RE: How to improve Hypopnea Index?
(05-15-2016, 09:34 AM)shewhorn Wrote: Would the same apply to ASV as well? I've been using an ASV machine for 16 days now. In that 16 days...
When you look at the details of how events are counted, you see that it lacks the precision required to make a determination in your case in such a short amount of time.
I say your case because your numbers are already good, it's only been 16 days, and you've got a ASV machine.
It takes time to adjust to CPAP therapy, so the numbers will change on their own. They can change on their own for seasoned users. too.
ASV machines are the hardest to adjust. I recommend staying with what you've got until the doctor gives you your first review. Then you can talk to the doctor about it and go from there.
The thing with the data and being a perfectionist ... Realize that for your machine to score a hypopnea the flow rate has to drop for a period of 10 seconds. If you got your hypopnea index down to zero, you might be tempted to change the criteria to 9 seconds. Under that criteria your index is not zero and so you try changing things to get it to zero. This is a battle you cannot win.
Everybody has reductions in flow rate. It's a natural part of the breathing process.
It's rather like exposure to nuclear radiation. It happens to everyone every day. It becomes a concern only when the amount is too high for too long. You might carry a radiation monitor around with you every day and try things to get the reading lower. You'll end up encased in a lead suit!
Sleepster
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: How to improve Hypopnea Index?
So you're saying I wasted all that money on a lead suit?  Good point though. I'm really not too worried about it, I'm happy with the numbers as they are. Personality wise though... I'm totally the guy who pressed the button labeled "DO NOT PRESS"! You know... it's just there, and I need to know what it does! 
RE: How to improve Hypopnea Index?
The free SleepyHead software will let you see how long the events last. For example, I have these so-called central apnea events. But they barely last for the minimum 10 seconds needed to register. Now, if they lasted for two minutes each I'd be much more concerned.
This is one of the things that the AHI doesn't reflect. Twelve events each lasting 10 seconds counts as twelve events, but one event lasting 120 seconds counts as one event.
Sleepster
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: How to improve Hypopnea Index?
(05-15-2016, 12:11 PM)Sleepster Wrote: This is one of the things that the AHI doesn't reflect. Twelve events each lasting 10 seconds counts as twelve events, but one event lasting 120 seconds counts as one event.
Yeah, I've always kind of wondered why so much weight was placed on AHI and none at all on time spent in apnea? Generally (with my own results) I've found that AHI correlates with time in apnea but that's not always the case. It seems like the best measure of the quality of treatment would be a combination of AHI AND time spent in apnea.
RE: How to improve Hypopnea Index?
(05-15-2016, 03:21 PM)shewhorn Wrote: It seems like the best measure of the quality of treatment would be a combination of AHI AND time spent in apnea.
The best quality of treatment metric is your sleep quality and only you can gauge that. The problem is with doctors and insurance companies. An insurance company can't decide on continuation of treatment based on you saying "you feel better" (although it is part of the criteria in my insurance) since your definition of feeling better and mine would be completely subjective. However, once you get down past the 5 AHI (I think I heard 10 now some where) then it can be easily measured and is a metric they can hire dummies to deal with.
If you are below 5, then start concentrating on quality, which is measured by how you feel the next day.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
RE: How to improve Hypopnea Index?
I think the UK and maybe elsewhere in Europe uses 10 as the cutoff. Given how I feel when mine is above 3, that seems unhealthily high. It is an index, not a direct measure, and the cutoff is arbitrary as Franks says. The same goes for the Cholesterol levels that our doctors check. There is no scientific reason why one side of X is ok and the other is bad. They just needed a number as an objective yardstick and chose one.
The only useful measure to us is purely subjective: how do you feel in the morning and throughout the day?
RE: How to improve Hypopnea Index?
(05-15-2016, 03:21 PM)shewhorn Wrote: Yeah, I've always kind of wondered why so much weight was placed on AHI and none at all on time spent in apnea?
It could be that AHI gives you a better way of determining how much your sleep is disturbed.
Regardless, it's all about medical research. Researchers use AHI to classify severities so they can do research on them. The same is (or was) true of BMI. It's purpose was research, but now you see it being used for all sorts of things.
Sleepster
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: How to improve Hypopnea Index?
(05-15-2016, 04:24 PM)Sleepster Wrote: Regardless, it's all about medical research. Researchers use AHI to classify severities so they can do research on them. The same is (or was) true of BMI. It's purpose was research, but now you see it being used for all sorts of things.
Well, I also think it is about economics. I think the insurance industry is pushing back on the 5 level for diagnosis. By moving it up to 10 they can buy a lot fewer machines per year. On the other hand, it is in ResMeds best interest for the number to be as low as possible. As in billions of dollars best interest.
So, we have three parties are trying to influence the decisions based on their own interest - insurance to save money, ResMed (et al) to make money, and Scientists to figure out what works.
I am not a Medical professional and I don't play one on the internet.
Started CPAP Therapy April 5, 2016
I'd Rather Be Sleeping
05-15-2016, 07:26 PM
(This post was last modified: 05-15-2016, 07:27 PM by shewhorn.)
RE: How to improve Hypopnea Index?
Agree Frank, re: the best metric being how you feel BUT... I think there is still a case for the patient trying to shoot for a certain metric. In my case for example, I feel no different than I did pre-treatment (but I DO feel better on the ASV than I did on the CPAP... the CPAP made me worse for sure). From what I understand, for me it may take a few months, maybe even a year before I notice a difference so... I'll aim for keeping the numbers down!
Re: Raising the AHI to 10 (for clarity, I know I'm preaching to the choir here)... pretty sure my doc would take issue with that. Here's how he would drive the point home... "I don't care if you call it mild, moderate, or severe. What would happen if, while you were sleeping, I held a pillow over your head for more than 10 seconds, stopping you from breathing? With an AHI of 10, that's what's happening to you every 6 minutes. Do you think you'll be getting a good night's sleep?"
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