Sudden jump in AHI with new medication

[puglover333]

I just started a new medication. Literally the next night, my AHI jumped up to 5.

I have been on APAP since October. Settled in on a pressure of 9-16 with ERP 3. My AHI is normally under 1.

It's been 4 nights now of higher AHI's. Any suggestions to settings to get it down?

First graph is what was a typical night. Second 2 are apparently my new normal.

Thanks

[LSAT]

well........

the obvious answer is to stop taking that medicine
it would appear that is is depressing your breathing

PERFECTION IS NOT POSSIBLE
if you need that medicine for something else that is more important
then you may have to accept the AHI increase

was there anything else that changed ?
was it one time or is it consistently high now?

is apnea a known side effect of the medicine?
is there an alternative medicine you could use

This is not obvious....Actually, If you simply slowly increase your minimum pressure from 9 to 12, I think you will find that your AHI will drop. Leave the medicine alone for now.

_________________

[Julie]

What medication is it if you don't mind my asking? It may not matter, or it may matter a lot (you may need to keep taking it after all, or possibly get it switched to a diff. one without the same side FX.

[puglover333]

What medication is it if you don't mind my asking? It may not matter, or it may matter a lot (you may need to keep taking it after all, or possibly get it switched to a diff. one without the same side FX.

Duloxetine - I've got chronic coccyx pain that has been resistant to multiple other attempts at treatment. It's a SNRI that has been approved to treat chronic pain. I'm pretty desperate to get that under control and would really like to give the medicine a chance.

[puglover333]

well........

the obvious answer is to stop taking that medicine
it would appear that is is depressing your breathing

PERFECTION IS NOT POSSIBLE
if you need that medicine for something else that is more important
then you may have to accept the AHI increase

was there anything else that changed ?
was it one time or is it consistently high now?

is apnea a known side effect of the medicine?
is there an alternative medicine you could use

I agree with LSAT - not helpful and not obvious.

[ajack]

probably a med with a muscle relaxant side effect of some kind.
I would contact the doctor and set my machine straight to 12-17 and see how it went.

[puglover333]

This is not obvious....Actually, If you simply slowly increase your minimum pressure from 9 to 12, I think you will find that your AHI will drop. Leave the medicine alone for now.

_________________

Thanks for the input. I'll try a slow advance on the minimum. I'll try 10 tonight.
Think I should raise the upper as well?

[puglover333]

well........

the obvious answer is to stop taking that medicine
it would appear that is is depressing your breathing

PERFECTION IS NOT POSSIBLE
if you need that medicine for something else that is more important
then you may have to accept the AHI increase

was there anything else that changed ?
was it one time or is it consistently high now?

is apnea a known side effect of the medicine?
is there an alternative medicine you could use

This is not obvious....Actually, If you simply slowly increase your minimum pressure from 9 to 12, I think you will find that your AHI will drop. Leave the medicine alone for now._________________

============

none are so blind as those who wont look

start medicine and AHI goes up
clearly that was the prime suspect in this crime drama

I clearly said that I believe the medication is to blame. However, if I was willing/wanting to stop it, I would not be on here asking for advice on my pressure settings.

So again - not helpful

[kteague]

I'm certainly not an authority on this, just a person with lung issues that have caused me to pay attention to things that might cause difficulty breathing. I've generally interpreted the warning of a possible side effect of difficulty breathing to be related to allergic reaction, unless the med could cause things like blood clots etc. It would surprise me if difficulty breathing means sleep apnea, but hey, what do I know? At any rate, you have a very few centrals (?) on one night, and you may or may not have been awake during those times. Most of your issue is with obstructive events and hypopneas, which should respond to a bit of pressure increase on your lower end as discussed. If this med is allowing you to sleep better due to the pain relief and/or you are more relaxed, an increase in AHI wouldn't be surprising. Of course it's a good idea to keep an eye out just in case with that increase in pressure comes an increase in centrals in your event breakdown. A med that could suppress the respiratory drive plus a higher pressure merits a cautious eye. You can cross that bridge if you get to it. EDIT: Just noticed your exhale relief is set on 3. Maybe it would be enough to change it to 2 or 1 for a few nights and see if it helps. Just change one thing at a time though so it will be clearer what helped.

[zoocrewphoto]

start medicine and AHI goes up
clearly that was the prime suspect in this crime drama

Yet the medicine may be very important. Since it isn't that hard to change settings to adjust, why would you assume it is best to eliminate a medication that could be very important?

[Guest]

I am surprised that no one asked if the sleeping position has also changed?

[aspen]

I can't take central nervous system depressants or muscle relaxants without my AHI jumping. CNS depressants boost my clear airway events (including sleep meds and the Cymbalta you've mentioned). Muscle relaxants up the obstructive apnea.

So I hear you .. an obvious connection. I was on CPAP and that was a disaster; if I took meds I'd have to guess where my pressure might be that night. I've just trialed two APAPs and I'm not sure they are the entire solution either (in particular if I want to use medications for my condition).

Following with interest.

[D.H.]

Good, point about sleep position. The medication could change affect the position in which one sleeps, in turn affecting the AHI (as opposed to a direct side effect).

Since the medication is the only thing that changed (is it?), it's the obvious suspect.

If the medicine is doing what it is supposed to, I would see if adjusting the pressure (upwards or downwards) might help. If your pressure was 1ish before and is 5ish now, you will probably notice that you don't feel as refreshed as before. Note that five or less is considered "acceptable," but that's an arbitrary number that the doctors made up based on incomplete knowledge.

[49er]

start medicine and AHI goes up
clearly that was the prime suspect in this crime drama

Yet the medicine may be very important. Since it isn't that hard to change settings to adjust, why would you assume it is best to eliminate a medication that could be very important?

========

rotflmao

he is taking an antidepressant for pain
so wrong medicine to start with

the known side effect of it is difficulty breathing
so second logical reason against continuing using the wrong medicine at all

he needs to use a pain medicine without that side effect

you sound like my DME
just get used to it
its all your fault
not going to change anything

come back when you have learned how to connect one dot
and we will try workign with you on two of them like this case has

https://www.google.com/search?q=antidep ... balta+pain

But the issue is that Puglover has chosen to take this med for pain. As long as she is fully informed about the risks/benefits in consultation with her doctor, that is all that matters.

Puglover, I am sure folks would like to know how your night went Increasing the pressure from 9.

49er

[LSAT]

"end-of-alphabet boy" is always right and always needs the last word.