highly variable AHI

[dizzy izzie]

Help! After about 6 months on CPAP my daily AHI score is HIGHLY variable. It can range from 6 to 18, even had one night at 2.9 and one at 29. The higher then number, the worse I feel the next day. Getting rather desparate, any suggestions for such a huge range? I've seen other posts with ranges in AHI, but not this big. Practitioner "doesn't understand" this.

Have downloaded data into Sleepy Head, but haven't figured out what it all means.

Thanks.

[zonk]

Help! After about 6 months on CPAP my daily AHI score is HIGHLY variable. It can range from 6 to 18, even had one night at 2.9 and one at 29.
Thanks.

AHI below 5 is normal while on cpap, above that number might indicate the therapy is far from optimal ... see the sleep doctor (not GP)
Whats the breakdown of AHI events and leak rate

[trish6hundred]

Hi dizzy izzie,
WELCOME! to the forum.!
Hang in there for more answers to your question and best of luck to you with your CPAP therapy.

[herbm]

You may know these things after six months of therapy but just in case:

Leaks?
Body position (e.g., on back one night, on side the next)?
Drinking alcohol some nights?
Drugs (prescription or elicit)?
Eating heavy before bed -- eating wrong stuff before bed?
Different medical problem -- see your doctor?

[justMongo]

I know we use AHI=5 as sort of the gold standard here.
I was at my doc's yesterday, and he said under 10 was good.

[c0reDump]

I know we use AHI=5 as sort of the gold standard here.
I was at my doc's yesterday, and he said under 10 was good.

From wikipedia: AHI values are typically categorized as 5–15/hr = mild; 15–30/hr = moderate; and > 30/h = severe.

I guess 10 is "good" depending on where you started from (I started at 50+). Though 10 still means that 10 times an hour (every 6 minutes on average) you are getting pulled out of REM sleep because you stop breathing. Ask you doctor if you could suffocate him for 10+ seconds every 6 minutes while he sleeps one night.

dizzie izzie) Having your AHI vary from 2.9 to 29 is not effective/consistent treatment. Your '29' nights are right at the severe category.

[justMongo]

I know we use AHI=5 as sort of the gold standard here.
I was at my doc's yesterday, and he said under 10 was good.

From wikipedia: AHI values are typically categorized as 5–15/hr = mild; 15–30/hr = moderate; and > 30/h = severe.

I guess 10 is "good" depending on where you started from (I started at 50+). Though 10 still means that 10 times an hour (every 6 minutes on average) you are getting pulled out of REM sleep because you stop breathing. Ask you doctor if you could suffocate him for 10+ seconds every 6 minutes while he sleeps one night.

dizzie izzie) Having your AHI vary from 2.9 to 29 is not effective/consistent treatment. Your '29' nights are right at the severe category.

Well, my machine is reporting under 3 per hour. I started at 32/hr during my study.

[PaulaO2]

There are a lot of things that go into a night's sleep.

Since you are having such a wide variety, I suggest you start a sleep diary.

Put a simple note pad by your bed and before you lay down, write what kind of day you had. Good, bad, high stress, low stress, spent with kids, had meetings at work, lots of exercise, whatever you feel is necessary. Even put in if you had something different to eat or drink, like if you went out to lunch with friends and had more beer than usual. Or less beer than usual.

Then in the morning, write down how you slept. Did you dream, do you remember them, do you feel rested, not rested, did you wake up any, why did you wake up, do you have any body pain. Again, whatever you feel is necessary.

Then later when you look at the data and you see another night of 29, take your sleep diary and see what was different. If anything was different. You may not see anything. But maybe the next time you have another night of high AHI, you'll notice something that was on the last time. Maybe it was you worked in the garden both days and was extra tired. Or those were the days you drank beer with your friends.

Some pattern will appear.

[3porpoise]

Hi dizzy izzie,
What everybody else said. While waiting to see your sleep Dr. Did you by chance get a copy of your sleep report for yourself?Did you get a copy of the prescription ? Can you post a good night and a bad night of data? Have you noticed if you are sleeping on your back when you get the high AHI's and on your side for the low AHI's?Did you sleep on your back or your side on the sleep study? Do higher AHI's coincide with increased leak rates? The more information you have about yourself the better to help the HCP to help you. You may or may not have already done this, food for thought.
Good luck,
3

[GreyParrot]

Use of opiate painkillers. Leak rate. Most nights I have under 1.0 now
for weeks. The two bad nights I had were the day I took 10mg oxycodone at bedtime. That night was 29.3! The other bad night was 10.2 Obstructive only.
I woke up on my back with the mask leaking badly. Viewing in ResScan showed a direct correlation to a big leak. This happened a few times as I was trying a new mask. The opiate night consisted of all centrals of about 10=15 seconds duration, lots of them. I find if I take pain meds after 1pm or so it effects my AHI a lot, so unless things are bad I don't do that if I can stand not to.