Are the Stats in SH too good?

[Iso0725]

Hi Gents/Ladies,

I was diagnose with severe OSA with 66.7 AHI but since using the 3 diff machine (PRS-1 Auto CPAP, PRS-1 BiPAP Auto, DreamStation BiPAP Auto) over 3 weeks, the AHI has dropped to 2.5 for day 1 and to below 0.9 after.   Majority of the mornings are awesome but some days were with headaches but score remain below 0.9.   Interestingly, I started to observed CA occasionally which wasn't detected during the sleep test

Are the results too good to be true?      Anyway for me to validate the accuracy (apart from a sleep test)?


Thank you,
Roy

[Gary1of2]

I am not an expert but I have read that sumtimes that cas could go away after your body gets use to pap. Try posting with sleephead. Infomation on how is in my signature.

[CB91710]

Every night is different.
Your sleep study could have been on a "very bad" night, or perhaps you are responding very well to therapy.

Sleepyhead is not "scoring" your AHI, it is reading data from your machine and reporting it. I do a quick check of my screen when I shut the machine off in the morning, and it *generally* matches SH... by "generally" I mean the machine reports AHI in X.X while SH reports X.XX, so often my machine will report 0.0, while SH will report 0.09... it does not seem like the machine rounds up. That happens to be exactly what happened Sunday... 10hr 49 minutes and one OA shortly before I got up.

[Sleeprider]

Roy, it is very common for someone diagnosed with severe obstructive apnea to be fully treated to levels consistently less than 2 AHI and frequently less than 1.0. Once the airway is patent, the events just don't occur, and you may eventually experience even lower event rates. CA events are common in all people and can be as simple as rolling over in your sleep and holding your breath. You can check the events, and many will be at the very minimum 10 second duration. These are nothing to worry about. In some individuals, BiPAP therapy with higher pressure support can increase CA events by reducing CO2 and affecting the respiratory drive. I doubt that is your issue.

You can validate the results by zooming in on the flow rate graph where you can see a record of every breath. If you don't see periods of flat-line apnea or diminished respiratory flow/volume then your results are real...no need for a confirming sleep study.

[Iso0725]

Roy, it is very common for someone diagnosed with severe obstructive apnea to be fully treated to levels consistently less than 2 AHI and frequently less than 1.0.  Once the airway is patent, the events just don't occur, and you may eventually experience even lower event rates.  CA events are common in all people and can be as simple as rolling over in your sleep and holding your breath.  You can check the events, and many will be at the very minimum 10 second duration.  These are nothing to worry about.  In some individuals, BiPAP therapy with higher pressure support can increase CA events by reducing CO2 and affecting the respiratory drive.  I doubt that is your issue.

You can validate the results by zooming in on the flow rate graph where you can see a record of every breath.  If you don't see periods of flat-line apnea or diminished respiratory flow/volume then your results are real...no need for a confirming sleep study.

Thanks for the tip!   Zooming in really help revel a lot of details - now it is for me to try to understand them

I did feel better after using the machines, in fact I felt like superman in the first week on the auto cpap but from middle of week 2 onwards, my body seems to have adjusted and normalized the effects from increased airflow(from SH) and likely oxygen.   I am ordering a CMS 50D+ to confirm if the latter is true.

[HalfAsleep]

Regarding headaches...

You might check on the position of your neck, shoulders, and upper back. These can get stretched or inhibited while you’re asleep, and can give you a goshawful headache. This is a muscular issue, not strictly a breathing issue.

The odds of this happening may be directly proportional to how much time you spent on the computer the day before.

You could check if it’s a muscular issue by applying heat (like with a hot water bottle) and seeing if the headache backs off.

You could try moving your pillows around or a special pillow designed to put a little traction in the neck. Some folks on this forum swear by buckwheat pillows (ask Kiwii, who doesn’t swear but raves).

You may also want to check if it’s a problem of low blood sugar or caffeine deprivation. Does a glass of orange juice fix the headache? How about a cup of coffee?

The problem could be all of the above.

I frequently suffer from headaches right before I’m fully awake and into the morning. Like today. Last Christmas the gift I gave myself was one of those buckwheat/rice neck thingies you put in the microwave. I go through stretches where I use it every morning when I first get up. Wondrous.

I’m working on the coffee and orange juice as we speak.

There might be low oxygen issues as well, but I’ll be figuring those out in the next month or two.

My message? Think more broadly about how your headaches might be caused, and not just about sleep breathing issues. This might explain why the headaches don’t seem to be correlated with the AHI.

[Quark]

Just to add to what HalfAsleep said - I recently discovered that some of my headaches were being caused by a too-small mask cushion.  When I had my mask fitting at the DME, I was on the border between small and medium, and chose small because I was worried about leaks.  After 4 months of getting headaches in spite of low AHI, and constantly tweaking machine settings, I realized that after I fell asleep, the small size mask was putting pressure on the bridge of my nose and causing sinus-type headaches that would sometimes last all day.  I recently switched to a medium cushion, and no more headaches.  I also have sleep position/neck issues that I suspect cause headaches, and am currently trialing a buckwheat pillow.  So, yes - it is good to look beyond just the machine and its settings when problem solving.