An unbalanced second stage regulator is basically a flap held closed by a spring. The force that opens the flap held closed by the spring is a combination of you sucking with a breath plus the intermediate pressure of the first stage, which is trying to push the flap open.
The lower the intermediate pressure, the less force there is opposing that spring , so you have to suck harder to open the flap.
Tank pressures higher than intermediate pressure don't matter to the second stage. The first stage regulates tank pressure down to intermediate pressure, which stays fairly constant as the tank empties (with some exceptions).
As tank pressure gets lower than the intermediate pressure, the valve opening "assist" supplied by the first stage gets less and less until, at some point, the valve won't open despite all the suck you can generate, due to the spring pressure.
A balanced second stage works much better. They often don't show signs of hard breathing until the intermediate pressure has dropped from 130 PSI to 50 psi.
But either way, you can't use the last fifty to one hundred or so psi in an empty tank.