jweeks wrote:Peppi,
To follow up on Gerry's comment, it is encouraging that your AI number is very, very low. That is great, especially for a new CPAP user.
I agree with both Gerry and John (jweeks) about how nice and low your AI number. The leak rate is nice and low too, especially for someone new to CPAP when adjusting and readjusting a mask is sometimes happening, letting a few more leaks through than will be the case later.
jweeks wrote: The HI events are not quite as damaging, and sometimes can be hard to get rid of. They might taper off as you get settled in. If they don't drop after 2 weeks, it would then be good for you to get your data downloaded and see your sleep doc or RT (or post it here if you have the software). An AHI of 5.4 is pretty good, but it is on the high side of 5.0, which is the upper limit for what is often considered to be effective therapy.
Personally I would not worry one bit about an AHI of 5.4 when using a ResMed machine, as you are, Peppi. I think the "AHI should be below 5.0" that we often see stated on the message board applies more to other brands of machines, particularly Respironics machines, and doesn't really apply to ResMed machines,
IF the AI part of the AHI is very low and it's the HI part that is driving up the AHI number. That's just my non-medical opinion though.
I think those two brands use such different "definitions" of hypopnea, there can be drastic differences in the HI
reported by either one, yet a person be getting exactly the same treatment effectiveness. That doesn't mean one brand reports hypopneas wrong and the other right. It's simply a difference in the amount of "flow limitation" each brand considers to be "hypopnea" instead of still just "flow limitation."
Anyway, I wouldn't worry for one moment about an AHI of 5.4 from a ResMed machine, when the AI (apnea index) was only 0.3 and it's the HI (hypopnea index) that was contributing the most to the AHI number.
If I saw an AHI of 5.4 from a Respironics machine, like jweeks, Gerry, and I use, yes, I'd probably do some tweaking to try to bring the AHI down below 5.0.
With a ResMed machine, however, I personally think an AHI below 10.0 is fine, if the AI is 1.0 or under and it's the HI raising the AHI number.
When I use a ResMed machine, I just mentally chop the HI in half then add that "half" to the AI to get a new, lower AHI. When I do that, my AHI is about equal to the AHI I normally get from my Respironics machines. What works for me might not apply to others at all, though.
Here are some more topics about definitions and about making AHI comparisons between Repironics and ResMed machines:
Chart posted by Velbor showing the differing definitions used by the different manufacturers:
April 2, 2009
http://www.cpaptalk.com/viewtopic.php?p=356255#p356255High HI affecting AHI rating. Should I be worried - topic started by ChrisC
Mar. 30, 2009
http://www.cpaptalk.com/viewtopic.php?p=355205Alternative ways to decrease the AHI - topic started by christo
Dec. 21, 2008
http://www.cpaptalk.com/viewtopic.php?p=324087#p324087I need to stop chasing 0 AHI. - topic started by fortomorrow
Dec. 4, 2008
http://www.cpaptalk.com/viewtopic.php?p=319432#p319432Hubby's AHI sucks... - topic started by Debjax
Feb. 15, 2009
http://www.cpaptalk.com/viewtopic.php?p=339278#p339278jweeks wrote: I am suspecting that bumping your lower pressure up to 6 would help based on a suspicion that 4 is too low to be helpful, and the machine takes too long to ramp up when you need the pressure to put down a series of events. Some folks react funny to APAP pressure changes, and since you are at the low end of the pressure scale, you might want to consider doing a straight CPAP setting just above your 95% pressure. -john-
I agree with jweeks that the machine might serve you better if you set the minimum at 6 instead of the current 4. I don't think there'd be any harm whatsoever in trying a minimum pressure of 6, as John suggests, for a range of 6 - 8.
Or even try straight CPAP at 7 or 8 as John suggested. Your doctor obviously thinks a pressure of 8 would not be a problem for you.
Using an autopap at a range of 6-8 is essentially like using straight CPAP anyway. But for some people, every little bit of "less" pressure helps them -- helping to prevent aerophagia, if a person is prone to that, or helping to keep mask leaks under control. Neither of those things seem to be a problem for you, however, Peppi.