Alcohol and AHI

[Ockrocket]

Well I'm sure it can vary with different people.. 

And I know it varies with me.. 

But consuming alcohol can have an adverse effect on your AHI. 

I had a big day on the road the other day, and when I finally got home I had two glasses of red wine.. and then went to bed 15 or 20 minutes after finishing the second one. 

I fell asleep quickly, and slept like a baby for several hours. 

When I awoke about 5 hours later I checked how long I had slept to that point, and what my AHI was at that point.  

Wow! up over 4.. 

Although I expected it to be up a little, as it has been in the past, this is the first time I've gone straight to bed after having a drink or two.
Given that I need to keep both my AHI and hours of use within certain numbers, I really can't afford to disrupt my routine to a major extent. 

My drinking is in the low level of consumption, so it doesn't bother me if I don't have alcohol if the timing doesn't fit with my upcoming schedule.
For the most part I might have drinks one night in a week, at most two nights ( but that is rare as I'm on the road working six or seven days a week.. and I use the "12 hours from bottle to throttle" protocol when deciding if I have a drink or not )

But given the results of the late drinks vs AHI during the night, I think in future I will just forego the CPAP for the night.

From a numbers standpoint I need to not have major blips showing in the data when my specialist has to submit it for my professional driving licence clearance.

Missing a night of 6 hours plus is such a rare thing for me that I can easily afford to skip a session without affecting my overall compliance significantly.
On the other hand, a crazy AHI spike will be more difficult to average out, my 30 day average is 1.4 currently.. and over 12 months is even lower from memory ( haven't felt the need to check Sleepyhead as often now that day/week/month numbers on the Dreamstation are staying consistently stable   )


None of the above is a whinge or question, but merely an observation I've made regarding drinking alcohol just prior to going to bed and hooking up to the machine to sleep. 
Late drinks is very rare for me - normally it is a glass with dinner, and maybe a glass after dinner, and at least 90 minutes before retiring for the night. 

[Walla Walla]

I know you didn't ask. But I'll say it anyway, your still getting some benefit from the machine even if your AHI is higher. Not using the machine will probably affect your alertness on the road. I think picking one night of higher AHI is better than going without.

[Sleeprider]

Maybe switch to auto mode on drinking nights?

[tedvpap]

Maybe switch to auto mode on drinking nights?

Or every night.  
OP - Letting the machine go a little higher when needed can make a big difference.  Set the minimum to your current pressure (8) and set the max to 9 or 10.

[mesenteria]

I know you didn't ask. But I'll say it anyway, your still getting some benefit from the machine even if your AHI is higher. Not using the machine will probably affect your alertness on the road. I think picking one night of higher AHI is better than going without.

I agree with this.  Let's suppose your 'treated' AHI after a couple of drinks is going to average out to the 4 you showed on the one night.  Without PAP, it might have been quite a bit higher than your determined apnea level prior to treatment.  If you had gone from a non-alcohol-affected AHI of 32 down to 1.4, imagine what that night would have been like had you neglected to fasten your mask to your face.   

Still, I take your message to heart and control my alcohol, and how late I consume it, for the very reason you have brought to us.  In my case, with AFib, it's doubly important I control caffeine and alcohol consumption.

[Ockrocket]

I know you didn't ask. But I'll say it anyway, your still getting some benefit from the machine even if your AHI is higher. Not using the machine will probably affect your alertness on the road. I think picking one night of higher AHI is better than going without.

I am aware of that perspective.. but I don't drink on nights where I am working the following day, and I don't drive for at least 12 hours after drinking ( so after a night of good sleep ) 

My numbers need to stay within certain boundaries to maintain my commercial driving licence- lose the licence means job/income/house/marriage all gone ( yes, things have been that rough over the last couple of years.. a work accident saw me lose my licence and job, I fought like hell to get my medical situation diagnosed and under control and my life back.. I'm not capable of going through all that again if they take my licence while I still need to earn a living and pay a mortgage and other bills )
I am a professional driver, and I have now been forced back in to business for myself just to have a job... regardless of the political BS claims made, at 64 years old I can not get a job easily, age discrimination does exist in Australia even though it is against the law. 

I would rather forego a night on CPAP than have my AHI numbers go over the limit that would see me lose everything again.

But my post here was more of showing what I had noticed with the drinks just before retiring for the night and using CPAP, in the hope it may help others who like a drink now and then manage to still enjoy the social side of living as well as getting benefit from treatment.

My way of managing the situation will be to simply not have late drinks before bed, something I don't normally do anyway.

[Sleep2Snore]

Here in the UK we are advised that drink later then 7pm will have an adverse effect on the level of AHI and quality of your sleep.  Turns out it does affect things by quite a bit, the more you drink the worse the affect.  Then I used to go to a hospital sleep department where one of the nurses suffered from OSA and she drank till late on when she had something on (she didn't really need an excuse) breaking her own rules lol.
We have to stay below 5 AHI (though they do not say if it is OSA or CA, but they could only monitor hours of sleep with the machines they used to give out) and have at least 5 hours of sleep every night to keep your driving licence here.
However, everyone is not the same and the main thing is how you feel.
The lowest number is not always the best, I feel better with about 2 than at 0 AHI, so it is how you feel.
If tired, do not drive or stop as soon as you feel tired and drink coffee or some stimulant drink.
But take a break as soon as you feel tired, your next blink might be your last.
I know a few people that said they just remember blinking and then all hell broke loose.
So drink does play a part in your sleep quality, so do not drink to much and limit it to early evening and drink less.
With a good drink I can go from 0 to 5 as I tend to lie on my back, which is not good for me or my rids (wife making sure I keep breathing)!

[Ockrocket]

Although not connecting it to the drinking aspect, I may look at going back to auto mode with my treatment to get my AHI even lower.

My respiratory specialist switched me to fixed pressure after my trial period on auto assessing the required pressure, he felt that fixed would give me more consistent results with the treatment.

I bumped my pressure from 7 to 8 because I felt I was short of air quite often, he didn't notice I'd changed it when he signed off on my clearance to drive last year.. he might notice it this year if I make changes again without consulting him first, I don't want to give him a reason not to sign off again this year.   ( he can be a bit testy if people have ideas of their own on treatment.. but he has come to accept that I'm "up to speed" on my personal health needs to some extent )

I'm normally within the required parameters with my current settings, so changing is not critical.

[Sleep2Snore]

I would need a very good reason for a doctor to change me from APAP to a fixed pressure.
How dare a doctor tell you what to do!  What does he know, he is only a doctor.    

Seriously though, why did he think changing you to fixed would be better, it might help if he adjusted it to cover most of your events and leave the machine to prevent the others.  You may have to suggest a change to him in such a way as he thinks it is his idea.  Some doctors can be a bit funny!