Weight Loss and Side Sleeping Therapy - AHI < 0.5

[AquaMan]

Since starting on my APAP machine I have begun side sleeping therapy and weight loss to mitigate my sleep apnea.

Prior to being prescribed the machine I was diagnosed with AHI of 37 in the lab sleeping on my back.

Currently I have an AHI of less than 0.5 and an average OA of 0.2 with pressure set to minimums (4 and 4)


How can I tell if I need the machine any longer?  I want to test how I do on my side... are there unbiased home tests?

I heard it once stated it was "rare" to no longer need CPAP, but I ask, how "probable" is it that someone with this level of OA at only 4cm,  namely 0.2 OA and 0.38 AHI, becomes clinical (more than 5 OA index) at 0 cm?

[cdplatt]

I can't speak to unbiased sleep tests.  However, there is a very strong correlation between OA/Hypopnea events and O2 desaturation events.  You might try monitoring your O2 saturation while sleeping with something like the Viatom/Wellue products or even a smart watch that tracks O2 while sleeping.  A smart watch won't provide the same level of detail as a dedicated oximeter, but it can give you a good idea if you are having high variations in O2 while sleeping.  If you wear a Viatom/Wellue product while sleeping, you can import the data into Oscar.  I do that on occasion as I try different methods to reduce my apnea events and see if I can sleep without CPAP - sleeping on my side, nasal dilators or various kinds, etc.  I find those things help, but after reviewing O2 data, I always return to CPAP.  When I wear just the O2 ring and stay off the CPAP, the O2 desaturations scored by OSCAR are always close to my original sleep test AHI score or higher.  I occasionally have a good night, but over time, the desaturation events continue to indicate at least mild apnea.  

   

[AquaMan]

Thank you very much @cdplatt!  That is a very good idea!

[Sleeprider]

A glance at your current results shows that although your apnea and event index is well managed, you have a lot of flow limitation and low respiratory volumes that would likely be greatly improved with higher pressure an the use of EPR. Your flow chart shows a lot of spikes that are likely respiratory effort related arousals. I would suggest increasing your pressure to 6 with EPR 2 or 7 with EPR 3 would feel a lot better and still control events. We have members from time to time that run the CPAP at these very low pressures to determine if they still need the machine. A sleep test without the therapy pressure is really the only way to know. Meanwhile, you are sacrificing comfort for a question you cannot answer while still using CPAP. The use of a recording oximeter using a control set of data with therapy and comparing to SpO2 without therapy might be useful, however I still would suggest not handicapping your therapy with these artificially low pressures. If you were using the Autoset mode, your pressure would rise a lot to resolve those flow limits. Providing a zoomed image of your chart (3-4 minutes) would likely show us the impact of these low pressures on your inspiratory flow rate.