Why do numbers go up when pressure does?

Ok...so when I had my sleep study and got my machine, I was told to set it at 9.0.
After a few weeks of sleeping the night through, I was getting tired again, so I borrowed an APAP
which went to 9.8 one night and 10.1 on the 2nd night, so the DME told me to set my CPAP for 10.0.

Fast forward a few more weeks to me getting a data capable machine on Craigslist (brand new!).
Because of issues with gas & bloating (at 10.0), I set it at 9.6 and regularly got AHI's and HI's between 1.0 and 1.5.
I figured it was time to try 10.0 again, but when I did, my AHI and HI's shot up to 3.6. My AI's stayed proportionally
low and my leaks are consistently 0.00, no matter what.

So just for kicks, last night I put my pressure back down to 9.0.
This morning my AHI and HI are at 0.4 with an AI of 0.00
Leaks are still at 0.00.

What gives?

I don't know but my AHI's are at 5.1 and they were 2.7 a couple weeks ago.
To me it seems like I'm sleeping better...well at least I'm not awakened and staying awake like I was. I can roll over and go back to sleep in a bit, which is a miracle in itself.

Anyone?

An AHI of less than 5 is usually not an issue. Which means you stopped breathing or had a partial obstruction for at least 10 second. The only reason I would be concerned would be if you had significant desats which resulted in a SAO2 of less than 88% that lasted for an extended period of time. Which if you don't have an oximeter you have no way of telling. If your CPAP is set at 9 then you should leave it at 9, assuming you trust you primary care physician and the lab at which you got you study done. If you don't trust them or feel like you need to self treat yourself and AHI of < 5 should not be an issue. Just a quick question. What was your AHI prior to be ing put on a CPAP?

Prior to CPAP my AHI during my sleep study was 62 per hour. My O2 levels went as low as 81%
I've had an O2 test since starting CPAP. I dont' know what my levels were, but the HMO said they were "great".

If you do best at 9.0 pressure ... you should maybe use 9.0 eh?

But actually you should not go by a single night of data. Instead collect 1 or 2 weeks of data and take the average as that will provide a more accurate picture of your pressure needs.

If someone came and woke you up 2 or 3 times an hour, how rested would you feel? Not very I'd bet.

That Sleep Tech wrote:An AHI of less than 5 is usually not an issue. Which means you stopped breathing or had a partial obstruction for at least 10 second. The only reason I would be concerned would be if you had significant desats which resulted in a SAO2 of less than 88% that lasted for an extended period of time. Which if you don't have an oximeter you have no way of telling. If your CPAP is set at 9 then you should leave it at 9, assuming you trust you primary care physician and the lab at which you got you study done. If you don't trust them or feel like you need to self treat yourself and AHI of < 5 should not be an issue. Just a quick question. What was your AHI prior to be ing put on a CPAP?

nobody,

I understand and I am not making light of anyone's situation. That being said like the previous poster said, do not go on a day by day basis; as far as adjusting goes. If you have to adjust yourself without medical oversight the longer the period you have data for the better. Also have you been wearing the mask all night? Because, there is no point in changing anything if you have yet to constantly be able to wear your mask for at least 2 weeks in order to give your body time to adjust to the new sensation. In the end just be careful if you must do and DIY diagnosis and remedy. But, as always at let your doctor know.

My comment had nothing to do with changing anything. It had to do with your seemingly dismissive comment that an AHI below 5 shouldn't be an issue. Have you done the math? If your AHI is just 2, how many times is that in an 7 hour night? 14 times. If someone woke you up 14 times per night, how would you feel the next day? Why don't you try it and let us know how rested you feel after a couple weeks of that.

I apologize if it seemed like I was dismissive but if you have and AHI of less than 5, unless your having prolonged event lasting over 30 seconds or minutes, then letting your body adjust is the best course. However, if your on a CPAP and waking up feeling unrested, after you've given yourself time to acclimate, then, and only then should you consider adjusting your pressure. Even at that point, I think it would be best to talk with your primary care and schedule an appointment. i meant no harm by my comment. I see a person doing more harm than good trying to self diagnose and treat who has been using a CPAP for less than 3 months. Also, going from and AHI of 62 down to less than 3 isn't too shabby. This is obviously a sore subject for you, nobody, perhaps if I didn't but Sleep Tech in my title it wouldn't have been an issue.

I agree with That Sleep Tech:

That Sleep Tech wrote:An AHI of less than 5 is usually not an issue.

That Sleep Tech wrote:like the previous poster said, do not go on a day by day basis; as far as adjusting goes. If you have to adjust yourself without medical oversight the longer the period you have data for the better.

That Sleep Tech wrote:I apologize if it seemed like I was dismissive but if you have and AHI of less than 5, unless your having prolonged event lasting over 30 seconds or minutes, then letting your body adjust is the best course. However, if your on a CPAP and waking up feeling unrested, after you've given yourself time to acclimate, then, and only then should you consider adjusting your pressure.

I didn't think you sounded dismissive at all or had anything to apologize for. Good advice.

nobody wrote:If someone came and woke you up 2 or 3 times an hour, how rested would you feel? Not very I'd bet.

Actually, I, and many (not all...many) other people who report data showing their treatment AHIs of 2.0 and 3.0 (and higher) can and do feel very well rested.

Thanks!

rested gal wrote: Actually, I, and many (not all...many) other people who report data showing their treatment AHIs of 2.0 and 3.0 (and higher) can and do feel very well rested.

Yeah and some people with very high AHI claim to feel fine too. It's interesting that many, probably most, people are not a very good judge of just how sleepy they are. There have also been many posts right here on this forum with people saying they do not feel rested if their AHI is 2 or above. Does anyone even know where the AHI of 5 or less being "normal" comes from? Were there large scale controlled studies done that came up with that number, or was that just something arbitrary?

That Sleep Tech wrote: perhaps if I didn't but Sleep Tech in my title it wouldn't have been an issue.

It wasn't about you, it was about what you said. Let us know when you've tried that out, I'm interested in knowing the results.

Sorry it took so long for me to get back to you. I've been rather


According to the International Classification of Sleep Disorders: Diagnostic and Coding Manual, Second Edition, 14 at least 1 of the following criteria must apply for OSA to be diagnosed:

* The patient reports daytime sleepiness, unrefreshing sleep, fatigue, insomnia, and/or unintentional sleep episodes during wakefulness. The patient awakens with breath holding, gasping, or choking. The patient's bed partner reports loud snoring, breathing interruptions, or both during the patient's sleep.
* PSG shows more than 5 scoreable respiratory events (eg, apneas, hypopneas, RERAs) per hour of sleep and/or evidence of respiratory effort during all or a portion of each respiratory event.
* PSG shows more than 15 scoreable respiratory events (eg, apneas, hypopneas, RERAs) per hour of sleep and/or evidence of respiratory effort during all or a portion of each respiratory event.
* Another current sleep disorder, medical or neurologic disorder, medication use, or substance use does not better account for the patient's condition.

http://emedicine.medscape.com/article/295807-diagnosis


In short the AASM set forth these standards. I'm still looking for the original research into where the AHI of 5 came into place when I find it I will be more than happy to post it for you nobody.


http://en.wikipedia.org/wiki/Internatio ... _Disorders

citation 2 is a PDF of the ICSD it only worked when I right click and "saved as"