Understanding AHI

Just wondering, what is the most important score when it comes to AHI, your overall AHI score, the hypopnea or the obstructive? For example, last night my total AHI score was 3.90, my hypopnea was 2.96 and for the first time since I started CPAP a few weeks ago my obstructive was 0.00.

Are those numbers good? Do I still need to work on getting my overall score down or the hypopnea score?

thanks,

Kyle

Seattleboy49 wrote:Just wondering, what is the most important score when it comes to AHI, your overall AHI score, the hypopnea or the obstructive? For example, last night my total AHI score was 3.90, my hypopnea was 2.96 and for the first time since I started CPAP a few weeks ago my obstructive was 0.00.

Are those numbers good? Do I still need to work on getting my overall score down or the hypopnea score? ...

An AHI score of 5 or under is considered "normal".

So, yes, that is a good value.

I tend to worry more about the apneas than hypopneas. But that's me. I almost ALWAYS snore a little - even at full pressure. I runs in the family. Though it's all relative. A REALLY high hypopnea number (say over 20) is not a good thing, either. So, it depends. But generally, I worry about the apnea score more.

But that's just my view of it.

I am similar in that most nights my ahi is composed of all hypopneas. My understanding is that a hypopnea is basically just a short apnea. Hypopnea= cessation of breath for 5-10 seconds and an apnea =10 seconds or greater.

Apneas will have a more detrimental effect on your oxygen desaturation levels.

Ok, good to know. thanks guys. It seems like my numbers are in "the norm," which is good to know. I have been on the CPAP for a little under 3 weeks and I still can't tell if it is having an effect on my overall energy level though. I am traveling out of state for the weekend and I am going to leave the CPAP behind, mostly because I don't feel like doing with it at the airport, but also because I want to see if I notice any change not being on it for a few days

Seattleboy49 wrote:Ok, good to know. thanks guys. It seems like my numbers are in "the norm," which is good to know. I have been on the CPAP for a little under 3 weeks and I still can't tell if it is having an effect on my overall energy level though. I am traveling out of state for the weekend and I am going to leave the CPAP behind, mostly because I don't feel like doing with it at the airport, but also because I want to see if I notice any change not being on it for a few days

Bad Choice.....You've been on CPAP for 3 weeks and already you are planning to skip nights. Because you don't "feel like" it is not an excuse.

Seattleboy49 wrote:... I have been on the CPAP for a little under 3 weeks and I still can't tell if it is having an effect on my overall energy level though. ...

What the the following residents of Meadow Lawns have in common?

Hey, it's only a mild heart palpitation. I feel fine. I'll ignore my medication for a week or so ...
Hey, it's just high blood pressure. I feel fine. I'll ignore my medication for a week or so ...
Hey, it's just diabetes. I feel fine. I'll ignore my medication for a week or so ...
Hey, it's just obstructive sleep apnea. I feel fine. I'll ignore my CPAP for a week or so ...

People do die of preventable complications all the time. You might be fine. Or it might be the time it does permanent damage. Obviously, it's your choice.

By the way, to what part of the world are you traveling? If you are headed toward my area, I will be certain we keep an eye out for a tired driver, who tends to fall asleep at the wheel.

No, seriously. It really is that important. In fact my the letter of medical necessity that my doctor writes, he has boilerplate verbage (read lawyer required and approved) that says failure to use the xPAP treatment can lead to serious accidents and should not be ceased without consulting the prescribing physician.

But it's definitely your choice:

http://youtu.be/0H3rdfI28s0

By the way, don't take my word for this:

Among sleep clinic referrals, men who scored high for sleepiness reported about a quarter more motor vehicle accidents and nearly five-fold more near misses than those scoring in the normal range, Kim Ward, BSc, of the University of Western Australia in Crawley, and colleagues found.

http://www.medpagetoday.com/Pulmonology ... ders/42270

Nearly five-fold more near misses ... a quarter more motor vehicle accidents ... Don't take the chance that it won't happen to you.

I understand what you are both saying, believe me and I appreciate the advice. I will just call me doctor tomorrow and see what he says. The reason I was thinking about not bringing it with me is because I am going to California for a few days and I am bringing my dog with me. I will also be going to a wedding so in one hand I am going to be carrying my dog (he is small and comes on the plane with me) and in the other hand I am going to have my carry on baggage as well as a suit. and honestly, since I can't tell if the CPAP is working for me or not I figured a few days off might make that clear. I won't be driving during the trip as my parents will be driving me and my fiance around so I don't have to worry about falling asleep at the wheel or anything. but still, I hear what you both are saying. I will call my doctor and if he advises me to bring it then I will bring it with me, no questions asked.

Seattleboy49 wrote:... I will call my doctor and if he advises me to bring it then I will bring it with me, no questions asked. ...

Great answer.

Sure you can do a holiday CPAP. But take it from someone who has used xPAP for almost 25 years now ... It does make a world of difference. Since your doctors probably caught it early, it's not as dramatic for you as it was for me. But like any chronic illness, it's the the individual days without it that's the problem. It's the accumulation of damage that is so deadly. Just like high blood pressure or diabetes or ... You get the idea.

And, yes, it definitely can be a hassle when traveling. By the way, you do NOT want to check the CPAP device. Luggage can take some awful bumps that is bad for the CPAP. It's much better to take it on the plane with you.

Cheers.

Thanks John! and yes, just called my doctor and he told me that since I have mild sleep apnea there is no problem with me leaving it home. He suggested using a few more pillows in order to keep my head elevated if I feel tired or start to snore.

and yes, goo advice on not sticking it in checked luggage. a few years ago one of those car GPS devices was stolen out of my checked bag so I learned to never put anything valuable into checked baggage again.

thanks again for the advice.

icipher wrote: My understanding is that a hypopnea is basically just a short apnea. Hypopnea= cessation of breath for 5-10 seconds and an apnea =10 seconds or greater.

No....not quite accurate.

Both the apnea and hyponea must last at least 10 seconds to earn a flag.
The difference is in the amount of reduction of air flow. Hyponeas might have only a 50% reduction in flow where an apnea might have 80 % or more reduction. Definitions vary between companies slightly.
http://sourceforge.net/apps/mediawiki/s ... r_Glossary


Apnea

An apnea is indicated if there is an 80%/75% (Respironics/ResMed) reduction in airflow for 10 seconds compared to the average airflow over an extended period of several minutes or if there is no airflow detected for 10 seconds.

Apnea/Clear Airway Apnea Detection the the Respironics System One.. An apnea is detected when there is an 80% reduction in airflow from a baseline for at least 10 seconds if there is no airflow detected for 10 seconds. During the apnea, one or more pressure test pulses are delivered by the device. The device evaluates the response of the patient to the test pulse(s) and assesses whether the apnea has occurred while the patient has a clear airway or an obstructed airway. The airway is determined to be clear if the pressure test pulse generates a significant amount of flow; otherwise the airway is determined to be obstructed.

Apnea Detection guidelines per ResMed machines..Apnea...When the respiratory flow decreases by more than 75% for at least 10 seconds.

Hypopnea

An hypopnea is indicated if there is approximately 40%/50% reduction in airflow for a duration of between 10 and 60 seconds, compared to the average airflow over an extended period of several minutes. Following a reduction in airflow, the therapy device must see two recovery breaths in order to label the event as a potential hypopnea. (Respironics detection is 40% reduction and ResMed detection is 50% reduction)

Seattleboy49 wrote:I understand what you are both saying, believe me and I appreciate the advice. I will just call me doctor tomorrow and see what he says. The reason I was thinking about not bringing it with me is because I am going to California for a few days and I am bringing my dog with me. I will also be going to a wedding so in one hand I am going to be carrying my dog (he is small and comes on the plane with me) and in the other hand I am going to have my carry on baggage as well as a suit. and honestly, since I can't tell if the CPAP is working for me or not I figured a few days off might make that clear. I won't be driving during the trip as my parents will be driving me and my fiance around so I don't have to worry about falling asleep at the wheel or anything. but still, I hear what you both are saying. I will call my doctor and if he advises me to bring it then I will bring it with me, no questions asked.

I used to think I slept okay. Then, once I started cpap, I learned just how bad I sleep without it. I do miss a night occasionally, usually due to falling asleep while watching tv. The next day, I feel like crap, and I usually have a headache.

When I first had the sleep study, I felt good the next day. The next night, I went to bed like normal, without a machine. I felt like crap the next day. I commented about how badly I slept. And then I realized it was normal. I just hadn't realized how bad my normal used to be.

I would not recommend skipping it while on a trip. The last place you want to feel like crap is when traveling. If your carry bag doesn't have a long strap, get one. Find a way to carry it all. This is very important for you. Also, keep in mind that many of the improvements are subtle. You don't really notice them right away. For example, I used to have headaches a couple times a week. It took me awhile to realize it had been weeks since my last headache. At some point, I realized I felt more cheerful, and my standard answer to "how are you" stopped being "tired". These changes didn't happen overnight, and I didn't notice them right away, but they happened within the first month. You have to keep at it.

Pugsy wrote:

icipher wrote: My understanding is that a hypopnea is basically just a short apnea. Hypopnea= cessation of breath for 5-10 seconds and an apnea =10 seconds or greater.

No....not quite accurate.

Both the apnea and hyponea must last at least 10 seconds to earn a flag.
The difference is in the amount of reduction of air flow. Hyponeas might have only a 50% reduction in flow where an apnea might have 80 % or more reduction. Definitions vary between companies slightly.
http://sourceforge.net/apps/mediawiki/s ... r_Glossary


Apnea

An apnea is indicated if there is an 80%/75% (Respironics/ResMed) reduction in airflow for 10 seconds compared to the average airflow over an extended period of several minutes or if there is no airflow detected for 10 seconds.

Apnea/Clear Airway Apnea Detection the the Respironics System One.. An apnea is detected when there is an 80% reduction in airflow from a baseline for at least 10 seconds if there is no airflow detected for 10 seconds. During the apnea, one or more pressure test pulses are delivered by the device. The device evaluates the response of the patient to the test pulse(s) and assesses whether the apnea has occurred while the patient has a clear airway or an obstructed airway. The airway is determined to be clear if the pressure test pulse generates a significant amount of flow; otherwise the airway is determined to be obstructed.

Apnea Detection guidelines per ResMed machines..Apnea...When the respiratory flow decreases by more than 75% for at least 10 seconds.

Hypopnea

An hypopnea is indicated if there is approximately 40%/50% reduction in airflow for a duration of between 10 and 60 seconds, compared to the average airflow over an extended period of several minutes. Following a reduction in airflow, the therapy device must see two recovery breaths in order to label the event as a potential hypopnea. (Respironics detection is 40% reduction and ResMed detection is 50% reduction)

Thanks for clarifying pugsy.. sorry for spreading bad info.

Thanks icipher. I guess the main reason I don't feel like carrying it is because I don't want to have to carry it in the huge, camera like bag they gave me for it, especially considering I will also be carrying two bags, one with my 20 pound dog. But maybe what I will do is wrap it in a towel and stick it in the bag I am taking on the plane with me. I have also been told that when traveling I don't have to bring the humidifier component of the machine with me so that would make it much easier to transport

Seattleboy49 wrote:Thanks icipher. I guess the main reason I don't feel like carrying it is because I don't want to have to carry it in the huge, camera like bag they gave me for it, especially considering I will also be carrying two bags, one with my 20 pound dog. But maybe what I will do is wrap it in a towel and stick it in the bag I am taking on the plane with me. I have also been told that when traveling I don't have to bring the humidifier component of the machine with me so that would make it much easier to transport

HAve you tried sleeping without the humidifier at home? I would try that before leaving it behind. I do not travel by plane, but I do travel a couple times a month. I put my cpap machine (in its carry case) inside my regular luggage along with my laptop. Only because it loads easier in the car. If I were traveling by plane, I would carry it separately as it doesn't count against the carryon limit, and would free up space in my carry on. Have you checked to make sure your dog isn't using up your carry on? The last time I considered traveling by plane, I learned that the cat, despite costing an extra $150, would replace my carry on, and I would have to pay even more to bring a carryon along with a cat. I opted to drive instead. The drive plus hotels cost about the same as the flight, and I was able to take a lot more with me.

zoocrewphoto wrote:... HAve you tried sleeping without the humidifier at home? ...

Good point and suggestion. Even when I travel by car I leave the humidifier at home. It's just easier to lug a smaller unit even if we travel by car.