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Features Include -
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Thanks for all the love & support!
Uncle Nicko

We all use the AHI (Apnea-Hypopnea Index) calculated by the CPAP machine to guide our CPAP therapy. We all assume it's accurate. It's not. Sometimes it's not even in the ballpark.

The American Academy of Sleep Medicine (AASM) recommends hypopneas be defined based on a ≥ 30% decrease in airflow for 10 seconds or more with some additional criteria included. It's the definition most specialists & sleep techs use when analysing diagnostic sleep studies.

ResMed (and other manufacturers) have increased the threshold from 30% to 50%. They've also stated hypopneas without flow limitation are not scored as they typically do not result in oxygen desaturation or arousal. I'm calling BS on that. It's almost like they don't want to flag events.

So unless there's a 50% reduction in your airflow, ResMed doesn't think it's worth flagging. It doesn't meet the 'criteria'. You could be having hundreds of 40% drops a night just like Joe, severely affecting your sleep quality, and you wouldn't even know! Although, you'd probably feel pretty shit during the day, which many of you are reporting.

Perhaps, and this is pure speculation. The manufacturers have set these high 50% thresholds, so the machines have an excellent probability of calculating an AHI under 5? It would be fascinating to see those MyAir app scores change if they dropped to 30%, as recommended by the AASM.

In all honesty, I don't like the AHI number. It's a 'standardised' number that isn't standard, often misleading. I'll give you an example. You could have someone with an AHI of 30 who has SEVERE APNEA. That person might have mostly 10-second hypopneas with mild 3% oxygen desaturations. Another person might have an AHI of 10, classified as mild, yet they have 1 minute long apneas with oxygen levels dropping to 50%. I would argue that severe apnea is the AHI of 10 in this scenario. There are many shades of grey, and this 'one size fits all approach to diagnosis and treatment needs a rethink.

https://sleephq.com is now available for ResMed AirSense 10 or 11 users. It's super easy to upload, review and share your cpap therapy data charts. We're adding new CPAP machines to the platform every month, so join our mailing list, and we will let you know when your CPAP is compatible https://cpap.review/sleephq-newsletter

If you use a different CPAP. OSCAR is open-source software that will enable you to view your flow rate (breathing data) - https://cpap.review/oscar

A big thanks to Warren (Waz) for letting me share his CPAP therapy data with the world. All the best for a speedy recovery, legend.

This will no doubt be a topic of debate. Feel free to discuss this in the comments. Please share your thoughts and insights.

#CPAP #ResMed #Apnea

00:00 - Hard Truths
02:25 - CPAP Flow Rate Data - Breathing!
03:25 - Normal Breathing - The Baseline
04:20 - Irregular / Unstable Breathing
04:55 - CPAP Flags
06:05 - CPAP vs Sleep Techs Apnea Count
06:50 - CPAP Trend Data
08:15 - Example 2 - Missed Flags
09:30 - What Caused This?
11:45 - The Solution
14:55 - RemSleep 02 Rings
15:10 - CPAP Advice
15:55 - Take Home Message