Change altitude and huge AHI Jump

[afloatandrew]

Hello from Colorado!

Looking for any insight, as I traveled to Colorado (roughly 6,200ft elevation, left sea level) and my historical nightly AHI per myAir almost always <5. I’ve read altitude is a non-issue since it’s a newer, auto CPAP.

I flew to Colorado for work just under two weeks ago, and my AHI is now over 10 on all but one night, and last night it was 37. 

I’ve changed out my mask and hose, no change (actually got worse, so switched mask back)

Machine will be 5 years old in November. 

I’ve just started with OSCAR today since my doc hasn’t answered in a week and it’s showing tons of “clear airway events.”

I’m not maxing out on machine pressure (never hit even close to 12), and I JUST saw my sleep doc three days before flying who reviewed my card with RESCAN and said everything’s perfect (other than not getting 6+ hrs/night...)

Left a voicemail with my sleep doc’s Office, still haven’t heard back, but want to know if I need to get my machine checked.

Any insight on things I might be able to do to trouble shoot? thanks for your help!

[jaswilliams]

The CA’s are altitude induced nothing to do with your machine. An Autoset 10 cannot treat Central Apnoea, how long are you going to be at altitude ? Is this going to be a regular thing or a one off. Try reducing EPR and see if it helps (it may not but costs nothing to try)

[Gideon]

This is most likely CO2 induced.  You need to increase the CO2 in your blood to get relief.  Step 1 is to turn off EPR.  
Please post OSCAR charts so we can see what we are dealing with.

The no-issue at altitude is only for obstructive apnea,

[Sleeprider]

An effective treatment is to take Diamox (acetazolamide) which is effective for a number of altitude related problems, but it specifically works to counter central apnea by slightly acidifying the blood.

Acetazolamide is a carbonic anhydrase inhibitor. That means this drug works to cause an accumulation of carbonic acid by preventing its breakdown. The result is lower blood pH, given the increased carbonic acid, which has a reversible reaction into bicarbonate and a hydrogen ion.

In other words, acetazolamide will precisely counter the mechanism by which you are having increased CA events. Talk to your doctor's office, and have the name and number of a local pharmacy where he can call in the prescription. This is a very common prescription to help adapt to altitude, including headaches, edema and pulmonary issues. If your insurance covers urgent care, a local UC facility will know all about altitude adaptation and provide a script or perhaps have some medication to dispense.