Change in AHI correlated to subjective sense of Change?

[Snoozin' Bluezzz]

This is my first attempt at a poll so please forgive me if I hose it up?

I'm interested in understanding at what AHI levels folks can correlate their subjective sense of improved well being to the numbers. I understand that supposedly movements or 1, 2 or 3 points are not statistically significant and people "should not" be able to discern these differences but I believe I do.

For instance an AHI of 5 is considered the Gold Standard and I can clearly tell the next day if I have have gone over 5 for whatever reason. I have typically been in the 3-3.5 range so to go over 5 means something was different and I feel it. I am grumpier, groggier, less alert and my concentration levels are noticeably less.

If, like today, I dip down to around 1, for whatever reason, I feel markedly more refreshed and alert when I get up although my fatigue/tiredness may progress in a more or less normal manner.

David

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CPAPopedia Keywords Contained In This Post (Click For Definition): hose, AHI

[-SWS]

I think this is a superb poll. My very vague hunch is that most people do not notice a significant subjective sense of improvement with an AHI of 1 versus 4 or 5. I could definitely be wrong, though. This may be one of those efficacy areas that sleep science will have to eventually revisit.

My other hunch is that those patients who do notice a significant clinical difference in incremental AHI deltas below 5, just may experience a different apnea-related etiology than the rest of us with "garden variety" OSA. For a few of us that difference in clinical response just may go back to concepts discussed in the Apnea -v- Hypopnea thread, which I will eventually try to simplify, SB.

[Snoozin' Bluezzz]

My other hunch is that those patients who do notice a significant clinical difference in incremental AHI deltas below 5, likely experience a different apnea-related etiology than the rest of us with "garden variety" OSA. That goes back to concepts discussed in the Apnea -v- Hypopnea thread, which I will eventually try to simplify, SB.

Thanks for the kind word.

I concur with your hunch from what I have read. I just don't know how my etiology may be different. I do not clearly identify with the hypercapnia trigger although I do think there is a CO2 relationship.

I feel consistently better on the Swift than on any other interface. This seems strange to me but it is clearly so. My subjective sense of well-being was starting to break down on the Hybrid after 12-14 days and my AHI numbers were all over the map in the range of <1 to 5.2 or so. Again, I wonder if it is rebreathing CO2 (although Hybrid clearance is strong I bet it is not as thorough as the Swift).

On the Swift, if my nasal congestion is well managed or not significant, my GERD is minimal and I eat less and not late my AHI can be consistenly around 1-1.5 and I feel much better. I am not as disciplined as I could be about all three factors and my AHI can begin to creep up into the 3's and 4's and I don't feel as well. I think my snores go up with later eating and eating dairy which are things I could, but will not necessarily, cease in a consistent manner. But even in the 3-4 range I feel much better on the Swift than I do on the Hybrid, Activa, Headrest and CL2 (the other interfaces I have used).

David

[Goofproof]

I put down 2 to 3, But I supect that's wrong, I think. it's more of a few bad days. over AHI 5, that cause me to be tired, Really it's, how I sleep, that's why I've been keeping track of my number of events and their length. I think the time we spend without breathing is a big factor. Jim

[krousseau]

Great survey-wish I could help-not enough experience yet-haven't gone over 2.6 since I got the card reader & software. Suspect that some people may be more tuned in to their bodies and be able to discern those subtle differences.
It does suggest the idea of keeping a sleep journal with a few notes one could relate back to the numbers-I've been tracking when I take Ambien to see how it makes me feel and how it affects numbers.

[RedThunder94]

i voted for over 5, i hope i did that right, i had a bad night wednesday, according to encore pro i had an ahi of 5.1, i definitely felt it in the morning, i felt like crud all friggin day thursday, haven't checked how i did last night but i suspect that 5.1 ahi was just my one bad day out of many, i have had really good nights too my all time best so far was an ahi of 0.2, and that day i even beat the alarm clock to the punch.

[MandoJohnny]

It's ironic that just a couple of hours ago, my less than competent DME RT called me for a follow up and asked me some 5-point scale questions that were obviously weighted to make the DME look good. He asked if I had any questions. I did have questions, but his answers were lame. I get much better feedback here. He wanted to get some canned feedback from me, but he really didn't want my feedback, if you get my drift.

This is a fun poll, but in truth, I think it puts the cart before the horse. I don't look at my AHI, see it is lower and then say, "Oh yeah, I did have a great night last night." It's more like I feel like I have had a great night. then I feel like I have a good day and then later, a low AHI is sometimes just one of the things I may notice, but not always. I can say lowering my AHI from over 40 in my PSG to consistently under 8 was noticeable. I can say that when my doc and I changed my CPAP settings and the AHIs went to consistently under 4 there was difference. But 4 down to 1 sometimes seems correlated with a difference, but sometimes not.

[krousseau]

I do not look at numbers first either. I'll get up thinking I feel great (or lousy) and go to the numbers to see if there is any correlation. None yet.

[Snoozin' Bluezzz]

This is a fun poll, but in truth, I think it puts the cart before the horse.

Ah, MJ, watta Imma gonna do with you? I always got to set you straight. There was no implication in my poll, or comment, of which order the horse and cart were in. Just can you, or anyone, correlate physical well being to AHI delta of those points. I happen to think I can, others seem to be able to as well, others don't seem to be able to or don't care. That's fine. I was curious to know.

I don't look at my AHI, see it is lower and then say, "Oh yeah, I did have a great night last night."

Neither do I. I get up, I feel really good, sorta good, not so good, really crappy - what's the numbers? I'm curious.

It's more like I feel like I have had a great night. then I feel like I have a good day and then later, a low AHI is sometimes just one of the things I may notice, but not always.

I generally have an idea what the other factors may, or may not, be but they can't be measured like AHI so AHI is what I'm curious about in this case.

I do not look at numbers first either. I'll get up thinking I feel great (or lousy) and go to the numbers to see if there is any correlation. None yet.

Thank you krousseau that is precisely the way I do it as well but, unklike you, I think I detect a correlation

Thanks for the feedback MJ. Its always good to have some chops to bust, in good humor of course.

David

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CPAPopedia Keywords Contained In This Post (Click For Definition): AHI

[NightHawkeye]

I had a good night's sleep last night, but I find that my AHI is just over 6.7 this morning, the worst it's been in over two months. It surprised me too!

My AI, however, was only 1.1, which while higher than usual, happens a lot for me. It's not the AHI so much that makes a noticeable difference for me, but the AI and length of individual apneas. I guess my problem has always been related to apnea length. When my AI goes up and length of the individual events is high then I notice a difference.

Regards,
Bill