AHI/Hr on SleepyHead Reports

I have an average AHI of 1.87 over the past 652 days according to my data from SleepyHead. This is very good. However, when I look at the details I see that my AHI/Hr rate fluctuates, often with a peak towards the end of the night (but not always). The maximum value of 22 was only reached on one occasion, but is fairly regularly above the 5 that is quoted as being the target to get below. My question is whether this is anything that warrants discussion with my sleep doc? Could this explain why some people "fail" on CPAP, because although the pressure is enough to prevent apneas for most of the night (resulting in a low overall AHI) there are still phases of sleep (REM?) when more pressure is really needed? Although I feel much, much better than before starting treatment, I feel there is more that could be done. Thanks for any thoughts on this, even if it is "that guy is crazy!"

SleepyToo2 wrote:My question is whether this is anything that warrants discussion with my sleep doc? Could this explain why some people "fail" on CPAP, because although the pressure is enough to prevent apneas for most of the night (resulting in a low overall AHI) there are still phases of sleep (REM?) when more pressure is really needed?

I call those times when I seem to have a significant number of events "clusters". Often preceded and followed by long intervals of no events which helps keep the overall AHI well below the acceptable AHI of 5. In my case these clusters are likely REM stage sleep since I know from my sleep study that I am worse in REM. Some people will have this happen when they sleep on their back.

An occasional cluster...I wouldn't worry about. Things happen. Now if I saw 2 or 3 of such clusters over the night...every night...then I would want to do something about them. When I first started therapy I had multiple clusters just like that along with feeling horrible with AHI 6 to 10. Using APAP I increase my minimum and maximum to the point where those clusters were broken up and became a very rare occurrence. I started to feel better when I did that and AHI dropped to 3 to 4.

So yeah, those clusters can mess with how we feel if we have very many of them. If I had not had the software so that I could see the clusters and figured out how to break them up...I would likely have tossed the machine in the closet because even with AHI of 6 to 10 I felt horrible and likely would have said "this crap isn't working".

The Clusters seem to be the events that bother me the most. I will usually suddenly wake up with a massive headache. Later, after I look at the data I realize that when I woke up I had just gone through a Cluster events over a very short period of time, like 12 events over 6-7 minutes. Now, I take a Tylenol and go back to sleep.

I have noticed lately, thanks to Sleepyhead, that the pressure usually starts building up when I have the clusters. More stuff to discuss with the Dr.