The journey continues........

[ImReallyTired]

Wow, talk about a lot of variation....2 nights ago my AHI was 10.39, last night........24.74!

I knew within 5 minutes of getting out of bed that the numbers were going to be bad, I couldn't stop yawning, almost as much as I was doing before I started all this. I had 139 OA's last night, not sure where to go next. It's been almost 4 weeks and the lowest AHI I've gotten is 10.23. I've tried the APAP route, with settings of 5-20 and 8-17, and now I'm doing straight CPAP with a pressure of 14.

Can the methadone have this much of an effect? Any other ideas? anyone?

[TheWerkz]

Wow, talk about a lot of variation....2 nights ago my AHI was 10.39, last night........24.74!

It's been almost 4 weeks and the lowest AHI I've gotten is 10.23. I've tried the APAP route, with settings of 5-20 and 8-17, and now I'm doing straight CPAP with a pressure of 14.

Can the methadone have this much of an effect? Any other ideas? anyone?

That is a huge difference and you had to have "felt" better when the AHI was down around 10 compared to 24.

Have you compared your AHI between straight CPAP and auto?

Given the fact that Auto mode seems to help more people by monitoring every breath and then adjusting your pressure on the fly I don't see how it couldn't be more effective compared to straight CPAP, since changes in weight or drinking will also change how your apnea reacts to them as well as drugs, especially drugs that depress the central nervous system.

If your sleep study said you needed 14 cm, you could try Auto from 10 cm to 18 cm to give the machine plenty of latitude, and as long as there's no major leaks it's not going to get a whole lot better while you're on a higher dose of a CNS depressant.

Whenever my back has flared-up and I've taken high doses of hydrocodone my AHI has gone way up too (7 to 8 range) when I'm not on them my AHI hoovers around 1.03 with many nights in the 0.5 range.

I wish you luck but I don't think you'll be able to really get your AHI under 5 or less until you can reduce your dosage enough or get off of it entirely.

I'm sure that's not what you wanted to hear.


Ren

[Ugly]

I was just curious if you are on any medications? Some do tend to relax the intake area more than normal when on medication causing higher AHI's.

I take antidepressants.

[ImReallyTired]

I wish you luck but I don't think you'll be able to really get your AHI under 5 or less until you can reduce your dosage enough or get off of it entirely.

Yeah, I think I've kind of resigned myself to that fact. I'm going to try to get another appointment with the sleep doc within the next couple weeks and review all this, but I'm pretty sure the prognosis is not going to be good.

[PaulaO2]

Wow, talk about a lot of variation....2 nights ago my AHI was 10.39, last night........24.74!

I knew within 5 minutes of getting out of bed that the numbers were going to be bad, I couldn't stop yawning, almost as much as I was doing before I started all this. I had 139 OA's last night, not sure where to go next. It's been almost 4 weeks and the lowest AHI I've gotten is 10.23. I've tried the APAP route, with settings of 5-20 and 8-17, and now I'm doing straight CPAP with a pressure of 14.

Can the methadone have this much of an effect? Any other ideas? anyone?

My thoughts are this: if you have been on this med for a while, and your dose is the same each day, and if you are not adding anything else (like an 'as needed' medication), then it is not the medication that is causing the difference. Your body and brain are used to it so I don't *think* it would result in such wide assortment of readings.

Yes, some medications can contribute to the apnea events.

Were all the events obstructive?

What are you leak numbers?

[ImReallyTired]

My thoughts are this: if you have been on this med for a while, and your dose is the same each day, and if you are not adding anything else (like an 'as needed' medication), then it is not the medication that is causing the difference. Your body and brain are used to it so I don't *think* it would result in such wide assortment of readings.

Yes, some medications can contribute to the apnea events.

Were all the events obstructive?

What are you leak numbers?

Hmmm, intersting, I hope you're right. I've been on Methadone for around 8-10 years, and on a relatively low dose of 40 mg/daily, it does seem a little odd that it all of a sudden it would create this kind of increase, although my AHI has been pretty erratic over the 3 1/2 weeks I've been on the therapy. (high of 28 to a low of 10).

The vast majority of last nights events were OA's, actually it was 134 OA's, 15 H's and 18 CA's. The leaks were fine.

The only other thing I can think of is this. I haven't been sleeping well at all, meaning I'm up alot of times throughout the nite. Yesterday it really caught up with me, and as soon as I hit the bed I was out. I think I just fell into a really deep sleep, and also ended up on my back for quite a while, which I know can also exasperate all this. Don't know if that makes sense or not, but it's all I got!

[PaulaO2]

Yes, sleeping on your back can increase OAs due to gravity.

And being very tired will also cause you to relax more which can also lead to more OAs.

When was the last time you and your doctor sat down to go over your meds and discuss options? I try to do this once a year (I currently am on 8) and just generally discuss what I am on and then every other year, we do some serious discussing. They are coming out with better and better medications all the time, especially in terms of pain control. If you like your pharmacist, you can also ask to discuss them with him/her. I go to a local pharmacy (vs chain) and have done this several times when I didn't trust my doc to see the entire picture.

Oh, wait, you've only been on CPAP for 4 weeks? Well, that's a different beastie!

Your body must already be ticked off if you are taking pain medication. Now you are making it tolerate CPAP. Sometimes, our bodies and brains are like, Heck no! and it takes a while to get everything in sync. Keep using the machine. Keep working at it. The AHI is lower than when you had your sleep test, right? As long as it stays that low, even if the numbers have such a wide swing, you are still better than you were before. You may not feel like it, but you are.

Several other members here have had to use their machines for nearly a year or more before they notice any significant improvement. When do you see your sleep doc again? Give it another two weeks then evaluate the data. If the numbers are still high, contact the sleep doc.

[ImReallyTired]

Thanks Paula....

My next scheduled appointment with my sleep doc isn't until mid-February. I may see if I can get in earlier if things continue like they are now. I made as much of an effort as I could to stay off my back last night, AHI was back down to 11.

You are right about things being better than they were, my sleep study showed an AHI of 44 while supine and 28 otherwise. Getting down to 11 or 12 is at least a step in the right direction!

Hard to believe some folks have had to wait a year before seeing significant improvement, but I guess if you have apnea for many, many years, it just takes time to train your brain/body. I do plan on sticking with this, but man, sometimes it gets really discouraging.

[Ugly]

To drift off topic, the best muscle relaxer I have ever used, and had no side effects, was Skelaxin.

I've invoked a better muscle relaxer but as it's sexual in nature and maybe a bit kinky depending on your standards, I shouldn't say it here.

[PaulaO2]

Hard to believe some folks have had to wait a year before seeing significant improvement, but I guess if you have apnea for many, many years, it just takes time to train your brain/body. I do plan on sticking with this, but man, sometimes it gets really discouraging.

Sleepster, I think, has had a year of waiting for better results.

Our bodies are creatures of habit and have a great memory. We sit at our desk at work and slip into work mode. Our favorite chair automatically causes us to relax. (this is why good sleep hygiene is so important. you want your body and brain to know that laying down in bed means sleep, not read book or watch tv)

As folks with SA, our bodies have gotten used to low oxygen, multiple wake-ups, and bad sleep. We have to convince them that this new normal is better. It can take a while.