After 9 Months 0.0 AHI, but Flow Limitations and Snores!

[OpalRose]

Well, have only been at this for 9 months and have been tweaking my pressure range trying to get it where it doesn't disturb my sleep and at the same time giving the best therapy. My AHI can be from .3 to 1.8, hardly ever goes over 2, so I am not complaining.

Yesterday morning was the first time I've seen an AHI of 0.0.
My question is this, while looking at my chart, does the fact that there are onlyFlow Limitations and Snores recorded mean that there were mini apneas that never materialized? Just trying to make sense of it.
Welcome comments from our many experts!

[attachment=1642]

The second image is from this morning, with AHI 0.11, but RERAs and flow limitations.

[Sleeprider]

I wouldn't worry about it. With RERA and FL indices below 0.5 and virtually no apnea, you're doing about as good as possible. I sure wouldn't want to chase that minor stuff. The closeups you provided do not show any indication of OA or H. Flow limitation is an indication of some respiratory resistance but not apnea, and RERA can be an arousal for any number of reasons. Again, unless you are getting disruptive levels of that (like above 2-3), I would ignore it.

[PaytonA]

No expert here but if you look at your pressure, you will probably see pressure increase in response. I think that the Resmed machines (what I have experience with) respond with pressure differently depending on the severity of the flow restriction and respond to flow restriction more aggressively than snores (depending, I would guess, on the severity and duration of the snores).

No, I do not see flow limitations or snores as mini apneas. They are a precursor to apneas occurring although they are caused by the airway beginning to collapse which can lead to a hypopnea or an apnea. They are like waypoints on the road to a hypopnea or an apnea.

I hope I am not being confusing.

Best Regards,

PaytonA

[OpalRose]

Sleeprider, I hardly ever have Obstructives, but will have hypopneas, and a few clear airways. When my AhI is higher, it's usually because of those two things.

I used to experience a lot more RERAs than I do now, and would wake up quite a bit, but once I limited the top pressure, that settled down. And now I sleep more sound.

PaytonA,
Thanks for your expertise....no, you didn't confuse me.

[MobileBasset]

Congratulations on excellent fine tuning of your therapy. I hope you are also enjoying the great night's sleep that one would expect with data like that.

[OpalRose]

Thanks MobileBasset,
Of course it has taken me several months of tweaking pressure ranges. Then I would keep a journal of how I felt. Because you can have low AHI numbers and not feel quite right.
That's why it's so important to check what the makeup of your AHI is. In my case, I used to have a lot more RERAs that I do now, which disrupted my sleep, and they are not counted in the AHI.

[Shastzi]

Can't always get an ideal night's rest but with your work, the machine is keeping you alive!

[iSnore]

Fantastic results... congratulations!

[AshSF]

OR: These are great results. Looking at your pressure stats in SH left side readout, I see that your max pressure is 11. That is basically the hunt n peck algorithm of the PRS1 machines (raise and decreases pressure by 1.5cm to see if anything gets better). This implies that there isn't much in your waveform that will make the PRS1 raise pressure in response to a real event of any type(FL, VS, H,O).

Consequently, you may want to try APAP with max = min = 9.5cm (essentially CPAP but with FL reporting in PRS1) and evaluate your results. Or you can bump it to 10 just to be on the conservative side.

[OpalRose]

OR: These are great results. Looking at your pressure stats in SH left side readout, I see that your max pressure is 11. That is basically the hunt n peck algorithm of the PRS1 machines (raise and decreases pressure by 1.5cm to see if anything gets better). This implies that there isn't much in your waveform that will make the PRS1 raise pressure in response to a real event of any type(FL, VS, H,O).

Consequently, you may want to try APAP with max = min = 9.5cm (essentially CPAP but with FL reporting in PRS1) and evaluate your results. Or you can bump it to 10 just to be on the conservative side.

Thanks AshSF,
I will eventually try that, probably 9.5min - 9.5max, flex 1.
I don't think I can go lower, but may have to bump to 10min-10max.