How does Denver (altitude and pollution) affect OSA

[DrPepper00]

I have two daughters and I would like to live closer to one of them. Currently I am in Seattle, one is in Dallas and the other and my sister are in Denver. The daughter in Dallas moves every few years and is hard to keep up with. The one in Denver hasn't moved. I used to live in Denver from 1988 to 1997 and feel like it almost killed me.
I began to sleep all the time. Fell asleep in meetings with my boss, slept at my desk, napped in my van at lunch. etc. I had a sleep study. I was diagnosed with narcolepsy and given Ritalin. It helped somewhat. Then the neurologist said you don't really have narcolepsy and Ritalin is bad for your heart. No more Ritalin. I worked in a "sick building" and felt a little better when I was allowed to sit in another building and work. My job was in Waterton Canyon and many powerful chemicals were used there with the air being trapped by the canyon. At that time, there was the "brown cloud" that hung over Denver. Is it still there? Anyway, I quit my job because I couldn't function. Moved to Oregon and then Seattle. I felt much better and then gradually worse. I was diagnosed last Nov. and have been on BiPap since Jan 6. I feel a little better, but not great.

Now my question. Does the altitude, thin air and pollution make those with OSA feel worse? I have only been back to visit 3 times since I left and came home feeling awful. I love Seattle, but I want to live near my family.

[copygirl]

I can't speak to the pollution, but I live in Colorado at a higher altitude than Denver, and I don't have a lot of problems--if my machine is properly calibrated that is, and I have the right pressures! (long story)

I definitely sleep better and have more energy at lower altitudes, though. So when I head to California for work, I expect to have more energy and sleep better. Oh well--I love living in Colorado!

[ameriken]

I read somewhere that the really high altitudes, suchs as 8000 and above can impact sleep apnea, but not terribly. Here at 5000 to 5500 you shouldn't have a problem.

As for the pollution, most of it occurs Oct through Feb because of winter temperature inversions, but the rest of the year we're good and I don't think the pollution has a major impact on apnea. One thought: the machine filter will probably eliminate most of the indoor and outdoor pollutants, so you're probably breathing better air at night than most people without sleep apnea.

[NightMonkey]

I feel a little better, but not great.

Two different questions.

- Are you keeping up with your data using SleepyHead and if so how effective or ineffective does it show your therapy to be?

- Do you drink Dr. Pepper? It has 41 mg caffeine per 12 oz. serving. I always recommend that CPAPers completely eliminate caffeine (including caffeine in chocolate). Some will tell you they drink caffeine in the morning and it doesn't bother them at night but there are recent studies that contradict this.

[DrPepper00]

I feel a little better, but not great.

Two different questions.

- Are you keeping up with your data using SleepyHead and if so how effective or ineffective does it show your therapy to be?

- Do you drink Dr. Pepper? It has 41 mg caffeine per 12 oz. serving. I always recommend that CPAPers completely eliminate caffeine (including caffeine in chocolate). Some will tell you they drink caffeine in the morning and it doesn't bother them at night but there are recent studies that contradict this.

How did you guess I like DrPepper? LOL...

I did drink about 24 oz a day. Even drinking it at night didn't seem to bother my sleep. (According to Zeo). However, I did quite drinking it 2 days ago. The past two nights, I have awakened 5 or 6 times each night with my mouth very dry and open. My AHI went from < 2 up to 6. I am trying the lowcarb diet and gave up my beloved DrPepper. My Zeo scores are pretty nice. In the 75-85 range. More wakeups without the DrPepper, but I will stay off it for a while.

[NightMonkey]

However, I did quite drinking it 2 days ago. The past two nights, I have awakened 5 or 6 times each night with my mouth very dry and open. My AHI went from < 2 up to 6. I am trying the lowcarb diet and gave up my beloved DrPepper. My Zeo scores are pretty nice. In the 75-85 range. More wakeups without the DrPepper, but I will stay off it for a while.

If you are now waking "5 or 6 times each night with (your) mouth very dry and open" and using nasal pillows (per your equipment profile) then I would expect your AHI to increase. When your mouth opens the therapeutic pressure escapes and you can have a bad level of breathing events.

The solution is to keep your mouth closed while sleeping (not always easy) or use a full face mask which will maintain therapeutic pressure and prevent events whether the mouth is open or closed.

As to why you notice mouthbreathing since discontinuation of caffeine intake, I speculate that you are getting more REM sleep (a good thing). During REM sleep the jaw is more likely to drop due to greater muscle relaxation.

I had these problems initially and solved them by using a full face mask and eliminating caffeine.

Not what the sleep doctor ordered.

[Newbie Woman]

Would it be feasible to live in the Denver area but not actually in Denver? I'd think you'd avoid a lot of pollution and still be close to your family. I envy those who live anywhere near the mountains.

[ameriken]

Would it be feasible to live in the Denver area but not actually in Denver? I'd think you'd avoid a lot of pollution and still be close to your family. I envy those who live anywhere near the mountains.

NW, not necessarily possible. When we do have a bad air day, the brown cloud can have a long reach and on really bad days it is thick enough to block the view of the mountains. I frequently drive to Greeley, a town that is a 55 mile drive from Denver, and I've seen the cloud reach from Denver toward that town.

Denver is far better now with it's pollution than I remember it being in the '80s, utilizing ethanol during the pollution prone winter months with wood burning restrictions as well. I think the state and city have done pretty good job of limiting the pollution as the high pollution alerts seem fewer and far betweener than they were years ago. It's no longer a place where you're breathing bad air on a continual basis, I think it's actually pretty good with few exceptions.

[pratzert]

I travel every year to Vail to go skiing.

My machine does not seem to maintain the pressure as well as it does at home due to the altitude.

If I lived there full time, I would have to learn what adjustments I would have to make.... but keeping the same settings as home, the pressure is accepatable.

[DrPepper00]

However, I did quite drinking it 2 days ago. The past two nights, I have awakened 5 or 6 times each night with my mouth very dry and open. My AHI went from < 2 up to 6. I am trying the lowcarb diet and gave up my beloved DrPepper. My Zeo scores are pretty nice. In the 75-85 range. More wakeups without the DrPepper, but I will stay off it for a while.

If you are now waking "5 or 6 times each night with (your) mouth very dry and open" and using nasal pillows (per your equipment profile) then I would expect your AHI to increase. When your mouth opens the therapeutic pressure escapes and you can have a bad level of breathing events.

The solution is to keep your mouth closed while sleeping (not always easy) or use a full face mask which will maintain therapeutic pressure and prevent events whether the mouth is open or closed.

As to why you notice mouthbreathing since discontinuation of caffeine intake, I speculate that you are getting more REM sleep (a good thing). During REM sleep the jaw is more likely to drop due to greater muscle relaxation.
Last nights numbers were good. AHI 1.3 My jaw doesn't drop because I wear a chin strap. However, my lips let the air escape. Since I wake up every time I change positions, I always sleep on my side. Last night I made sure my face was angled down toward the pillow instead of tilted up. Mmm....maybe I should try mouth exercises to tighten the lip muscles. I have a full face mask which worked well at lower pressures. Now it leaks and vibrates and the forehead piece interfers with my Zeo.
I had these problems initially and solved them by using a full face mask and eliminating caffeine.

Not what the sleep doctor ordered.

[DrPepper00]

Would it be feasible to live in the Denver area but not actually in Denver? I'd think you'd avoid a lot of pollution and still be close to your family. I envy those who live anywhere near the mountains.

When I lived there, we tried to escape the pollution by moving to the mountains. You could actually see the brown cloud and see when you were above it in the mountains. However, the woodsmoke hung in the little valleys where everyone lived and the breathing was even worse.

I guess I am just as concerned with daytime breathing. I had pnuemonia a few years ago and developed asthma. I am hoping that feeling well enough to exercise will help my breathing.

[DrPepper00]

Would it be feasible to live in the Denver area but not actually in Denver? I'd think you'd avoid a lot of pollution and still be close to your family. I envy those who live anywhere near the mountains.

NW, not necessarily possible. When we do have a bad air day, the brown cloud can have a long reach and on really bad days it is thick enough to block the view of the mountains. I frequently drive to Greeley, a town that is a 55 mile drive from Denver, and I've seen the cloud reach from Denver toward that town.

Denver is far better now with it's pollution than I remember it being in the '80s, utilizing ethanol during the pollution prone winter months with wood burning restrictions as well. I think the state and city have done pretty good job of limiting the pollution as the high pollution alerts seem fewer and far betweener than they were years ago. It's no longer a place where you're breathing bad air on a continual basis, I think it's actually pretty good with few exceptions.

Can you still smell the stock yards in Greely from miles away?

[chunkyfrog]

I used to drink diet cherry vanilla Dr Pepper.--LOVED it!
I can still get it where they have the Coke Freestyle machines;
but I don't drink Dr Pepper or any cola hardly ever--
--after I found out the phosphoric acid leaches calcium out of your bones.
At barely 4'11", I'm quite short enough already.

[jilliansue]

Hmmm, interesting! I live in Gunnison, CO, elevation 7700'. But I was diagnosed here and so can't give an opinion on SA in other locations. I believe that the machines automatically adjust for the altitude, so I can't see why the SA would be any worse. From what you describe, it sounds like it may have been the chemicals and the general air pollution at fault. I think the brown cloud in Denver is better than it once was, but I know that during the winter there are days on which wood fires are prohibited due to air quality concerns....Perhaps if you live in Boulder or some place close by, and yet not East-ish of Denver, you would be close to family, but not have the same air quality concerns....

Good luck!
Jill

[ChicagoGranny]

I guess it is terribly impractical, but everyone who uses CPAP would be better off if they lived seaside. The greater density of the air is a big help. Even small changes in elevation make a big difference.

My house is at 700 feet. Every summer I stay a couple of weeks with my sister who lives on the shore at elevation 30 feet. I can clearly tell that CPAP works better and I feel much better.

If I win the lottery I will buy a house in my sister's neighborhood and my husband will sell his business and retire there.