elevated blood pressure at night from apnea

[laurie h]

Hi,
I have both central and obstructive sleep apnea so therefore a cpap and bi-pap makes me worse.
I sleep with oxygen but still have apnea although it does help a little.
I wake up throughout the night evry 2 hours with my blood pressure elevated even though I take medicine for blood pressure and i am wondering if anyone else has this issue.
Can anyone relate ? Does anyone else have their blood pressure go up at night because of the apnea?

[PaulaO2]

CPAP or bilevel PAP would not make you worse. They would treat your OSA but not your CSA, true, but not necessarily make it worse. If you have mixed apnea, then you need an ASV machine.

Oxygen isn't going to treat your sleep apnea, either. Only a PAP machine can.

Untreated sleep apnea is going to elevate your blood pressure, yes. Definitely! I have proof of it. Using a CPAP or bilevel PAP would not raise your blood pressure unless they were causing more events due to incorrect settings.

[trish6hundred]

Hi laurie h,
WELCOME! to the forum.!
What Paula said.
Best of luck to you in getting your problem resolved and continuing with your CPAP therapy.
Hang in there for more responses to your post.

[Peter_C]

As a person that got his first CPAP many years ago, then switched to a BiLevel, and just recently to an ASV machine I can honestly state that any of the three is better than nothing at all.

FYI? If you search, you can find many, many posts where I say that (for me) an AHI of 10 or less is great - because I could never get it to stay any lower - and an 8 or 9 is much better than a 35 or 40.

Finally, on my ASV machine, my AHI has *averaged* 2.1, with the bulk being 'H's - OAs and CAs less than one, every night.

My untreated OSA led to heart issues, and it's taken roughly 10+ years of CPAP therapy to improve/repair the damage OSA has done to my heart.

All of us are different, but OSA is forever.

[DocWils]

Apnoea is only one cause of elevated blood pressure, but it one that at least is treatable. Get the correct machine for your problem, and it will ease some of the symptoms and your bp. If your bp remains elevated after a month on the correct machine, you may have other areas that need looking into. I trust you are already taking medications for your bp, so the spikes you have upon waking would well be from apnoea episodes. If you are not on medications for bp, then you probably need to go on some. If you are taking other medications for other problems, they can raise your bp in some cases, so that also needs to be looked into. Here your GP is your best guide. For the machines, a proper diagnosis and properly set machine is what you need, and that is in the realm of the specialist.

[laurie h]

CPAP or bilevel PAP would not make you worse. They would treat your OSA but not your CSA, true, but not necessarily make it worse. If you have mixed apnea, then you need an ASV machine.

Oxygen isn't going to treat your sleep apnea, either. Only a PAP machine can.

Untreated sleep apnea is going to elevate your blood pressure, yes. Definitely! I have proof of it. Using a CPAP or bilevel PAP would not raise your blood pressure unless they were causing more events due to incorrect settings.

Hi, Thanks for your quick response. I went to a sleep doctor who has a very good reputation and he said that in 25 yrs of practice, i am one of his most challenging cases. lol. They had their best techs work with me and tried numerous masks and settings.
In my case, while i was in the sleep lab 3 separate nights, both the cpap and bi-pap machines increased my central episodes. Only at an extremely high setting, did it seem to help even a little and the Dr felt the risk of air leak to my eyes is not worth the risk as it did not much help.
they tried oxygen in the sleep lab and found it helped my apnea so i use it at home but still wake up 4-6 x a night with bp of 150/92 and higher.
Just wondered if anyone else here is dealing with this.

[laurie h]

As a person that got his first CPAP many years ago, then switched to a BiLevel, and just recently to an ASV machine I can honestly state that any of the three is better than nothing at all.

FYI? If you search, you can find many, many posts where I say that (for me) an AHI of 10 or less is great - because I could never get it to stay any lower - and an 8 or 9 is much better than a 35 or 40.

Finally, on my ASV machine, my AHI has *averaged* 2.1, with the bulk being 'H's - OAs and CAs less than one, every night.

My untreated OSA led to heart issues, and it's taken roughly 10+ years of CPAP therapy to improve/repair the damage OSA has done to my heart.

All of us are different, but OSA is forever.

Thank you for your feedback and shared experience. I do have heart problems [one stent] from this and wear a nitro patch at night .I am considering going to Shands Hospital in Gainesville for another opinion even though it is 2 hours from my house.

What is an asv machine? I am relatively new to all this..

[justMongo]

An ASV machine is just a type of PAP machine that is used to treat mixed sleep apnea. (Mixed being both central and obstructive.)
Straight CPAP and BiPAP does not treat central apnea. In some people, positive pressure can induce central apnea.
If you were not tested on an ASV type machine, then this avenue should be explored.

Just using oxygen does not help CA. If you are not breathing, it cannot get into the lungs.

The ASV senses a CA and applies pressure to inflate the lungs. Think of it like a ventilator.

Of course the art of medicine must address the total person. And your elevated BP may be from other causes.
You quoted 150/92 which is higher than one would like; but not an emergency. Reducing BP is to avoid the long term effects on the heart like left ventricular hypertropy and valve leakage.

You have a stent and use nitro, so I assume you are being followed by a cardiologist.
The cardio doc should be doing annual echocardiograms and occasional stress tests to follow any changes.

[laurie h]

An ASV machine is just a type of PAP machine that is used to treat mixed sleep apnea. (Mixed being both central and obstructive.)
Straight CPAP and BiPAP does not treat central apnea. In some people, positive pressure can induce central apnea.
If you were not tested on an ASV type machine, then this avenue should be explored.

Just using oxygen does not help CA. If you are not breathing, it cannot get into the lungs.

The ASV senses a CA and applies pressure to inflate the lungs. Think of it like a ventilator.

Of course the art of medicine must address the total person. And your elevated BP may be from other causes.
You quoted 150/92 which is higher than one would like; but not an emergency. Reducing BP is to avoid the long term effects on the heart like left ventricular hypertropy and valve leakage.

You have a stent and use nitro, so I assume you are being followed by a cardiologist.
The cardio doc should be doing annual echocardiograms and occasional stress tests to follow any changes.

Many thanks for your response. I will research more info about an ASV machine and ask my Dr. why they didn't try that on me. Maybe I will get a second opinion nearby before going to Shands.
May God bless you .

[Peter_C]

I do not know how long ago your last tests were? "ASV" is sorta new, like the last few years or so? In *my* case, all my CAs are cause by the pain meds I must take. Opiates and Apnea do not mix well. I have also had both nose and throat surgery. I would not consider throat surgery until every other possible course was found to not work. I would get my nose fixed again in a heartbeat.

In my case, my long term untreated OSA caused my at-rest-heart-rate to suddenly be 122 - neither sleep nor valium would lower it. Today my at-rest-heart-rate is bout 70. Some stuff will get better with time.

My average CA count was around 1-20/hr as recent as a month ago, got my ASV machine just a few weeks back, and now they are less than 1.0%. Yes, I did have an ASV titration study first.

Questions to ask, and answers to write down:
What is/was my "AHI" during my study?
How many OAs per hour?
How many CAs per hour?
What was my lowest blood O2 level, and for how long??

Sidenote: Many people get CAs at the start of CPAP therapy, and most/or all can go away the first month or so.

A CA or Central is when your brain just forgets to make you breathe, and your airway is open.
An OA or obstructive apnea is where your airway is closed and you are trying to breathe, but can't, and have yet to wake up - I used to have OAs last +90 seconds