Anyone with low AHI but symptomatic?

[Tim M]

Has anyone out there had mild Apnea but terrible sleep? Have you had successful surgery, possibly MMA? I have 6.6 AHI but wake with anxiety and feel as though I have not been breathing. The last 3 hrs. of sleep are very agitated, waking with flashes of panic. I feel hungover, wrenched neck, headache and tired. I have had UPPP and it helped; radio-frequency tongue ablation and it helped; auto-biPAP and it helped. But some doctors say my AHI shows Apnea is not my problem and they point to things like depression and better sleep hygiene. I have a profound problem I think these doctors are really out of the loop when I describe these symptoms and they dismiss Apnea because of my AHI. Now I am looking at MMA surgery. Can anyone here relate?

[trish6hundred]

Hi Tim M,
WELCOME! to the forum.!
Hang in there for answers to your questions and best of luck.

[eviltim]

Yep, my AHI is basically perfect and I still wake up frequently, though thankfully not in a panic or sweat or anything. I just wake up for no apparent reason, then go right back to sleep. It's very frustrating.

Sounds like you need to either be more forceful with your doctors or find better ones...they may very well be correct that your sleep issues are not a result of sleep apnea, but that doesn't mean you don't have a real problem that needs serious attention.

I had the MMA surgery. Didn't help my apnea a whole lot. Wouldn't recommend it unless you absolutely cannot tolerate PAP. You say you have 6.6 AHI is that with PAP treatment?

[Tim M]

Without PAP. Do you think your problem could be something other than Apnea? MMA is a hell of a thing to go through and not get good results. One doctor says he could do a tracheostomy to rule out Apnea 100%. I've heard MMA success rate is 90%. I am surprised you didn't do better.

[mdh235]

Yep, my AHI is basically perfect and I still wake up frequently, though thankfully not in a panic or sweat or anything. I just wake up for no apparent reason, then go right back to sleep. It's very frustrating.

My sleep study AHI was less than 7, but my O2 levels dropped down to 86% so I ended up on CPAP.

Initially, I slept pretty well, only waking up once or twice. After a month on CPAP I've started waking up more frequently, probably three or four times a night. I have no idea why. My AHI is usually below 3, and half of that are centrals.

Usually I just go back to sleep. No panic or sweats or anything like that.

I do fell better on CPAP, but I'm becoming resigned to not being able to sleep through even half the night any more.

It could be worse, I guess.

[eviltim]

Without PAP. Do you think your problem could be something other than Apnea? MMA is a hell of a thing to go through and not get good results. One doctor says he could do a tracheostomy to rule out Apnea 100%. I've heard MMA success rate is 90%. I am surprised you didn't do better.

What I mean is that although the surgery improved my apnea it did not cure it. My AHI is only near-zero with PAP treatment. Success for sleep apnea surgery is generally defined as 50% reduction in AHI. But as you say, it's a lot of trouble to go through if you still have to use the machine afterwards, which is what I was hoping to avoid. In my case I also had a severe underbite not correctable with orthodontics, so it wasn't for nothing. And now that my apnea is under control with PAP, I'm still waking up a lot, so I *think* it might be something else. Although I have read that sleep apnea can cause long-term insomnia as, supposedly, your brain gets used to waking up frequently.

[DocWils]

Yeah, I am still symptomatic a bit - I wake up a few times to full consciousness in the night (that is also a bit of a function of ageing, alas) and am still often tired or sleepy in the day, despite a nice, low AHI and good general readings - some of this is a function of age or other factors, such as weight, etc, and some may have to do with the thyroid playing up or certain vitamin deficiencies (I have no ability to store D, for instance, so am constantly way too low there, and that has a ton of knock-on effects). So you may have to cast the net deeply - I would, as I always do, advise to avoid surgery for this unless you absolutely have no other way out, as eviltim had with the underbite, and work with the PAP as well as you can. Again, diet, exercise and good sleep hygiene can also go a long way to helping (I think this is my broken record bit).

[PaulaO2]

AHI is but one bit of the picture that is Sleep Apnea. We cannot put too much weight onto that number.

There's a lot of factors that go into a good or bad night's sleep.

I've had an AHI of 5.6, with CPAP, and woke up feeling great. I've had AHI of .6 and woke up feeling like crap.

In looking at how we evaluate how the treatment is, or is not, working is we have to look into the entire picture.
AHI
how we feel
environment (temp, noise, etc)
mood
sleep hygiene

There's lots more to that list.

[archangle]

You may have to take charge of your own CPAP therapy.

What exact model of BiPAP machine do you have?

What does it say on the top of the blower unit?

Is it a Philips Respironics unit, or just a Respironics unit?

Which one of these does it look like?



What software do you have?

Before you risk being butchered with further surgery, you need to get a really good look at your breathing while using CPAP.

Even an AHI of 6.6 can really screw you up.

[Kritiker]

There are many things that can disrupt sleep sufficiently to be debilitating and they may coexist with sleep apnea.

If you haven't already done so, you might want to consider:

• having your medical history reviewed by a sleep specialist
  • Respirologist (Pulmonologist) for possible respiratory problems, over and above your OSA
  • Neurologist for possible neurological problems, e.g., PLMD/PLMS (periodic limb movements during sleep)
  If you have already consulted sleep specialists, you might want to consult different ones, to get a second opinion.
  
• getting a full-blown overnight sleep test (i.e, Level 1 Nocturnal Polysomnography) in a reputable sleep lab to monitor
  • brain waves (EEG)
  • heart rhythm (EKG)
  • breathing patterns
  • oxygen levels
  • limb movements

Level 3 Polysomnography, i.e., essentially a sleep apnea trial with an APAP machine, may provide only an incomplete picture of your situation.