OSA/AHI/Depression/Anxiety/Sleepiness/Fatigue: A 2010 Study

Interesting.......thank you for sharing.

One thing this study looks at, is the OSA population without co-morbidities.......

Is is a somewhat limited test population--49 individuals........

but interesting in stating that the ahi isn't necessarily the best predictor of the significance of OSA's impact on quality of life for the individual

I don't think we have to look very far to confirm that AHI does not relate to sleep quality. Many people here report a machine scored AHI below 1, yet still complain of crappy sleep.

Sleep disorders are very complex. Removing obstructive apnea is part of the solution, but that is simply done by xPAP therapy in most people. If arousals are the source of unrestfull sleep, the focus, after removing obstructions, needs to be on how to minimize the impact of the arousals. I am not convinced that blowing air up your nose at higher or lower pressure, or pulsing air flow is the best way to deal with arousals.

On one hand we need arousals otherwise we would sleep until we die. On the other hand we don't need to have arousals occurring 30 times an hour while we are trying to sleep.

This reminds me of the chicken and egg discussion. Do arousals cause so much fatigue that apnea occurs, or does apnea trigger an arousal. Or does an underlying imbalance (like a lack of cellular magnesium... ) throw the bodies electrical system out of whack causing both arousals and apneas... and heart rhythm irregularities.

I like the study, small though it is, for the way it selected the people studied and the questions it asks in relation to the measurement of sleep-breathing and the effects of disrupted sleep and low overnight O2, while the selection took things like obesity, other diseases, and treatment choices out of the picture, for the most part. Well, there is that, and also the fact that it agrees with my way of thinking about it all.

There is a long history on this board of reminding people that AHI measurements should not be overstressed, since treatment-AHI, and especially any home-machine estimate of it, is only one small measure of what is happening and what is being treated.

Fixing bad breathing during sleep makes a lot of people healthier and helps them feel better. But it is not a magic pill that makes a person's sleep perfect from that day forward, and treatment of bad breathing during sleep won't magically cure every health problem a person has.

Breathing well at night during sleep makes it that much easier to solve other sleep and health problems, so it is worth it to do all we can to breathe well while asleep. At the same time, we have to make the other right choices when it comes to things like nutrition, physical activity level, treating other problems, and the way we live our lives and handle our relationships, if we hope to take care of ourselves as we should.

Anyway, the study was a good reminder to me that someone with so-called mild OSA might be just as miserable, or more so, than someone with very severe OSA, since the severity is generally labeled based on AHI alone without regard to symptoms. Often I tend to assume that the thing being measured is the most significant thing, simply because that is what is being measured. It is good for me to remember that the things not getting measured can be just as significant, or even more significant, in the case of any individual trying to fix his or her sleep and his or her breathing during sleep.

Maybe one day there will be larger studies along these lines; or maybe they have been done, or are being done--I don't know. The only thing I don't like about the study is that, to me, once you find out someone has the problem, the ethical thing to do would normally be to help the person get it treated right away. And that is reason #427 why I would make a lousy medical researcher!