small AHI increase, big symptoms

[rdavis]

Hi friends! I'm having increasing issues with fatigue and trying to narrow down if it could be apnea related.

I've been on my APAP since 2014. For most of that time I've felt good, and my average AHI was below 1, usually around .7 or so.

In the last year or so, I've dealt with increasing fatigue--dragging out of bed in the morning, needing more naps, not always feeling up to exercise. In the last 2 years, my average AHI has crept up above 1...it's now around 1.2 or 1.5 (again, on average....some nights it's in the 2 range). And about half of my nightly events are now flagged as central events, which was not the case before (previously, most flagged events were hypopnea).

I went to see my pulmonologist yesterday. He's a good doctor and we respect each other. He told me that based on decades of treating CPAP patients, he doesn't think such a small increase in AHI should be causing noticeable symptoms, especially since my average AHI is still on the low end of the normal range. He suggested I address some leak issues with my mask, and wait out a medication change for another health issue that I have going on (that might contribute), and then get back to him for further investigation of my symptoms. So he didn't exactly blow me off, but neither was I completely satisfied when I left the appointment.

What do you guys think? Is it possible that a small AHI increase, which is still in the range of "normal," could cause a noticeable increase in symptoms? If so, how would YOU address this? Push to have your minimum APAP pressure increased? Investigate why there are more central events now?

Thank you!
Top

[factor]

First, You need to know all Philips Machines are under recall. See post in main forum.

I also would say if you can post the OSCAR data it would really help.

Well since you have some other medical history its kind of hard to tell. I can tell you if I hit 2 or so I feel bad.
Have you gained weight? Started a new medication? Do you have some illness that can cause Centrals like Afib or CHF?
Are you still using an REMstar Auto in you profile? You might trade it in for the ResMed Airsense 10. Much better machine than Phillips.

[Gideon]

I'm not saying it couldn't happen but it would be unusual. I would call those differences normal variation.

What meds are you taking?, Anything for the CNS? Meds do impact AHI .

[S. Manz]

A small elevation in AHI while still below the 2 range, is what people without Apnea can experience, so it is doubtful that your new heightened lethargy has anything to do with your AHI and in fact your elevated AHI might be having something to do with your frequency of awakening mid-sleep.
Getting up more frequently at night would be contributor because you do not get the quality of sleep that you need, including the deep stage and REM phase.
I side with your pulmonologist regarding the change in your medication.