Is CPAP lowering my AHI whilst increasing arousals ?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
sunnyk
Posts: 4
Joined: Mon Jan 08, 2018 3:50 pm
Location: UK

Is CPAP lowering my AHI whilst increasing arousals ?

Post by sunnyk » Mon Jan 08, 2018 5:20 pm

Hi, hoping for some desperately needed help please !

I have been using CPAP for 3years but have never felt "normal"

Initially I had been diagnosed with OSA with an AHI of 19

On starting CPAP (10cm setting on a Resmed Escape S9), I immediately noticed a difference - I could finally fall asleep easily instead of experiencing insomnia for hours every night, often all night. Only problem is, that, even though I felt "a little better" I still felt way too tired with a foggy brain etc.

The Sleep Clinic then put my machine up to 12cm and again I felt better still - a bit less tired and my brain seemed to tick a bit more like it used to, but again no where near how I used to feel. Following this, overtime the setting was incrementally increased to 16cm, but things just got worse. My memory is failing and I am unable to do simple tasks that I would have done without thinking in the past - my cognitive ability is reduced considerably

My 2nd sleep study indicated an AHI of 6 but I had 53 arousals per hour (I guess that means my brain was being kicked out of a lower / deeper stage of sleep). That sleep study was performed with my CPAP machine set to 14.4cm

I have a 3rd sleep study scheduled where I will be using my CPAP machine with a setting of 12cm. The setting has been reduced as things get worse as the setting is increased. I suspect that the result will be similar (maybe slightly less worse) to the last sleep study.

I'm not sure if I'm jumping to conclusions here but it almost feels like the more my AHI comes down the higher the arousals get

Sorry for waffling on but any thoughts would be greatly appreciated

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jnk...
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Location: New York State

Re: Is CPAP lowering my AHI whilst increasing arousals ?

Post by jnk... » Mon Jan 08, 2018 8:19 pm

The job of the CPAP is to keep your airway stable so that airway instability doesn't cause arousals. However, many things can cause arousals--limb movements, medical conditions, chronic pain, treatments for chronic pain, drugs medical and otherwise, etc. Generally CPAP doesn't cause arousals (other than for some UARS-type sufferers), but it can unmask other forms of arousals by getting airway arousals out of the way so that the other forms of arousals can be investigated and their cause(s) hopefully eventually identified.
-Jeff (AS10/P30i)

Accounts to put on the foe list: Me. I often post misleading, timewasting stuff.

TedVPAP
Posts: 974
Joined: Sat Jun 12, 2010 10:29 am

Re: Is CPAP lowering my AHI whilst increasing arousals ?

Post by TedVPAP » Mon Jan 08, 2018 8:40 pm

If your machine has an SD card, follow the three links below.

_________________
Machine: DreamStation Auto CPAP Machine
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: AutoPAP 16-20, Ultimate Chin Strap http://sleepapneasolutionsinc.com/
Use data to optimize your xPAP treatment:
how to see your data https://sleep.tnet.com/resources/sleepyhead
how to present your data https://sleep.tnet.com/resources/sleepyhead/shorganize
how to post your data https://sleep.tnet.com/reference/tips/imgur

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LSAT
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Joined: Sun Nov 16, 2008 10:11 am
Location: SE Wisconsin

Re: Is CPAP lowering my AHI whilst increasing arousals ?

Post by LSAT » Tue Jan 09, 2018 5:39 am

TedVPAP wrote:If your machine has an SD card, follow the three links below.
Machine is S9 Escape...Limited Data

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Fisher & Paykel Vitera Full Face Mask with Headgear (S, M, or L Cushion)
Additional Comments: Back up is S9 Autoset...... Buckwheat hull pillow

TedVPAP
Posts: 974
Joined: Sat Jun 12, 2010 10:29 am

Re: Is CPAP lowering my AHI whilst increasing arousals ?

Post by TedVPAP » Tue Jan 09, 2018 7:01 pm

LSAT wrote:
TedVPAP wrote:If your machine has an SD card, follow the three links below.
Machine is S9 Escape...Limited Data
That's unfortunate - thanks

_________________
Machine: DreamStation Auto CPAP Machine
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Humidifier: DreamStation Heated Humidifier
Additional Comments: AutoPAP 16-20, Ultimate Chin Strap http://sleepapneasolutionsinc.com/
Use data to optimize your xPAP treatment:
how to see your data https://sleep.tnet.com/resources/sleepyhead
how to present your data https://sleep.tnet.com/resources/sleepyhead/shorganize
how to post your data https://sleep.tnet.com/reference/tips/imgur

SnoringInOregon
Posts: 60
Joined: Sun Nov 26, 2017 6:47 pm
Location: Oregon

Re: Is CPAP lowering my AHI whilst increasing arousals ?

Post by SnoringInOregon » Wed Jan 10, 2018 4:49 am

sunnyk wrote:I have a 3rd sleep study scheduled
I don't know where you're located, but my one and only sleep study in Oregon cost a lot more than the cost of a good, capable, CPAP machine that can log data for examination by SleepyHead. Plus I absolutely hated the overnight stay.

The financial incentives here seem pretty perverse. Someone wants to make money on repeated sleep studies instead of simply examining SleepyHead data (or using the "professional" equivalent software that Respironics has)?

That's insane. There should at least be more-detailed information viewed. Are you having obstructive apnea events? Are you having "clear airway" events? Are you exhibiting Cheyne–Stokes respiration? Etc. All of that can be determined from logs. Not as accurately as in a sleep lab. But the data is certainly "good enough" to allow some experimenting by tweaking a few "knobs" on a CPAP machine before bringing you back for another overnight study.

sunnyk
Posts: 4
Joined: Mon Jan 08, 2018 3:50 pm
Location: UK

Re: Is CPAP lowering my AHI whilst increasing arousals ?

Post by sunnyk » Wed Jan 10, 2018 3:08 pm

Thanks for the responses !!!
SnoringInOregon wrote:I don't know where you're located
I am based in the UK and am getting treatment via the NHS (National Health Service) so do not directly pay for the treatment - just pay extortionate amounts of overall tax The CPAP machine is provided by the NHS as well and unfortunately I am stuck with it unless the Sleep Clinic sees a reason to change it. Judging by the SleepyHead output, the Resmed S9 Escape seems like a basic machine which just records machine settings and times used etc

My interpretation of what the Doc said is that I am having 53 clear airway events(arousals) per hour with CPAP set to 14.4cm. I'll ask him to clarify when I see him next after my 3rd sleep study which will most likely be months away even though my sleep study is next week. Things don't happen fast on the NHS
jnk... wrote:many things can cause arousals--limb movements, medical conditions, chronic pain...

I'd tend to think I don't have limb movements. I would hope a limb movement problem would have flagged up in my sleep study results ? If I did have RLS, I would have noticed by now, or again, am I being too optimistic ?

I have no pain but I do have some minor discomfort when the machine starts hitting the higher numbers (from 11cm/12cm onwards) where my stomach feels like it's being inflated. I've realized that if I stay on my back it's more comfortable. Sometimes I'll just restart my CPAP machine so it ramps up from 4cm again over 45min and hopefully fall asleep whilst still at lower settings. Restarting the machine immediately normalizes my stomach. I don't feel the need to burp or pass gas. Is this just a normal side affect of CPAP ?

I've been Googling around and acid reflux has been suggested as a possible cause of these arousals. I don't think I have acid reflux as I don't seem to have any symptoms so clutching at straws. I have bought myself an OTC medicine to try out for a few days just as a little experiment