AHI less than 5...Sleep Therapist says 'not to worry'

[RuthArt]

Fortunately, since being on APAP, my AHI has been consistently less than 5 so my
sleep therapist says I shouldn't be concerned about my readings

Should I believe that? I don't feel any better yet and the whole month of March
I had issues with my mask (or something) which caused me to hyperventilate
a lot, so off the mask would go.

Last night I had 6 hours straight with the same mask, even when I would wake up to
roll over, I did not have any problems, so I thought my AHI would be low like I want,
but it was 2.1 Should I even be concerned that there were H, OA and CA if the
AHI was that low?

[Pugsy]

Should I even be concerned that there were H, OA and CA if the
AHI was that low?

I wouldn't be worrying as long as I was sleeping decently and feeling decent.

[LSAT]

2.1 is a great AHI...You have only been on CPAP for a couple of months. AHI will fluctuate from night to night. No one sleeps the same every night. The key is how you sleep and how rested you feel. If you are having issues with your mask it will affect AHI.

[RuthArt]

I have had some great nights with AHI less than 1, so I suppose that is what I keep striving for and
when I don't get it, I wonder what I'm doing wrong.

thanks for the encouragement

[Papit]

Last night I had 6 hours straight with the same mask, even when I would wake up to
roll over, I did not have any problems, so I thought my AHI would be low like I want,
but it was 2.1 Should I even be concerned that there were H, OA and CA if the
AHI was that low?

Hi RuthArt. Most folks here would be delighted to have AHI readings of 2.1. Mine too have come down to that and I too don't wake up in the morning feeling wonderful, refreshed and alert. In general, breathing at AHI=2 is much healthier breathing than breathing at AHI=14, for example, or any higher number. Seems to me that we're much less likely to die in our sleep.

[Twelve12]

When you say you don't feel any better, do you mean you are not feeling more rested now? Do you feel sleepy during the day? Has day sleepiness increased, decreased or stayed the same?

I know there is a lot of focus on data/numbers here -- and I am just learning all of that. I also think how we feel is important. Low AHI does not necessarily mean more sleep, deeper sleep. Hopefully and I think even generally it works out that way...that we sleep better when we can breathe and are not mini waking all of the time. I don't know statistics for the learning curve to get used to CPAP. I would suspect that it takes some people a while to get to sleeping with a mask. Maybe this impacting how you feel. Even though your AHI is in a good (enough) range, you just need some more time to get used to it and/or get the benefits from it??? Sometimes tweaks are necessary -- different mask, pillow, humidity, etc. They might not impact AHI but might go toward overall comfort level.

[Twelve12]

Adding that sometimes being too focused on AHI seems like watching the clock. I learned a long time ago not to look at clock at night when I wake up because I just get focused on it and it doesn't do any good. It seems your AHI is in good enough range. Overly focusing on a 1 might just increase anxiety about sleep.

[bwexler]

It sounds like you are making progress but I do believe it is worth while to look at your sleepyhead graphs.
If a cop stopped you on the freeway for speeding at 100 miles an hour and you told him your average speed was only 60 because the traffic slows you down so often, what would the cop do.
When you look at your sleepyhead data you can see and identify all sorts of detail about what may be causing issues.
You can also add a recording oximeter. When you spot trouble, you come back here and ask for specific help on that problem. It could be leaks or flow limitations or desats or pressure swings. Maybe you will discover everything is working great and you just need to overcome accumulated sleep defisit.

Keep up the good work.

[Luthie2006]

I believe Pugsy is 100% right and others. It depends on how rested you are. My AHI is constantly on a regular basis 0.0 or 0.2 or 0.7 (always under 1 since I started CPAP therapy) and I sleep lousy, fragmented sleep a lot of the evening and hard to fall back asleep when I do wake up. So I think my very low AHI is somewhat "misleading" because a lot of that time I am breathing normal being wide awake, so my AHI number to me is skewed. I am never refreshed in the morning and tired all day long with my low AHI number. So for me, yeah it's great that my AHI is so low, but I am still not refreshed and very tired in the morning. So do you see the difference here? Low AHI every single night but fragmented sleep and feeling lousy all day still.

[Papit]

When you say you don't feel any better, do you mean you are not feeling more rested now?

That is Correct, Twelve12 .

Do you feel sleepy during the day?

Correct

Has day sleepiness increased, decreased or stayed the same?

It has stayed about the same. Check out Luthie2006's post below. My experience is just like hers. Btw, your initial post is what motivated me to put up the new POLL: "How do you feel using your xPAP?" It will be interesting to see how other members have responded to their treatment. You may simply need a couple weeks or a couple month's time to allow the therapy to work more fully for you. I wish you the best.

[Hydraulix989]

I notice that how well rested I feel in the morning is VERY correlated with my AHI even down to <1. Whenever I feel amazing in the morning, I check my AHI and it's almost always < 1, but on crappier nights, I feel not so well rested, and when I check the machine in the morning, the AHI is usually in the 1.5-2.0 range. I'd say it's a pretty strong correlation, in that I rarely see the opposite cases (sleep bad, AHI < 1 or sleep good, AHI > 2).

To me it seems pretty illogical and arbitrary to draw a cutoff line at AHI 5. That means you still stop breathing FIVE times an hour in your sleep! It appeals to the human perspective that stopping breathing in your sleep at all shouldn't be considered normal.

[Twelve12]

Btw, your initial post is what motivated me to put up the new POLL: "How do you feel using your xPAP?" It will be interesting to see how other members have responded to their treatment. You may simply need a couple weeks or a couple month's time to allow the therapy to work more fully for you. I wish you the best.

Thank you for posting the poll. So far, the results are encouraging. I will receive my machine in 6 days (not like I'm counting). It's odd to be so close to something that might help sleep and have to wait a tiny bit more...and then maybe the tendency is to put TOO much hope into it. I think optimism is a good thing. I am going into this with the hope that it will make a difference.

But I'm like you with the numbers - I would like to get best possible numbers and it seems it can be almost a puzzle to figure out how to accomplish that. People here are crazy smart/experienced with this stuff...interpreting the data. I am sure my doctor (just a regular family doctor) is not nearly as knowledgeable as many people here. I hope you figure it out!

[RuthArt]

Today was my day with the Sleep Therapist....I told her about the comments you have all made and she
feels I should stop being fixated on the numbers (she almost didn't give me back my SD card!) and not
look at the data but maybe once/month.

I don't always feel as sleepy during the day as I used to, but I have gained weight and don't get the
exercise I know would help, so now I will start focusing on that aspect.

Thank you all for your comments and suggestions.

[Wulfman...]

Today was my day with the Sleep Therapist....I told her about the comments you have all made and she
feels I should stop being fixated on the numbers (she almost didn't give me back my SD card!) and not
look at the data but maybe once/month.

I don't always feel as sleepy during the day as I used to, but I have gained weight and don't get the
exercise I know would help, so now I will start focusing on that aspect.

Thank you all for your comments and suggestions.

What are all of your settings?

Since it's YOUR therapy, I hardly think it's relevant for the "sleep therapist" to be the judge of it.
With the types of comments she made, I'd be "kicking her to the curb".

Oh......and did I mention that it's YOUR therapy? (and not hers)


Den

.

[palerider]

I'd say that trends are probably more relevant than day to day numbers.... things ARE going to fluctuate up and down day to day, but looking at the trend is where I'd suggest you go, things generally getting better, worse, staying the same...