? At the very least you can use it to see which masks work best for you, and to see if it really meets your needs.
CPAP really didn't work for me and actually set me back a long way, whereas APAP responds to all my needs.
Having said all that, all types of PAP no matter how well adjusted will disturb you at times. Either its the masks leaking, or its the hose getting in the way, or your skin itches under the mask, or the noise bothers you or ... I believe that on xPAP you need to consider it as managing your health, not as a cure. You will always have OSA, and it will always need treating and xPAP is the best way to do that - even if at time is can be a real pain.
If you can't hire an APAP, then maybe you ought to ask about having the pressure raised a little until you feel you are getting some real symptom relief. Depending on what machine you have, I'm sure there would be plenty of people on this site who could tell you how to do it yourself.
Hope this helps
sir_cumferenc
The only way I know of to get the information you need is by using APAP. I use a Resmed autoset spirit and I look at my AHI every day, and what I have noticed is that it varies night to night. Sometimes I have almost nothing sometimes it's up in the 4 - 5 region.
Is there any way you can hire an APAP for a period of time? At the very least you can use it to see which masks work best for you, and to see if it really meets your needs.
CPAP really didn't work for me and actually set me back a long way, whereas APAP responds to all my needs.
Having said all that, all types of PAP no matter how well adjusted will disturb you at times. Either its the masks leaking, or its the hose getting in the way, or your skin itches under the mask, or the noise bothers you or ... I believe that on xPAP you need to consider it as managing your health, not as a cure. You will always have OSA, and it will always need treating and xPAP is the best way to do that - even if at time is can be a real pain.
If you can't hire an APAP, then maybe you ought to ask about having the pressure raised a little until you feel you are getting some real symptom relief. Depending on what machine you have, I'm sure there would be plenty of people on this site who could tell you how to do it yourself.
Hope this helps
sir_cumferenc
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sir_cumference
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Hi Lindas88s
I couldn't help giggling when I saw your comment about my name "yawn". I tried to pick a name that was unique and appropriate but I think maybe I should have picked something more "positive". ...I'll give it some thought.
In the meantime, after reading so many posts, I'm finding that there is no such thing as a "quick fix" for OSA and that's tough to get used to. This is a world where "instant gratification" is often the case. I guess I'll have to work on my "patience" (I used to pray for more patience when my kids were little...guess I should start that up again).
Thanks...Amy
I couldn't help giggling when I saw your comment about my name "yawn". I tried to pick a name that was unique and appropriate but I think maybe I should have picked something more "positive". ...I'll give it some thought.
In the meantime, after reading so many posts, I'm finding that there is no such thing as a "quick fix" for OSA and that's tough to get used to. This is a world where "instant gratification" is often the case. I guess I'll have to work on my "patience" (I used to pray for more patience when my kids were little...guess I should start that up again).
Thanks...Amy
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sir_cumference
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- Joined: Wed Jun 29, 2005 10:47 am
- Location: UK
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rested gal
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Sir_C, I think the expert who told you the symptoms are more important to consider than the AHI itself, is absolutely right.
THE APNEA-HYPOPNEA INDEX: USEFUL OR USELESS?
That link was posted first by -SWS (I think), then by ozij. Very interesting take on how much (or more to the point, how little) we should rely on the "AHI" to indicate whether we should be treated or not.
Dr. Colin Sullivan is one of the pioneers of cpap treatment. He thinks the AHI is not a good indicator to determine if a person should receive cpap treatment or not. I (just a layperson) agree.
As a side note, I also feel that when looking at our autopap data, we should not get all hung up on what the AHI is for any given night. It's easy to get like a dog chasing its tail if we start doing a lot of instant tweaking just because our AHI goes up or down a few points from night to night.
The mask being used can affect what the machine senses. So, again, I wouldn't worry about one mask putting a few more tick marks on the graph than another -- especially regarding hypopneas and limited flows, which can vary a good bit depending on which mask is being used. While the machine is marking what it senses, that doesn't mean the "marks" really reflect what was happening in your breathing in every instance. Could be simply what the machine sensed in the air flow from the type of mask being used....not really what was going on in our breathing every time.
I guess bottom line for me is that if I feel the same in the morning with a higher AHI using mask A, as I do with a lower AHI using mask B, I'm going to wear whichever mask is more comfortable regardless of extra tick marks giving a slightly higher AHI. As long as the AHI is decent, I'm not going to worry about one mask producing a higher AHI on the data than another mask. What matters to me is which mask I can sleep with more comfortably.
I figure the AHI we see on our overnight data might or might not be accurate when it comes to hypopneas. Those can be tricky little rascals to tote up anyway. Even the sleep professionals have differing definitions for what "counts" as an hypopnea.
THE APNEA-HYPOPNEA INDEX: USEFUL OR USELESS?
That link was posted first by -SWS (I think), then by ozij. Very interesting take on how much (or more to the point, how little) we should rely on the "AHI" to indicate whether we should be treated or not.
Dr. Colin Sullivan is one of the pioneers of cpap treatment. He thinks the AHI is not a good indicator to determine if a person should receive cpap treatment or not. I (just a layperson) agree.
As a side note, I also feel that when looking at our autopap data, we should not get all hung up on what the AHI is for any given night. It's easy to get like a dog chasing its tail if we start doing a lot of instant tweaking just because our AHI goes up or down a few points from night to night.
The mask being used can affect what the machine senses. So, again, I wouldn't worry about one mask putting a few more tick marks on the graph than another -- especially regarding hypopneas and limited flows, which can vary a good bit depending on which mask is being used. While the machine is marking what it senses, that doesn't mean the "marks" really reflect what was happening in your breathing in every instance. Could be simply what the machine sensed in the air flow from the type of mask being used....not really what was going on in our breathing every time.
I guess bottom line for me is that if I feel the same in the morning with a higher AHI using mask A, as I do with a lower AHI using mask B, I'm going to wear whichever mask is more comfortable regardless of extra tick marks giving a slightly higher AHI. As long as the AHI is decent, I'm not going to worry about one mask producing a higher AHI on the data than another mask. What matters to me is which mask I can sleep with more comfortably.
I figure the AHI we see on our overnight data might or might not be accurate when it comes to hypopneas. Those can be tricky little rascals to tote up anyway. Even the sleep professionals have differing definitions for what "counts" as an hypopnea.