08-19-2019, 10:36 AM
AHI and diet
Hello again. It's been a while since I've posted. My basic info is: 66 year-old moderately obese male (BMI=33), idiopathic complex sleep apnea, using Philips System 1 ASV for a few years now. General health is good. No medications.
I was diagnosed with OSA in 2006 and used a non-data-capable Resmed S8 for almost 11 years, at a constant pressure setting of 11. When that machine finally broke down, I was given a bi-level "DreamStation" a few years ago. That machine revealed a fair amount of PB and CA events. After another sleep study, which failed to reveal any underlying cardiac condition, switching to a neuro sleep doctor, instead of a pulmonologist, the ASV was prescribed. With the help of the good people here, and a lot of patient self-experimentation, I got my settings dialed in. Since then, my usual AHI is under 2. Occasionally I'll get a few days of higher readings; but I'll also get strings of readings below 1. 99.9% of all events recorded are hypos. Once in a while a CA will sneak in; very rarely, an OA. And that's been fine. My more pressing sleep problem has been the normal senior's problem of waking up earlier than I'd like to.
Two weeks ago, I started getting higher AHI readings: from 5s to 9s. Again, they've been almost all hypos, with a few CAs and a single OA in the mix. My two-week average for this period is 6.1; I had just one day under 5, with a 3.0. I feel generally okay through all this, except when it gets up to above 7, at which point I feel jetlagged during the day. But of course I've been concerned, and would like to know what's going on.
I haven't fiddled with settings; I figured I'd just wait it out and see if it went back to normal. Then I noticed something interesting. I tried to discern any change in my daily living habits that might account for the high AHI. I couldn't find anything, until I checked my diet diary. I eat a healthy whole food plant-based diet, but I'm still obese, because I just eat too much. No mystery there. Two weeks ago, I started a strict kind of regimen that involves three measured meals and absolutely no snacks. So I eat dinner at 6:00 pm and then nothing until the following morning at about 7:30 -- almost 14 hours of fasting.
The first night of that diet was the first night of higher AHI, I discovered.
As I mentioned, there was one day with a lower AHI of 3.0. On that day, I had eaten a starchy snack in the evening: some rice and grilled peppers. I didn't do that again, and the numbers went back up.
My birthday was this past weekend, and we had a little party yesterday. I decided to use the occasion to do a little experiment. I simply ignored the diet, ate whatever I wanted, had a couple of beers, and enjoyed myself. In the evening, I had a leftover slice of key lime pie (my preferred birthday cake). This morning my AHI was 1.6.
This is not much of a data set to form any strong conclusions, but I'll add this. When I was younger, I could do fasting pretty easily, bus as an older person I've discovered I don't tolerate it well. If I try to fast for a day, by late in that day I start to feel definite "fight or flight" sensations of sympathetic nervous system arousal. This current diet has been effective, in that I've dropped over 7 pounds in the two weeks, but the calories are pretty low for a man my size. And of course there's the fact that I'm fasting 13-14 hours overnight every day.
So I'm just putting this out there for your consideration. My theory is that my diet is causing my cortisol levels to go way up, and that is somehow causing the hypos. I haven't found a lot of information about the relation between cortisol and CAs or OAs, except a few studies suggesting that apnea evens cause elevated cortisol, which certainly makes sense. But since idiopathic CA is still very...idiopathic, I'm not ruling out the possibility that there's a two-way causal connection.
Anyway, my plan is to modify my diet to include an evening snack of oatmeal and blueberries, and see what happens to my readings. Maybe this experiment will be of use to someone else who reads this.
Have a great day everyone.
I was diagnosed with OSA in 2006 and used a non-data-capable Resmed S8 for almost 11 years, at a constant pressure setting of 11. When that machine finally broke down, I was given a bi-level "DreamStation" a few years ago. That machine revealed a fair amount of PB and CA events. After another sleep study, which failed to reveal any underlying cardiac condition, switching to a neuro sleep doctor, instead of a pulmonologist, the ASV was prescribed. With the help of the good people here, and a lot of patient self-experimentation, I got my settings dialed in. Since then, my usual AHI is under 2. Occasionally I'll get a few days of higher readings; but I'll also get strings of readings below 1. 99.9% of all events recorded are hypos. Once in a while a CA will sneak in; very rarely, an OA. And that's been fine. My more pressing sleep problem has been the normal senior's problem of waking up earlier than I'd like to.
Two weeks ago, I started getting higher AHI readings: from 5s to 9s. Again, they've been almost all hypos, with a few CAs and a single OA in the mix. My two-week average for this period is 6.1; I had just one day under 5, with a 3.0. I feel generally okay through all this, except when it gets up to above 7, at which point I feel jetlagged during the day. But of course I've been concerned, and would like to know what's going on.
I haven't fiddled with settings; I figured I'd just wait it out and see if it went back to normal. Then I noticed something interesting. I tried to discern any change in my daily living habits that might account for the high AHI. I couldn't find anything, until I checked my diet diary. I eat a healthy whole food plant-based diet, but I'm still obese, because I just eat too much. No mystery there. Two weeks ago, I started a strict kind of regimen that involves three measured meals and absolutely no snacks. So I eat dinner at 6:00 pm and then nothing until the following morning at about 7:30 -- almost 14 hours of fasting.
The first night of that diet was the first night of higher AHI, I discovered.
As I mentioned, there was one day with a lower AHI of 3.0. On that day, I had eaten a starchy snack in the evening: some rice and grilled peppers. I didn't do that again, and the numbers went back up.
My birthday was this past weekend, and we had a little party yesterday. I decided to use the occasion to do a little experiment. I simply ignored the diet, ate whatever I wanted, had a couple of beers, and enjoyed myself. In the evening, I had a leftover slice of key lime pie (my preferred birthday cake). This morning my AHI was 1.6.
This is not much of a data set to form any strong conclusions, but I'll add this. When I was younger, I could do fasting pretty easily, bus as an older person I've discovered I don't tolerate it well. If I try to fast for a day, by late in that day I start to feel definite "fight or flight" sensations of sympathetic nervous system arousal. This current diet has been effective, in that I've dropped over 7 pounds in the two weeks, but the calories are pretty low for a man my size. And of course there's the fact that I'm fasting 13-14 hours overnight every day.
So I'm just putting this out there for your consideration. My theory is that my diet is causing my cortisol levels to go way up, and that is somehow causing the hypos. I haven't found a lot of information about the relation between cortisol and CAs or OAs, except a few studies suggesting that apnea evens cause elevated cortisol, which certainly makes sense. But since idiopathic CA is still very...idiopathic, I'm not ruling out the possibility that there's a two-way causal connection.
Anyway, my plan is to modify my diet to include an evening snack of oatmeal and blueberries, and see what happens to my readings. Maybe this experiment will be of use to someone else who reads this.
Have a great day everyone.
