Can you feel a difference in AHI 0.0 to 4.0 ?

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Can you feel a difference in AHI 0.0 to 4.0 ?

Post by Physician » Sun Oct 24, 2010 11:46 pm

I know several CPAP users who now refuse to look at their morning AHI value. Why ? Because when it's 0.0 they feel fine the entire day.

When it's above 1.0, then they do not feel as well.

So when they stopped observing their night's AHI, they always felt fine all day.

Can YOU detect when your AHI = 0 vs. AHI >2.0 but < 5.0 ?

Do you look at the value every morning ?

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by williamco » Sun Oct 24, 2010 11:49 pm

Oh yes, I can know the difference before I see the software

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by Physician » Sun Oct 24, 2010 11:53 pm

williamco wrote:Oh yes, I can know the difference before I see the software
Tell the difference between which values ?

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by Big Daddy RRT,RPSGT » Mon Oct 25, 2010 5:54 am

I don't feel any different between different AHIs however I do recognize that my sleep was more disrupted before I look at the data. My daytime sleepiness doesn't track the AHI or sleep disruption, it seems independent of these factors. Some nights I think I slept poorly but feel good. Then I think I slept great and I feel terrible. My Auto set usually has a low AHI < 1 occasionally I have a bad night AHI about 4 or 5 but it doesn't seem to make a difference. However if I lower my pressure below 12 cmH2O I have a lot of trouble sleeping...again I don't feel a lot different. If I sleep without my CPAP I feel terrible/sleepy all day.

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by robysue » Mon Oct 25, 2010 6:22 am

I've only been doing CPAP/APAP for a bit more than a month. So this is the perspective of a relatively new CPAPer who's still adjusting to the using the machine at night.

Before getting my CPAP machine, my sleep doctor told me that I would have "little or no" trouble adjusting the CPAP and that I would "soon" be feeling much better than I was before starting CPAP and that I didn't need to worry about tracking my AHI numbers at home. But ...

During the first two and a half weeks I felt miserably tired and sleepy during the day----like 100+ worse than anything I felt before starting CPAP. The only thing that kept me going in those first two weeks was the S9's AHI was always between 0.3 and 1.7. If I hadn't had something to tell me that CPAP was working to minimize the apnea/hypopnea episodes, I would have chucked the machine and given up---I felt sooooo much worse on CPAP.

Since a change to APAP and a decrease in pressure both authorized by the sleep doctor, I've merely felt somewhat worse than I used to in my pre-CPAP days. I'm still waiting on a day that I truly feel back to normal, much less better than I did prior to CPAP. I've currently got a head cold and there have been two days in the last week where my AHI was reported as 2.4 and 3.6. The 2.4 reading surprised me, but I didn't worry too much about it during the day and felt about as good as I have felt on any day since starting CPAP. The 3.6 reading was NOT a surprise, excpet for just how high it was: I tossed and turned that whole night and remembered waking up too many times to count. Of course I also had a nasty head cold that was at its worst that night. The next day I felt really ill due to the cold, but functioned "ok" during the day. That night I went to be very early, slept soundly through the night (for a total of 12+ hours) and woke up feeling much better and knew before I looked at the AHI that it would be way down: It was down to 0.6.

So overall, it does get into my head if I have an AHI over 1.5 right after I wake up, but I don't let it bug me all day long. So far as I can tell, I feel much worse during the day when there is an identifiable cause that is independent of my overnight AHI such as a head cold, seasonal allergies, or muscle aches from sleeping in an awkward position. [The muscle aches ironically seem to be tied to super-low AHI's for me and they seem to stem from my not moving around in bed as much as I normally did in my pre-CPAP days,]

So in conclusion, I still badly need the AHI report in order to keep me believing that CPAP is indeed doing some theraputic good for me and hoping that (some day) I will actually wake up feeling refreshed and alert and looking forward to starting the day. Because if I didn't know my AHI is much lower on CPAP than it was on my diagnostic sleep study, I would have quit by now and joined the legions of ex-CPAP users.

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by Tielman » Mon Oct 25, 2010 8:14 am

Physician wrote:Can YOU detect when your AHI = 0 vs. AHI >2.0 but < 5.0 ?
I've NEVER had a AHI <= 1, much less 0 in 10 months using CPAP. This despite my titration that shows that my pressure (11) "resolved all apneas".

I can tell when my AHI is above about a 3 (which seems to be my magic number). I feel more refreshed, and have more energy with less (but not 0% tiredness). A couple of weekends ago I had a 6.1 and a 4.3 back to back on a Friday and Saturday nights. Sunday was actually WORSE than Saturday because of the combination of two days. That's also why it's hard to answer your question honestly as it depends on the day before (sometimes).

I had an exception to this rule the other day, as I felt fine, and it was a good day, when I looked at my numbers it was a 4.3. Here's where the exception was explainable; in looking at the breath-by-breath data you could see that 80-90% of the 4.3 occurred during approximately one hour (2-3 am, fairly early) and the rest of the time, including the just before wakeup time was really, really good.

Hope this helps!

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by kempo » Mon Oct 25, 2010 9:18 am

I can not tell any difference on AHI 0-5. Anything above yea but not much. I have never had anything above 8 since using my machine so I can't say.

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by DoriC » Mon Oct 25, 2010 9:27 am

My husband's AHI is usually between 1-2cms. On occasion only if it gets to 3.0 on 2 successive nights, he'll need an extra nap on the third day. Thankfully it happens rarely, only if his damaged hip acts up.

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by jmelby » Mon Oct 25, 2010 11:11 am

No... I cannot feel the difference, but I never really had strong daytime symptoms from apnea pre-cpap. I think what you are getting at is that the AHI number reported by the machine can have a psychological influence on someone's self-reported wellness... I definitely think that is the case. I think it is important for people to remember that the numbers reported by a machine are good for trending... and determining whether your settings are correct over time, but not to be taken as completely accurate on a day-by-day basis. Each machine has its own slight differences in the algorithm used, and can certainly sometimes detect certain breathing patterns as hypopneas, for example, when a trained sleep technician who is also monitoring oxygen concentration and actual sleep state would recognize they are not.

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by tattooyu » Mon Oct 25, 2010 12:07 pm

I can tell the difference when I desat or don't desat. The numbers don't always correspond to how I feel.

Example:

I could have an AHI of 1.8 (AI of 0.2; HI of 1.6), but let's say one of those two apneas dropped my oxygen significantly (I ended up on my back for some reason). I might feel terrible, even though the numbers are technically good.

In contrast, I have had times where I had an AHI of 3-4 with no apneas (all hypopneas) and felt TERRIBLE the next day.
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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by Physician » Mon Oct 25, 2010 1:16 pm

DoriC wrote:My husband's AHI is usually between 1-2cms. On occasion only if it gets to 3.0 on 2 successive nights, he'll need an extra nap on the third day. Thankfully it happens rarely, only if his damaged hip acts up.


Really ? And yet up to 5.0 is considered "normal" ?

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by tattooyu » Mon Oct 25, 2010 1:37 pm

Physician wrote:
DoriC wrote:My husband's AHI is usually between 1-2cms. On occasion only if it gets to 3.0 on 2 successive nights, he'll need an extra nap on the third day. Thankfully it happens rarely, only if his damaged hip acts up.


Really ? And yet up to 5.0 is considered "normal" ?
The AHI is probably useful, but really isn't it all about SpO2%?
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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by elena88 » Mon Oct 25, 2010 3:29 pm

absolutely not.. when I get out of bed, I will try to guess what it is before I check it..

sometimes I will feel like absolute crap, and I check it and have great numbers,
other times, I feel not as awful , and have much worse numbers..

my sleep study said I had severe apnea, but I never knew..

I even got my first 0.0 a few nights ago, and felt like crap when I woke up..

I dont think the apap and I are meant to be together somehow.. we are having a difficult "marriage"

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by DoriC » Mon Oct 25, 2010 5:21 pm

On those nights he's having more events I'm also observing his restlessness and semi-arousals and so it just makes for a plain lousy night's sleep as well as a higher AHI. Although <5 is considered good therapy I notice most people don't feel their best unless their AHI is lower. Of course, even those without OSA can feel tired the next day after a bad night's sleep.

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Re: Can you feel a difference in AHI 0.0 to 4.0 ?

Post by Janknitz » Mon Oct 25, 2010 5:34 pm

I've had the occasional bad night with a lot of leaking and it will show in my AHI. But I don't notice any particular difference in my day, which doesn't surprise me because the difference in AHI is minimal--below 1.0 most of the time and I think I got "all the way" up to 1.3 on a very leaky night. Still light years better than 77 AHI on my sleep test (and I thought I slept particularly well that night ). I've never seen anything above the 1.8 average AHI that I had in the very beginning, so I wouldn't know if I'm going to feel worse at 3.0 or 4.

I'm not particularly focused on good days or bad days, but I do notice the occasional bad night.
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