The AHI Lie: When Good Numbers Hide Bad Outcomes
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Sleep apnea, for sleep professionals, feels EASY to diagnose - but what about when it isn’t cut and dry? For patients who don't fit the stereotype, don't respond perfectly to CPAP, or need more than one provider involved in their care, the path can feel impossible.
Emma Cooksey spent roughly a decade living with undiagnosed obstructive sleep apnea. She was exhausted, waking with headaches, struggling to stay awake, and treating anxiety and depression without getting to the underlying problem. It wasn't until she fell asleep at the wheel with her newborn baby in the car that she finally received a referral to a sleep specialist and got diagnosed.
In this episode, Emma joins Jason Tierney and Dr. Erin Elliott to share how her experience eventually led to Sleep Apnea Stories and her advocacy work with Project Sleep. What started as a podcast became a much broader look at the gaps patients face, from insurance problems and disconnected providers to limited awareness of treatment options beyond CPAP.
They also get into one of the biggest disconnects in sleep care: what the numbers say versus how the patient actually feels. Emma explains why a great AHI or strong CPAP data doesn't necessarily mean the patient feels great, and why clinicians need to ask what outcome the patient is actually looking for instead of assuming the metric tells the whole story.
The bigger lesson is about creating a system that works for real people. That means breaking down silos between providers, making more treatment options accessible, educating primary care providers, listening to patient experiences, and ensuring people can see themselves represented in the sleep apnea conversation.
What's on the Menu
- Emma's 10-year journey with undiagnosed obstructive sleep apnea
- Why sleep symptoms can be mistaken for anxiety, depression, or personal failure
- What happens when patients need options beyond CPAP
- Why great sleep data doesn't always mean a great patient outcome
- The importance of asking patients what success actually looks like
- Breaking down silos between sleep physicians, dentists, and other providers
- How Project Sleep is working to challenge stereotypes and expand awareness
A Few Threads You'll Hear
Listen to the patient, not just the numbers. Emma spent years telling her sleep specialist that she was still significantly sleepy while being reassured that her CPAP data looked great. Her point is simple: good numbers matter, but the person sitting in front of you matters too.
Patients need more than one pathway. CPAP worked well enough for Emma to make a major difference, but it wasn't the end of her treatment journey. She explains how difficult it can be to coordinate multiple treatment options across providers, even when you have knowledge, resources, and connections.
Stop deciding who "looks like" they have sleep apnea. Emma's Sleep Apnea: Let's Face It campaign is built around breaking the stereotype of who gets the condition. Patients are still avoiding testing, and even being dismissed by providers, because they don't fit the expected profile.
Patient voices can change the system. Through Project Sleep, Emma has moved from sharing her own story to helping other patients speak up, educating providers, advocating for research and funding, and pushing for patients to have a seat at the table when sleep care is being shaped.
Resources & Links
- Emma Cooksey - sleep apnea patient advocate, creator of Sleep Apnea Stories, and staff member with Project Sleep
- Project Sleep - patient advocacy nonprofit supporting education, awareness, research advocacy, and programs for people living with sleep disorders
- Sleep Apnea: Let's Face It - Project Sleep awareness campaign focused on challenging stereotypes around who can have sleep apnea
- Sleep Apnea Squad & Coffee with Emma - free Project Sleep education and support resources for people navigating sleep apnea care
The Big Idea
Sleep apnea care can't stop at getting the diagnosis, handing someone a CPAP, or bringing their AHI down. The real question is whether the patient is getting the outcome they need.
Ask how they're functioning. Ask what they're still struggling with. Make sure they understand their options. Build relationships with other providers so patients aren't left to connect the dots on their own.
As Emma puts it: “This journey was hard enough for me, but for most people out there, it's impossible. So we have to do better.”