Is AHI really the "gold standard" for apnea treatment ?

Reading in this and other cpap forums has lead me to believe that it's all about AHI.

Really ?

I've struggled as most have, and have tested 4 different masks, tweaking my cpap pressure. I've been able to get my AHI down to 2.1 . Alas, I really felt like shit the whole day after. Which leads me to question if I should be chasing AHI so rigorously ? Last night I decided to give myself a break from this chase - backed off my pressure. Much easier night, and my resulting AHI was 3.3 . As expected, moving backwards. Yet I feel sooo much better today.

So I ask - is getting my AHI down to 1 really worth it ? Am I really going to feel more energetic and less lethargic ?

The official target is to get under 5 for AHI. Getting down to 1 is nice but not essential in my opinion. I know I can't get there. It has to be a balance between AHI and comfort. With more comfort one should get a better sleep.

As Sierra said it is a balancing act. You need enough "comfort" to sleep with this contraption on your face, then you need to get your Apnea under control (<5) then comfort again tales over. Keep in mind that apnea is only one cause of sleep disruptions, there are many others. Look at Sleep Hygiene, the meds you take and other factors. On all the apnea forums there is focus on apnea, go figure.

With my old gen 8 RESMED machine I had a residual AHI of 3.0. When I upgraded to the Gen 10 Airsense for Her, it decreased to a residual AHI of under 0.3 and I noticed a significant improvement in how I felt. Notwithstanding that under 5.0 is considered the goal.

Since my problem is that I desat pretty drastically, even a few apneas during the night can make me feel miserable the next day. So, don't look only at your residual AHI numbers, but also consider your O2 desat levels. To do that you will need an overnight recording oximeter, but they are available online.

Net/net, for those who DO desat badly, if may be important to get the residual AHIs down as low as possible.

Many people will never have an AHI of 1 or less. 3 or 4 will be as good as they will every get. If you feel much better and your AHI is 3 instead of 2, then go with it. Especially if your other medical parameters are good.

First post here. Two year Cpap user. The AHI sure seems to be the gold standard especially at the doctors office. It should be everyone's desire to achieve the lowest number possible, but not at the expense of sleeping well or feeling better. I have used 10 different masks in my short 2 year usage, full face, nasal & nasal pillows. I presently use pillows but in the beginning I had a difficult time with a pillow because I was a mouth breather. With continued practice I learned to keep my tongue at the top of my mouth and learned to breath solely out of my nose. I have seen my AHI remain consistently <1.00. I truly feel the first place to start is a proper, comfortable fitting mask. For some of us it takes a long time and sometimes it doesn't hurt to go back and try previously used masks you didn't care for.