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[Treatment] Is AHI a true indicator of sleep quality?
#1
Is AHI a true indicator of sleep quality?
I use Respironics Dreamstation. My settings are 12 cm fixed pressure with FX nose pillow. Normally my AHI range is 0.6~1.8. I feel good with these results. The reason I raise this question is everytime I look at the SleepyHead data, I see some inconsistencies. When I see a event flag, I always check the flow rate and see how the waveform looks like. I have been doing this for quite a few years and my experience tells me that a CA or OA may not always give a pause of breathing of more than 10 seconds. It may not even be a flat line which means that there is a little bit of breathing in between. On the other hand, Hypopnea and " pressure pulse " can be a stoppage of breathing of more than 10 seconds. All these lead me to question the validity of AHI as an indicator of sleep quality. Should we not just look at the raw data ( waveform ) and determine how good our sleep is? Regardless of what the AHI number the machine shows, I always get 2~3 pauses ( breathing stoppage ) of 10~13 seconds every night. Please comment. Thanks.
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#2
RE: Is AHI a true indicator of sleep quality?
I don't think it's meant to be a sleep quality indicator. It's just suppose to be an indicator of disruption to breathing. It's not perfect but it does a pretty good job in letting you know if the machine is treating you. I think anything under 2 AHI is pretty well treated. It doesn't mean there isn't other sleeping problems.
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#3
RE: Is AHI a true indicator of sleep quality?
Sleep quality is a qualitative judgement that should be able to be made without the use of data. AHI is a quantitative measure of breathing disruptions. The two may or may not be correlated, but in general if you have a lot of AHI events, you're unlikely to look back on that night as particularly good. I have often seen members comment that their best nights are not always the ones with the lowest AHI. "Normal" does not mean zero events. Most of us are on this therapy due to considerably above normal events without CPAP.
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#4
RE: Is AHI a true indicator of sleep quality?
Good AHI is NOT an indicator of good sleep quality. However, a high AHI is pretty much guarantee of poor sleep quality.

OMMOHY
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#5
RE: Is AHI a true indicator of sleep quality?
(11-25-2017, 06:54 PM)OMyMyOHellYes Wrote: Good AHI is NOT an indicator of good sleep quality.  However, a high AHI is pretty much  guarantee of poor sleep quality.

OMMOHY

I'll go with that one.
I am NOT a doctor.  I try to help, but do not take what I say as medical advice.


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#6
RE: Is AHI a true indicator of sleep quality?
AHI is a fairly crude but easily quantifiable measure, which is what bureaucrats and bean counters need to justify / refuse payment for machines and treatment. It's also an easy way for sleep docs and techs to determine if the treatment is "working".

AHI counts the number of events, but does not consider their duration. It also doesn't take into account clustering of events. You could (hypothetically) have eight 60 second apneas in the space of 15 minutes but none for the rest of your 8 hour sleep. Resulting AHI is 1.0 - wonderful! It doesn't take into account that those 15 minutes of extreme apnea might have done you a lot of harm.
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#7
RE: Is AHI a true indicator of sleep quality?
Yep, I can see a lower AHI on some nights but a horrible night of sleeping; most all of my CA events can be 30 seconds with a lot 40-50 seconds.  I analyze my data and look at the number of apneic time vs machine time, then I have to take into consideration if I couldn't go back to sleep because of lack of treatment.
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#8
RE: Is AHI a true indicator of sleep quality?
(11-25-2017, 06:54 PM)OMyMyOHellYes Wrote: Good AHI is NOT an indicator of good sleep quality.  However, a high AHI is pretty much  guarantee of poor sleep quality.

OMMOHY

On being informed that my sleep test indicated serious SA, I pointed out that I had little trouble sleeping, waking reasonably refreshed, to a certain extent it is a difficult one to quantify.
My medical fool said that I might think I was getting a good nights sleep, but really I was not! Oh-jeez

Having been given the story that if left untreated my SA would lead to heart attack and or stroke. In a spirit of medical experimentation I went off treatment for 5 weeks, waking feeling little different and clearly still alive, in addition I came off treatment when suffering from a heavy cold/chest infections with no harmful affects, other than from the whisky taken.

It appears to me that the only indications of a good quality sleep are how sleepy you feel the next day, and that you are actually alive the following morning.

In conclusion, when they said I had high AHI I was in fact sleeping well, when I went on treatment, managing only 4-5 hours sleep a night I had lower AHI but with little change in my feel good factor.
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#9
RE: Is AHI a true indicator of sleep quality?
Throat muscles relax more in deep rem sleep, resulting in hypopneas or apneas. Long rem sleep is the gold standard for me for a good night's sleep. Sure enough, those nights my AHI will typically be higher than on largely sleepless nights--or anyway, nights when my sleep is shallow and I'm waking up often. I'm pretty dialed in on my settings, so on a deep rem sleep night I might have a 1.0 or higher AHI; whereas on a bad night I often have a 0.4 or 0.5 AHI. I'll gladly take the rem sleep and higher AHI every time.
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#10
RE: Is AHI a true indicator of sleep quality?
REM sleep is the gold standard for me for a good night's sleep. My jaw and throat muscles relax deeply in such sleep. As a result, I often have a higher AHI on nights when I sleep great than on those nights of shallow dreams and constant awakenings. I'll gladly take the deep REM sleep and higher AHI every time.
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