Is AHI of 3 good enough?

OK, I know just titling the past like this will lead to an array of answers saying things like how I feel is more important than ahi, etc. and I do feel like I'm rehashing many posts with this, but it is something I'm wondering. I'm 5 months in, not really feeling better, averaging an AHI of about 3. No mask problems currently, feel like I'm sleeping well. So, my question is, should I feel significantly better by having apnea events only about 3 times per hour rather than the 20 times per hour I had before cpap? (I would think that would feel better!) Or is the fact that I am still having roughly 20 events a night enough to make me still feel crappy? My brother is also on cpap (many years), and he was surprised I'm still having apnea events at all. To be honest, how I feel on a day to day basis seems to have absolutely no correlation to ahi or even the number of hours I sleep. So, really I'm just curious if you all feel pretty okey-donkey when you have an ahi of 3 or if that is too high to feel good for you.

It really depends on what the 3.0 AHI is composed of. We really need to see some sleepyhead charts. How many OA, H, CAs ?????

I've posted a bunch in the past. A typical night will have about 2 CA, 2 OA, and about 17 H. Hypopneas is always the highest, with an average of 16-20 a night.

Rainmom17 wrote:OK, I know just titling the past like this will lead to an array of answers saying things like how I feel is more important than ahi, etc. and I do feel like I'm rehashing many posts with this, but it is something I'm wondering. I'm 5 months in, not really feeling better, averaging an AHI of about 3. No mask problems currently, feel like I'm sleeping well. So, my question is, should I feel significantly better by having apnea events only about 3 times per hour rather than the 20 times per hour I had before cpap? (I would think that would feel better!) Or is the fact that I am still having roughly 20 events a night enough to make me still feel crappy? My brother is also on cpap (many years), and he was surprised I'm still having apnea events at all. To be honest, how I feel on a day to day basis seems to have absolutely no correlation to ahi or even the number of hours I sleep. So, really I'm just curious if you all feel pretty okey-donkey when you have an ahi of 3 or if that is too high to feel good for you.

Way to many unknowns from your post, but if it were me, I would be scrutinizing my settings. And, everybody's different.
Have you taken control of your own therapy or are you depending on your doctor to dictate your settings?
How much sleep time are you actually getting? That can make a big difference in how you feel.

At two months in, I was under 1.0 (from an untreated AHI of 45 in my sleep study) with a straight pressure of 10 cm.


Den

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I've actually received lots of feedback in the past about my settings, etc. guess I'm really just curious if an ahi of 3 feels fine to the experienced folks out there.

Rainmom17 wrote:I've posted a bunch in the past. A typical night will have about 2 CA, 2 OA, and about 17 H. Hypopneas is always the highest, with an average of 16-20 a night.

I'm confused. You have a straight pressure machine listed in your profile (Dreamstation Pro) but your screen posting of November 8th (posted Nov. 9th) shows an APAP with a range of pressures.......with a whole lot of pressure changes during the night. Some people don't sleep well with changing pressures ( I sure don't ). At this point, you might try a straight pressure setting for awhile to see if it helps with "how you feel".


Den

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3-5 range wasn't good for me. Didn't feel any better until the forum members helped me get it down to around 1. It's different for everybody.

2-3 seems to work well for me.

There are people for whom an AHI of 3 simply isn't enough for them to feel much (if any) improvement and there are some that can't tell any difference in how they feel no matter how good or bad the "numbers" are.
So is it impossible not the residual AHI is enough to cause you to feel less optimal....of course it's possible.

Some people can pretty much tell the difference between a night with AHI of 1.0 and 3.0....and there are people who can't tell a difference between 2.0 and 10.0.

3.0 would be "good enough" for most doctors in terms of therapy on paper but on paper doesn't always reflect real life unfortunately.
There's always the same stuff potentially going on that we have discussed in the past that also plays a part in how we feel that doesn't necessarily show up on the "reports". Getting nice low AHI numbers doesn't always guarantee that we feel as good as the numbers lead us to believe that we should feel.

Are you still having trouble with sleep quality if you try more pressure? I know we have talked about this in the past but you had problems with a relatively small increase (like 0.5 cm) in an effort to reduce the number of hyponeas. Have you tried a little more pressure recently?

Some people think that if the events are "only hyponeas" that they really aren't that big of a deal but my thinking on that is if they weren't all that important then why are they part of the AHI and part of the diagnostic criteria. They still have the potential to disrupt sleep or cause arousals and its the arousal part that messes with the sleep quality/architecture needed for the best chance for the restorative powers of sleep to work their magic.

In the past you still were complaining of multiple awakenings during the night....are you still have those?
If so, any idea why they are happening?

Personally, an AHI of 3 would have me trying to troubleshoot to get it down. I do understand we all have to pick our battles, like if increased pressure causes more centrals, air in the belly, or excessive leaks. I think a reasonable philosophy is to go as low as you can go without crossing a line of diminishing returns, especially if you're feeling there is still room for improvement. Based on the struggles you've already gone through getting adjusted, it seems to me you're making progress. Maybe your AHI will settle down over time, but whatever helped you get your AHI down to 3, would a bit more of those efforts be doable?

Thanks everyone. Appreciate the feedback.
Pugsy, I have found a minimum pressure of 7.5 is currently working best for me. I tried about 2 weeks with 8 minimum, but ahi was routinely higher. Weird, I know. Since going back to 7.5, it's ranged from 1.1-4.8, with an average around 2.7. At 8 minimum is was 2- 6.4, with an average around 3.5. Maybe not hugely different, but every time I've tried 8 it's been the same.
With the 4 day weekend I've gotten extra sleep. Averaging 8 hours a night with an ahi average of 2.4. Generally sleeping solidly through the night. The sleep itself feels good, just not the awake part. Feel just as crappy as usual. I'm still trying to figure out how much is apnea-related vs some other health issue. Think it may be the lady hormones - I am in the menopausal phase of life. Will see my doc this week to talk about it.

I don't know anything honestly but if your getting good results with xpap and still not feeling better is it possible you have another issue?
Do you have depression or anxiety or other medical issues that could also cause you to feel the way you do?
Not saying you do but if if these great people can't help you feeling better then I think it's definitely worth getting checked for other issues so you can hopefully feel better.

Rainmom17 wrote:Thanks everyone. Appreciate the feedback.
Pugsy, I have found a minimum pressure of 7.5 is currently working best for me. I tried about 2 weeks with 8 minimum, but ahi was routinely higher. Weird, I know. Since going back to 7.5, it's ranged from 1.1-4.8, with an average around 2.7. At 8 minimum is was 2- 6.4, with an average around 3.5. Maybe not hugely different, but every time I've tried 8 it's been the same.
With the 4 day weekend I've gotten extra sleep. Averaging 8 hours a night with an ahi average of 2.4. Generally sleeping solidly through the night. The sleep itself feels good, just not the awake part. Feel just as crappy as usual. I'm still trying to figure out how much is apnea-related vs some other health issue. Think it may be the lady hormones - I am in the menopausal phase of life. Will see my doc this week to talk about it.

Do you wake up "naturally" or do you have an alarm clock?
By waking up to an alarm clock you could be in some sleep stage that makes you feel "out of it" for awhile.
We cycle through the sleep stages at 90 - 120 minute intervals.


Den

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During the week I use Sleep Cycle alarm clock to get up for work. It has a 20 minute wake up range - it tries to determine the optimum time during that cycle. So I am seldom woken during really deep sleep. On weekends and holidays, I wake up naturally. Feel lousy either way. Although I will say that during the work week, I tend to feel best around Thursday, which I can only attribute to the regular wake-up time during the week.

Rainmom17 wrote:During the week I use Sleep Cycle alarm clock to get up for work. It has a 20 minute wake up range - it tries to determine the optimum time during that cycle. So I am seldom woken during really deep sleep. On weekends and holidays, I wake up naturally. Feel lousy either way. Although I will say that during the work week, I tend to feel best around Thursday, which I can only attribute to the regular wake-up time during the week.

Can't hurt to read this and try to work on sleep hygiene especially if you think the routine during week helps.
https://sleepfoundation.org/sleep-topics/sleep-hygiene