[DiggyJohnson]

Wait are you claiming your still wake up feeling like shit even though you are objectively getting better sleep? Or just that you haven't been able to improve your sleep apnea symptoms (AHI count) despite treatment so you still wake up feeling like shit?

Because even if there are some outliers like yourself, I can confidently claim that most people can correlate improvements in sleep apnea symptoms and sleep quality more generally with the way the feel in the morning.

[elric]

One of the many problems with sleep apnea treatment, is that we're treating AHI. AHI is an imperfect proxy for all the things that really happen on account of sleep apnea. Not breathing, underbreathing, micro arousals, clustering of apneas etc. Things like UARS can go undetected nearly forever.

You can have an AHI of 1 and still get zero REM sleep because every time you start going into REM, a respiratory event knocks you out of it.

Apneas and Hypopneas have to last for 10 seconds or more to be included in the AHI count. You can literally have hundreds of respiratory events and have an AHI of zero, but you're still going to feel pretty bleedin' awful.

There is also an RDI, Respiratory Disturbance Index, which includes the AHI events but also includes arousals caused by breathing issues. It is typically much higher than AHI in un(der)treated patients. It's also imperfect, and it's harder to measure.

Then, of course, we come to the CPAP machine reported AHI, which seems to be what insurance and doctors are interested in. In short: the number is garbage. These machines are absolutely TERRIBLE at correctly identifying events. Using those numbers as the basis for any kind of decision is awful.

Maybe one day we'll get CPAP devices with EEG devices in the head strap and with unobtrusive SpO2 sensors that actually work. Maybe then we can start reporting useful numbers which can actually be used in support of treatment.

Until then, it's very much possible to keep feeling like shit even though your sleep apnea is allegedly "under control".

[Shadowmist]

I don’t feel a difference, and in some ways I feel worse, such as when there is a slight leak which leads to my tank running dry. If I don’t use the machine then sometimes in the middle of the afternoon I think about just laying down on the floor wherever I am. I never feel great after using the machine though, and I’ve looked at the log data and it is working. The only reason I keep using the machine is that my spouse gets better sleep.

[DiggyJohnson]

That's interesting, it's still not clear to me that you don't have a faulty setup (avoiding leaks is important!) but nevertheless I appreciate the clarification. Good luck, and I hope you sleep well.