06-08-2020, 10:15 PM
Altitude, dehydration, and centrals
First off, a big thanks to Technopauper for the details of his journey, and his recent update to “Chart Envy”: reading through it seems to have lit up a lightbulb or two with me.
I’ve had my machine for a few months past a year, and have had “mixed success” with getting the numbers as low as I’d like. Ignoring a several-month period of eye surgeries and recovery (which really jacked with my numbers), I’ve had some mild successes, but never seemed to get things below 3.0 or so for any length of time. Also, annoyingly, there would be spikes in nightly AHIs every now and then - up to 8 - 10 or so - that have had me chasing my tail trying to figure out.
In past OSCAR data, it seems that on “bad nights” OA events increase somewhat, but CAs always seem to be what suddenly went from “not much” to often “dominating”. I’ve always chalked these up to “not figuring things out yet”, or “temporary adjustments” - which is why I generally posted only “good nights” OSCAR examples.
Reading through Technopauper’s story, I noticed a very similar trend (although thankfully with much smaller peak AHIs). The big commonality is altitude: I currently live at around 5,300 feet. Every time I have traveled east, I’ve dropped 4,000 feet or so: the first night and definitely the second usually showed a solid AHI improvement. Likewise, when I travelled back home, the first night and definitely the second usually showed a spike that took a night or two to normalize back to old (home) values. For at least the next couple of years, sleeping at altitude will continue to be a basic fact of life for me.
It’s also pretty dry here year-round. I’ve found that during the last two times that I got pretty dehydrated (which is really easy to do), my AHIs would get much worse (12 - 18 at times) for at least a couple of days while I corrected the problem.
One of the commonalities between shifting-altitude effects and dehydration is that not only do my AHIs (definitely CAs) increase, but even without events the breathing waveform has segments that look decidedly periodic. These are sometimes being flagged as such by OSCAR on really bad nights, sometimes not.
My new game plan is to stop trying different masks, chin straps / collars, mouth taping, and the like, hold with what has been “best” so far, and see what fluctuations happen on their own. I’ll then likely post both the good and the bad nights, to get feedback on what really may be going on.
Past experience has shown that how I felt and functioned mentally the next day when I was at or below 2 AHI were dramatically better than after a night of 3.5+. My goal (hopefully taking less than another year to reach) is to get my nights down closer to that < 2 AHI level on an on-going basis. We’ll see how this plays out.
Also a really big thanks to the Apnea Board forum admins and contributors as well. I’ve been dealing with apnea treatment for at least a decade, first using an oral appliance and now APAP. Over the years, I have found my sleep-related medical professionals to run the gamut from very helpful and insightful to absolute bozos. Self education is so crucial when dealing with apnea, and the knowledge found on on-line forums (Apnea Board being a strong one) have been a key part of that.
I’ve had my machine for a few months past a year, and have had “mixed success” with getting the numbers as low as I’d like. Ignoring a several-month period of eye surgeries and recovery (which really jacked with my numbers), I’ve had some mild successes, but never seemed to get things below 3.0 or so for any length of time. Also, annoyingly, there would be spikes in nightly AHIs every now and then - up to 8 - 10 or so - that have had me chasing my tail trying to figure out.
In past OSCAR data, it seems that on “bad nights” OA events increase somewhat, but CAs always seem to be what suddenly went from “not much” to often “dominating”. I’ve always chalked these up to “not figuring things out yet”, or “temporary adjustments” - which is why I generally posted only “good nights” OSCAR examples.
Reading through Technopauper’s story, I noticed a very similar trend (although thankfully with much smaller peak AHIs). The big commonality is altitude: I currently live at around 5,300 feet. Every time I have traveled east, I’ve dropped 4,000 feet or so: the first night and definitely the second usually showed a solid AHI improvement. Likewise, when I travelled back home, the first night and definitely the second usually showed a spike that took a night or two to normalize back to old (home) values. For at least the next couple of years, sleeping at altitude will continue to be a basic fact of life for me.
It’s also pretty dry here year-round. I’ve found that during the last two times that I got pretty dehydrated (which is really easy to do), my AHIs would get much worse (12 - 18 at times) for at least a couple of days while I corrected the problem.
One of the commonalities between shifting-altitude effects and dehydration is that not only do my AHIs (definitely CAs) increase, but even without events the breathing waveform has segments that look decidedly periodic. These are sometimes being flagged as such by OSCAR on really bad nights, sometimes not.
My new game plan is to stop trying different masks, chin straps / collars, mouth taping, and the like, hold with what has been “best” so far, and see what fluctuations happen on their own. I’ll then likely post both the good and the bad nights, to get feedback on what really may be going on.
Past experience has shown that how I felt and functioned mentally the next day when I was at or below 2 AHI were dramatically better than after a night of 3.5+. My goal (hopefully taking less than another year to reach) is to get my nights down closer to that < 2 AHI level on an on-going basis. We’ll see how this plays out.
Also a really big thanks to the Apnea Board forum admins and contributors as well. I’ve been dealing with apnea treatment for at least a decade, first using an oral appliance and now APAP. Over the years, I have found my sleep-related medical professionals to run the gamut from very helpful and insightful to absolute bozos. Self education is so crucial when dealing with apnea, and the knowledge found on on-line forums (Apnea Board being a strong one) have been a key part of that.
