Should I strive for an AHI of zero?

[streetwolf]

Since going to APAP and adjusting my min/max I got my AHI down to around 2. Is it worth playing round with the min pressure to get me to zero? I gradually have increased the min and doing so always reduced my AHI. I'm currently at 16.5/18. My 90% pressure is usually around 17 and change and occasionally hits 18. Would increasing my min pressure to 17 do any good and is it worth it to try to get an even lower number. How about increasing the max pressure a little?

Btw... I know the value for the 90% pressure is the value given and lower for 90% of the time. Is the lower part the min pressure I set, in my case 16.5, or can the pressure go even lower?

[Walla Walla]

It all depends on how you feel. Do you sleep well right now? Do you feel rested in the morning. If so than there's no need to chase the numbers. However if you feel you need to make a change and want advice you need to post your sleepyhead chart.

[Mosquitobait]

According to the stuff I read from sleep doctors, anything under 3 is good. Getting under 1 is a realistic goal for most, but not achievable by some. Trying to achieve zero is an unreasonable goal as you will beat yourself up if you don't get there. If increasing your pressure increases problems, then leave it where it is. Revisit it in 6 months to a year and experiment again.

[DaveL]

Posts are so helpful.  I've recently chosen a new mask. I've slept better, mainly by watching sleep habits

New mask is an N20. I had 4 or 5 DreamWear masks.  Numbers were good, but I didn't sleep well.

I use a chinstrap too.  I sometimes mouth breath.  (i tried an F20. It leaked terribly.)

Dave
Toronto

[dwd1249]

Sometimes I'll have a few 0 nights in a week. I can't say that I feel any better after a 0 night.
A lot of time I don't know I had a 0 night until I download the data.

[Sleepster]

Since going to APAP and adjusting my min/max I got my AHI down to around 2.  Is it worth playing round with the min pressure to get me to zero?

Probably not, but if you're like me you can't resist the temptation to try.  

But don't ignore your leak rate graph. If you don't have your leaks under control worrying about a AHI of 2 is not relevant.

I gradually have increased the min and doing so always reduced my AHI.  I'm currently at 16.5/18.  My 90% pressure is usually around 17 and change and occasionally hits 18.  Would increasing my min pressure to 17 do any good and is it worth it to try to get an even lower number.  How about increasing the max pressure a little?

It depends on if that AHI of 2 is due to obstructive apneas and hypopneas or due to central apneas. If the former then I would try raising the maximum pressure to 18.5 and see how often it goes above 18. Assuming there's no discomfort with the higher pressure.

I don't see how raising your minimum pressure will do anything, it's already so high that you may as well be on straight CPAP, again assuming the higher pressures don't bother you.

Btw... I know the value for the 90% pressure is the value given and lower for 90% of the time.  Is the lower part the min pressure I set, in my case 16.5, or can the pressure go even lower?

It will never go lower than 16.5.

[Sleep2Snore]

Hi Streetwolf,
I just upgraded to an APAP Airsense 10, and the low was set at 10 and the high to 20, however, it only gets to 11.7 normally 11,8 the other night but I knocked the mask off, woke up as the pressure got to 11.8.  I have found that the closer the low is to the pressure you normally need the easier it is to get on with and the lower AHIs.  However, it does not always work this was and getting the lowest AHI does not mean that you will feel at your best.
If your AHI is below 5 and you feel fine I wouldn't bother looking for the magic 0.0, I have had this and I didn't feel any better that the 0.2 - 0.4 I normally get.
I would say that if you are down to 3 it is not worth trying to get it down any lower if it is a bit of a fight to do it.
If you feel fine you are doing fine.  I didn't worry about my AHI for years and I have been on CPAP for well over 20 years.
The first machine I had didn't even record how many hours it had run let alone any other data.
So they tended to go by how you felt and a Sleepiness Scale to check how you were doing.  Of course, you didn't need any chart to see how you were doing, if you felt tired you rang them up and 9 out of 10 they would put up the pressure, which was about all they could do until other machines came out that were a bit more sophisticated and could do a lot more than just blow air at you.
It is up to you if you chase the magic 0.0, but to be honest, if you feel fine and using the machine from going to bed to getting up then you are doing fine.
My machine is set to 10 low and 20 high although it never has risen over 11.8 so far, even after knocking the mask off.
I tried lowering the low pressure, but it just disturbed me when the machine kicked in, but then I am used to a constant pressure on CPAP.
I like the new machine, however, the Nasal Pillows I use could be improved by putting the hose over/to the side of the head as the hose drops forward and I keep catching it and pulling it off by accident.  I wrote the the manufacturer of the Nasal Pillows (same manufacturer as the machine) but they just didn't appear to get the point I was making about the pillows.  Instead they pointed out the p10 with all the same problems, though they praised themselves saying the hose was a lot more flexible as they had a lot of complaints about the hose not being flexible enough!
I don't think this was the problem in the first place.  However, I digress.
If you feel fine and use you machine all the time, don't worry as long as the number is lower than 5.  As for increasing the low pressure, try it, you can always put it back.  I wouldn't lower it as it is more ground the machine has to make up when you do have an event.

[Rcgop]

I strive for zero AND on 3 occasions I have achieved that goal. However, they were not my best nights for sleep quality. My best night’s sleep come in at around 1.5. Go figure.

[OMyMyOHellYes]

Zero? Nah. You get twisted up worrying about a number and that causes more problems in and of itself. In some of my circles, it's called PII - Preoccupation with Inconsequential Increments.

OMMOHY

[Rcgop]

Zero?  Nah.  You get twisted up worrying about a number and that causes more problems in and of itself.  In some of my circles, it's called PII - Preoccupation with Inconsequential Increments.

OMMOHY

I second that.