COVID and sudden changes in AHI etc

[tmoody]

Hello, everybody. I haven't posted in a while. I have "mixed" apnea, generally well controlled with my recalled Philips System 1 ASV. Most nights, my AHI is between 0.7 and 2.4, which I consider satisfactory. The events I do have are almost entirely hypos. I've been using this machine for six years and, the way things are looking, I'll be using for a few more. But that's a matter for that other monster thread.

Last Thursday night (July 14) I started feeling crappy. I had chills and fever. I went to bed. I tested positive for COVID in the morning. I had about three days of fever, headache, coughing, etc. No shortness of breath or chest pain. I started Paxlovid on Sunday, three days ago. My temp returned to normal, and all other symptoms went away, except for the feeling of lack of stamina. My AHI during these first few days fluctuated from a low of 1.8 to a high of about 8.0. I expect to see this kind of thing when I'm sick. But then, yesterday morning I saw my AHI was 17! That surprised me.

I pulled the card--something I hadn't done for ages--and had a look, after updating Oscar. Normally, I just glance at Dreammapper, when it's working. There were a few centrals, a bunch of hypos, and a lot of periodic breathing. During the day, I felt fine, apart from the fatigued feeling I'd had since COVID symptoms appeared. No drowsiness, headache, or anything. 

But, just to be prudent, I sent a message to the sleep doc. I have a new sleep doc, whom I don't know very well. I've only had a single video meeting with her. My old doc moved away. With a bit of finagling, I was able to get some data to her, but I haven't heard back.

This morning, my AHI was 15. Once again, I feel fine today. And again, my AHI has generally been under 2, for years, with the occasional outlier, usually when I'm not feeling well. Even the first few days of COVID, when I was feeling pretty miserable, my AHI didn't go crazy.

So, obviously, I'm wondering what could be causing these last two nights of very high readings, with a ton of periodic breathing. My suspicion is that even though I've had no blatant respiratory COVID symptoms, something's going on with my air supply that's throwing everything off. More to the point, I'm wondering if anyone else had a similar experience with COVID, or flu, for that matter. I haven't seen anything like this before.

For what it's worth, I'm pretty sure I picked up the COVID at a conference in St. Andrews, Scotland, the weekend before last.

[staceyburke]

COVID did not cause these, they are positional apnea. Positional apnea is when you get in a position that cuts off your own airway. No pressure changes will help.

Think of it as a kink in a hose, no pressure will get the water moving - only getting the kink removed will help.

It is also known as chin tucking where your chin drops down to your sternum cutting off your airway.

This happens many times for sleeping on your back, although it can happen in any position. It sometimes happens when you are sleeping on to high of a pillow.

If you can’t fix it by simple changes you will need a collar. There is a link in my signature, please take a look at the link.

[tmoody]

Thank you. I'll certainly do some experiments to test your hypothesis. And both covid and the heat may contribute to my thrashing around more than usual at night, and perhaps ending up on my neck on in other untenable positions.

I wouldn't have thought that positional apnea could cause all that PB but I don't have a better theory.

[staceyburke]

If you look at the link I have in my signature on collars, you can see people without using a collar and the same people with collars. Huge difference. More even than yours.

[Gideon]

You could be sleeping in the same position as you were pre-Covid and Covid has swollen your respiratory track resulting in your previous position causing a problem.
The fix is still to us a Collar, at least for now.

[tmoody]

The collar will be on tonight. Watch this space for results.

[tmoody]

Result: AHI dropped from 15 to 5.8. All hypos. That's still high, but not crazy, And I don't know that the collar was fitted just right. My COVID test was barely positive this morning, so if that's relevant at all, it's getting better.

[tmoody]

So, after a few days with the collar, as my AHI dropped down to under 2, I tried sleeping without the collar and it stayed low for weeks, then shot up again. After a few days of AHI climbing up to 12, I tried the collar again, which brought it back down. 

It remains mysterious why I intermittently have this positional problem, but I'm glad to learn a solution, thanks to the people here. 

Since I also have idiopathic centrals, I was interested to find this somewhat speculative article. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6361311/ which I thought I'd share.