Inconclusive sleep study

Hi all,

I recently got a sleep study because of some persisting fatigue, the sleep study shows an AHI below 5. Though my symptoms are pretty strong and the RDI is above 5. The RDI during REM is even 8.8, which would disturb my rest quite a bit I'd figure. The sleep doc says this can't be the cause and my fatigue must come from something else, I wonder what you think?

Some background:

I’m pretty sensitive to poor sleep and notice it quickly the next day if I don’t sleep well or go to bed late.
For years, my partner has noticed that I sometimes struggle to breathe or even stop breathing during sleep, but I never really had symptoms myself so I didn’t look into it. Since late last year it’s been happening more often, and now I’m getting noticeable daytime symptoms.

At night I wake up regularly, snore quite a bit, sometimes gasp for air, and often wake up in the morning with a dry mouth and bad taste in my mouth. My breathing often sounds strained and I often dream that I can't breathe. I also grind my teeth a lot, which my dentist made me a splint for. I tried using a chin strap to prevent mouth breathing but it makes me snore more. It does help against the dry mouth though.

During the day I feel tired (even after a full night’s sleep), have trouble concentrating, feel foggy, and am more forgetful. I also crave coffee more and sometimes feel like I could nap, which I never used to. In the evenings I have little energy for hobbies, sports, or social stuff, which I think is the worst of all.

Overall it’s starting to affect both my work and social life quite a bit.

Your symptoms are awful. Sometimes, a sleep study gives a false negative. Ask your insurance company whether they will pay for a second opinion and, hopefully, a second sleep study.

Try to find a sleep doctor who will listen to all the symptoms you just noted. Print them out to take with you.

Your sleep study report appears to be from a WatchPAT home sleep test, which monitors blood flow via Peripheral Arterial Tonometry (PAT) in order to indirectly identify moderate to severe cases of obstructive sleep apnea (OSA).

It's important to note that PAT-based home sleep tests don't directly monitor respiratory activity, and thus are well-known for their frequent ineffectiveness in detecting mild OSA and/or all central sleep apnea (CSA.)

More info here, if interested: Key Limitations and Diagnostic Gaps in PAT Technology Home Sleep Apnea Testing

TLDR: Home sleep tests are a convenient and inexpensive entry-level diagnostic tool for identifying moderate to severe OSA. Since your home test indicates that you don't appear to have moderate to severe OSA, and you continue to have persistently disruptive symptoms of other sleep-disordered breathing, you should push your sleep doc to push your insurance company to authorize a more expensive and much more accurate in-lab polysomnography (PSG) test.

More info here, if interested: Decoding sleep apnea tests: Home vs. sleep clinic studies

Sleepzilla wrote: ↑

Thu May 14, 2026 2:40 pm

you should push your sleep doc to push your insurance company to authorize a more expensive and much more accurate in-lab polysomnography (PSG) test.

Ditto