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Chasing numbers and how do you feel.
#1
Chasing numbers and how do you feel.
Many times I read on this forum about getting low numbers for AHI. It is advantageous to anyone with sleep apnea that their target AHI should be as low as possible. A low AHI will indicate that a person is experiencing fewer apnea and hypopnea which will mean that they should begin to feel better. However, this is not always the case.

Often times it is the experience of a treated patient to get AHI numbers in the 1-3 or 4 range but the complaint inevitably surfaces, “I don't feel good.” So, if anything under AHI 5 is considered treated, then why is it that we may still feel bad? The answer to that is as unique as a patient is unique themselves.

Everyone has their own specific set of symptoms and just like a snowflake, for example, there are never 2 that are identical. The math for how AHI is written in stone, but how we feel is our own experience. There are many more questions that can be posed for this broad topic and thus the purpose of this thread.

We will not likely settle any debates that may occur here, and I'm purposely leaving out a lot. But the big hope that I have is that the sharing of experiences and a fair debate on some topics will shed some light on AHI and how we feel, and how do we get to feel better.

Thanks to everyone that contributes and asks more, I'm going to look here for insights and wisdom for the articles I've got in the works and articles that we may need to hone and articles we may need to create.

Most importantly,  for those that are still feeling bad or having bad days, I hope you find the answer to feeling good for yourself here.

Thanks Y'all!

P.S.- for myself, CPAP is a life changing therapy and I believe CPAPs therapeutic value is priceless. It's an honor to help when i can and i genuinely enjoy being a part of this forum, therefore I'm grateful to those who have helped me and look forward to getting more answers for the questions that I post here.
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#2
RE: Chasing numbers and how do you feel.
Well said.

And I add the caveat that getting the AHI to zero is not a realistic goal. With our software and wifi cards and all that stuff, we can too easily get caught up in the "get it as low as I can" mentality.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.




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#3
RE: Chasing numbers and how do you feel.
So, i am very guilty of this myself, but its easy to focus on numbers, but remember that quality of sleep is determined by a whole variety of things, some CPAP related, some not. And even a low AHI can be misleading in the absense of context.

For AHI - You can have a score of 1, which looks great. But if your night only consisted of 4 hours of sleep, that is still one event an hour; and just one disruption an hour can cause you to not get a deeper sleep that you need. Or even a more realistic sleep of 6 hours (like what i normally get)... even an AHI of 2 -3 is a significant number of events in one night.

Even with a low AHI and long hours, it still may not be restful. If you are constantly being disturbed by an ill-fitting mask, machine noise, or any one of a number of physiological problems that can disturb you (i deal with significant back pain, which kills my sleep, even on a .5 AHI night).

I also think alot of people forget or neglect that what you eat or drink before sleeping will also impact your rest. A heavy meal, or carbonated drink can and will disturb you (gas, burping, indigestion). I won't lie - ive been awoken by a burp or two before; you dont think anything of it, but if it takes you all the way to alert, that is a pretty big disturbance.

While i love my machine, and i genuinely think it saved my life, i think people need to take a holistic approach to their sleep, and not just assume that the machine will fix everything. Much like losing weight, its not JUST about one thing.. normally, its fixing several things as a whole.
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#4
RE: Chasing numbers and how do you feel.
My ASV faithfully rewards me with AHI's averaged under 2.0. Occasionally this is somewhat higher or lower, Cap'n Obvious Dave says because 2 is the average I remember right now. I will report that I am beginning to feel better for the ASV treatment, manifesting by more rest and feeling a bit more energy in the daytime hours. Can I say that I'd feel more rested if I'd faithfully get a 0 AHI. No I can't. To the best I recall, anything under AHI of 5 feels the same to me. I have had nights of 3.something and zero.something, and I wake up feeling basically the same with both.

Coffee
Dave

I'm not a doctor in real or fictional life. My posts include opinions based upon user experience regarding CPAP therapy and should not be considered medically professional direction or advice. Even a 1,000 mile trip requires a good first step. My recommended first steps include getting good walking shoes, 1 great cup of coffee, and a good GPS.

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#5
RE: Chasing numbers and how do you feel.
This reminded me of a thread started a few years ago.

http://www.apneaboard.com/forums/Thread-...vs+Reality

I’ve always enjoyed a low AHI reading, usually 1.5 and under.  No CA’s, hardly ever see an Obstructive.

On many days early in my treatment, I would wake up feeling bad, like I did battle with someone or something.  Then I would see an AHI of .5.   I should have felt great, right?  After looking at SleepyHead,  I noticed lots of Reras’s and Flow Limitations.  

Then there were the mornings I woke up feeling great, only to discover my AHI was high (for me) >4.
I should have felt bad, right?  But I didn’t feel bad, I felt really good.

Hence...Perception vs Reality.

Now, after three+ years, I do take a quick look at the reading on my Apap display in the morning,
but unless the AHI is higher than what is normal “for me,” I look no further.  I download the data monthly.

Sure, when your new, it takes time to get your numbers dialed in, and you should look over your data and try to learn, but obsessing over low numbers, and trying to reach an AHI of 0.0 won’t necessarily make you feel better.

Life is short, live it and try not to obsess over numbers too much.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
RE: Chasing numbers and how do you feel.
I feel good generally. I still drag out of bed most days but i get moving and i feel fine in 30 minutes. I've heard of sleep inertia and i think i suffer from that and probably laziness.
My AHI is anywhere from 2-4 usually and sometimes 5. I don't expect to feel great all the time. Most days I'm not great, I'm good. I struggle with allergies big time, but I'm well managed with medications. So, i know that i have other contributing factors for sleep quality. I generally don't practice good sleep hygiene practice either, but i accept how i feel and i am satisfied most of the time.

I've quit chasing numbers, and don't set goals to get low AHI anymore.
Only goal i keep is that me and the wife use our machine. If any issues with therapy come up, we will address them and move on.
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#7
RE: Chasing numbers and how do you feel.
What I have found with my wife's S9 machine is that I can get lower AHI's (<1.0) with higher pressures and no EPR. However, she likes the EPR, so I sacrifice her AHI to keep EPR comfort, and limit max pressure. I think the basic issue is that if you get lower AHI numbers but the pressure is waking you up in the night, you may not feel better in the morning.
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#8
RE: Chasing numbers and how do you feel.
By definition, anyone that experiences 5 or fewer apnea, hypopnea, and/or RERA is classified as normal. As sleep apnea patients we strive to be normal and in order to get normal we go to great lengths. We secure our faces to machines through hoses that blow pressurized air into our body. Is it worth it? Of course!

So when we get to our normal AHI, we should feel normal and fresh in the morning. But we don't. Anyone that is not a sleep apnea patient isn't going to feel refreshed all the time. People without sleep apnea wake up groggy and sore and they too, feel bad from time to time.

As sleep apnea patients we are under a little more stress. Our routine is not as easy as just putting our head on the pillow and shutting our eyes. We work at getting a thorough nights rest so that we can feel better the next day. We practice and experiment to a degree to keep feeling better. The end result is that we consistently sleep well this week, next month, and the rest of the years that follow.

We know what the consequences are if we don't follow this regimen of therapy. Along with the complications that most of us endure, it is absolutely vital that we try to nail down some numbers that we need to get to feeling more normal. But we need not add more stress, especially right away, in getting close to 0.0 AHI.
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#9
RE: Chasing numbers and how do you feel.
Thanks I got called normal! AHI numbers under 5!

lots-o-coffee
Dave

I'm not a doctor in real or fictional life. My posts include opinions based upon user experience regarding CPAP therapy and should not be considered medically professional direction or advice. Even a 1,000 mile trip requires a good first step. My recommended first steps include getting good walking shoes, 1 great cup of coffee, and a good GPS.

Wiki Info for Beginners
Sleepyhead Chart Organization
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#10
RE: Chasing numbers and how do you feel.
No Dave. He wasn't talking about you.  Rolleyes
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