Low AHI feels worse

[Okaythen]

When on CPAP, why would a low AHI—e.g. under 1—make one feel more tired and worse in the morning than a higher AHI—e.g. 2 or 3? This has been my experience.

[ChicagoGranny]

How do you know the low AHI is the cause? There are many variables to sleep, rest, the body and the mind.

[chunkyfrog]

Add in bed comfort, room temperature, humidity, noise level, whatever;
or if you are coming down with a "bug".

[Okaythen]

ChicagoGranny, this is the pattern I experience. Nothing to do with cause. What happens in my body when my AHI is below 1 to make my sleep worse? I have no idea.

[Okaythen]

ChunkyFrog, no, it’s none of that. I’ve seen people ask this question before but nobody seems to know the answer. So it doesn’t happen to just me.

[ChicagoGranny]

Nothing to do with cause.

Huh? It was you who said it was the cause.

why would a low AHI—e.g. under 1—make one feel more tired and worse

[Okaythen]

Pardon me for not wording it properly. Why do I feel worse with an AHI of under 1? I should have said. Just semantics.

[ChicagoGranny]

Because you've noticed a correlation, you seem to be stuck on the idea that it is causation. You are rejecting other ideas. For instance, you rejected these ideas:

bed comfort, room temperature, humidity, noise level, whatever;
or if you are coming down with a "bug".

Do you use OSCAR to closely monitor your breathing?

[Okaythen]

You obviously don’t have the answer, so why bother responding? It’s not those things. I mentioned that it’s happened before, on multiple occasions actually. It’s probably more microarousals, for whatever reason, since the breathing events are being addressed. Thus the worse sleep quality.

[ozij]

You obviously don’t have the answer, so why bother responding? It’s not those things. I mentioned that it’s happened before, on multiple occasions actually. It’s probably more microarousals, for whatever reason, since the breathing events are being addressed. Thus the worse sleep quality.

Maybe on the low AHI nights you're not getting into deeper sleep or REM sleep - and are therefore more tired.

[Okaythen]

Ozij, I’ve thought of that. Good thought.

[lazarus]

When there seems to be a consistent correlation between one night's AHI and how one feels in the morning (either opposing or aligning), I suggest not checking AHI until the end of day to make sure expectations aren't inadvertently coloring the perceived correlation. It is too easy for the mind to think "then why don't I feel better/worse this instant?' when seeing a number. We have to do our best to double-blind ourselves with our own data.

It's the long trending that matters anyway, so it's probably better not to look every day. Reducing one night's AHI into some sort of a Magic 8 Ball or daily horoscope that we then consider always wrong or always right is probably a fundamental abuse of what that one night's data is for anyway, in my opinion, in the context of optimizing treatment.

But, yeah, I do it too.

[Hang Fire]

When on CPAP, why would a low AHI—e.g. under 1—make one feel more tired and worse in the morning than a higher AHI—e.g. 2 or 3? This has been my experience.

You left out a key piece of information. What is the breakdown of those AHIs - clear airway/obstructive/hypopnea?

[Okaythen]

Lazarus, this is all well and good but I’ve been on CPAP for 6 years now and this is the pattern. Always when I’m more relaxed via interventions that calm the CNS. Never fails. If AHI goes under 1, I am more exhausted. The purple under the eyes even matches it. I understand if nobody has an answer. Neither do I.

[Hang Fire]

I suggest not checking AHI until the end of day to make sure expectations aren't inadvertently coloring the perceived correlation.

Wouldn't it be the other way around? You see a higher AHI which becomes a self-fulfilling prophecy for "feeling worse"? Strange duck who sees a lower AHI and says, "Oh no, I'm going to have a bad day."