CPAPtalk.com

flocof wrote: I downloaded the resmed software and made a few screenshots to send to DR. no problems with the graphs for me..??

I suspect that they were probably using an older version of ResScan that won't work with S9 OR
the person attempting the download was a dufus.

I will appear so smart...thanks to you Pugsy

They will wonder how and where you got the software and might even get ugly about it.
Just laugh and tell them everything is available on the internet and leave it at that.

wiki/index.php/Apnea_Hypopnea_Index

Good AHI vs. Bad AHI
Less than 5 events (apnea or hypopnea) per hour is considered normal. 5 or more events per hour is considered Mild sleep apnea 15+ considered Moderate 30+ considered Severe (from T. S. Johnson MD, Sleep Apnea - The Phantom of the Night, page 211)

Flow limitation or Upper Airway Resistance Syndrome (UARS) is another important, subtle form of SBD. The airflow meets resistance in the nose or mouth, causing the brain to waken the sleeper. The American Academy of Sleep Medicine advocates counting apneas, hypopneas, and flow limitations/UARS for the Respiratory Disturbance Index, RDI, which is more comprehensive than the Apnea-Hypopnea Index.

At 13 events/hour, I felt like something the cat dragged in;
(living in zombie-land)
but BCBS would not have covered it without 'co-morbidities"
"Luckily", I also have high blood pressure (diabetes may not have been enough.)
Lucky me!

My ENT says the same thing. I argued a bit with her nurse but they said that is the info that they are given. ??? However, they are helping me and I appreciate that. At least I can talk with them. So, someone is giving out erroneous info from the top tiers. Again, it really burns me that with such an epidemic of sleep apnea patients (diagnosed and undiadnosed) that more study, research, and effort isn't given to this disease/disability. I wish I knew what to do to be more of an advocate or better treatment.

flocof wrote:Hi all,
I have had sleep apnea for many years but officially diagnosed November. Cpap journey: first week, I felt great! then gradually returned to not so great but much better than pre cpap. AHI was 60 and now with cpap varies between 10-15 with two thirds being CSA.
After five months on cpap with help from a member here to fiddle with the numbers...I finally got an appointment with the Hospital's Senior Sleep therapist. He tells me that there is nothing to worry about, it is quite acceptable to have an AHI of 10-15. He says I am being unrealistic to expect to achieve an AHI of 5 or under... That I may never feel any better, but reassured me that I was fine and should just go on with the CPAP at 10...
Is there any documentation that states that AHI over 5 is detrimental to my health, or that it is not effective therapy? He seems to think that it is widely accepted that from AHI60 down to 10-15 is effective therapy.

Wow I would try and find another Sleep Dr. Had the same issue with mine, she tried to tell me people on my machines rarely ever get under 12's. Luckily this site has educated me quite a bit, so I was able to dispute most of what she was saying. Finally she said, "oh, I can tell you've been reading up on this". So now I finally got approved for another Sleep Study to try to get things ironed out, that's all I ever wanted. Sometimes you have to keep on them, or you get swept under the rug.

First I'd ask the idiot if he like it if he stopped breathing 15 times an hour not to mention the waking up part. 10 to 15 is granted, still in the mild range and they would prescribe a cpap in for someone in that range. Go to this site: http://www.apneaboard.com/ They have manuals you can download for different cpaps that will tell you how to raise your levels.

What's unbelievable is a pressure of 10 isn't that high, mine is 12. It would be a simple matter, if insurance won't pay for another study, to increase pressure in increments of 2 until things improved. All he'd have to do is read the card's info and say, up it, leave it, lower it. That's what the doc did with my last study. They couldn't find a pressure high enough to stop the apneas on my back before the night was over so he prescribed 12 and then had me bring sd card in. My apneas were like .4 so they left it at 12. If it had been above 5, he'd probably have upped the pressure to 14 and repeated the process.

flocof wrote:

Julie wrote:Absolute nonsense... if that guy were a sleep therapist here I would report him for being a quack of the worst order!

I know that is how I feel...What can I say? I have tried and tried and we have agreed to disagree... He is the senior doctor at the sleep centre specializing in complex sleep apnea...I know I will eventually need an ASV machine to treat the centrals...and I will probably try to buy one secondhand and get help to titrate it here... sigh... it's US and THEM!!

Kairosgrammy wrote:What's unbelievable is a pressure of 10 isn't that high, mine is 12. It would be a simple matter, if insurance won't pay for another study, to increase pressure in increments of 2 until things improved.

OP has already been down the increased pressure road...the problem is that the pressure increases causes the centrals. If we reduce the pressure to where the central numbers aren't alarming...then the obstructive apneas and hyponeas are alarming. If we increase the pressure to deal with the obstructive events...the centrals go up and with too much pressure...they go way up in number.

Maybe going to sleep feeling angry helps...My AHI was down to 6.74 last night.. best in months! Maybe we can insult eachother before we go to sleep

flocof wrote: I finally got an appointment with the Hospital's Senior Sleep therapist. He tells me that there is nothing to worry about, it is quite acceptable to have an AHI of 10-15. He says I am being unrealistic to expect to achieve an AHI of 5 or under... That I may never feel any better, but reassured me that I was fine and should just go on with the CPAP at 10...
Is there any documentation that states that AHI over 5 is detrimental to my health, or that it is not effective therapy? He seems to think that it is widely accepted that from AHI60 down to 10-15 is effective therapy.

Generally speaking, a person on CPAP strives for an AHI of less than 5. However, you mentioned central sleep apnea. It sounds like your doctor is considering the facts of your particular situation: He is weighing the effects of too much pressure (more CAs, fewer OAs) against too little pressure (fewer CAs, more OAs). That's the type of weighing process that doctors are supposed to do.

Generally speaking, a person on CPAP strives for an AHI of less than 5. However, you mentioned central sleep apnea. It sounds like your doctor is considering the facts of your particular situation: He is weighing the effects of too much pressure (more CAs, fewer OAs) against too little pressure (fewer CAs, more OAs). That's the type of weighing process that doctors are supposed to do.[/quote]

This is not a new situation...It has been going on for 5 months...The doctor is not doing his job if he is refusing the possibility that I may need an ASV machine to treat both CSA and OSA, where the apneas are predominantly central, we have tried to up pressure and centrals increase...down pressure and obstructives increase, we are at the end of the simple CPAP being effective and now need to try another machine!

Anything over 5 and I don't feel right.

In a totally normal person, AHI 5-15 is considered too mild to treat. HOWEVER, if you have other complicating medical problems like heart disease, hypertension, diabetes, and other things that will get worse without treating the OSA, then you qualify.

Anyone that has complicated medical conditions should never be happy with AHI over 5. The very reason you have CPAP is to slow the progression of you diseases. Also, untreated or undertreated OSA just gets WORSE. You need a new doctor that really knows his stuff.