Sleep issues and meds

[bmanley]

Just wondering if anybody has issues with sleeping and their pain meds. Not sure how much this could be playing in with my sleep troubles. I can't take as much pain meds before bed or I know I have more issues. First time I though much about it was when I had my cancer surgery and I was on a pain pump. Once I hit the button and a short time later I would get sleepy and when I would start to dose off the apnea alarm they had me on would go off and wake me up. This also was the first time they told me I might need a cpap machine. They would not have released me from ICU unless I had a cpap machine. So after this they sent me for my first sleep study. Turned out I did stop breathing but they said I didn't meet the requirements for medicare to pay for it so I didn't get one. Sent back for another sleep study after another problem in the hospital and this time I was bad enough for them to pay for it.

Now as I've talked about in other posts I'm a little over 5 years into using one but still having issues and stop breathing. With that I'm just trying to figure out if meds are becoming more of an issue. The last few times they have put me under for treatments for my pain issues they have noted I stop breathing which is something I had not had trouble with before. Can the use of pain meds cause my breathing issues to get worse as time goes on? And if so is there a limit to the trouble it can cause? The reason I ask is I'm not going to get off the meds unless something would change and I don't see that happening. But if this is slowly causing my problems I need to figure out what if anything can be done

[Julie]

Meds may or may not be affecting your sleep and/or Pap, but what are your pressure settings, which machine and model are you using... any mask issues? It's possible your orig. settings were low for today's circumstances.

[Pugsy]

Did you ever get that new full data machine you were talking about in past posts?
Or are you still using the S9 Escape?
If you are still using the S9 Escape...please add that to the comments sections of your equipment.
If you are using the new machine...please update your profile to reflect the new machine.

Pain medications can suppress respiration and/or make the airway tissues more "floppy" and thus make sleep apnea worse.
They can...but it isn't always a given that they are or will make things worse...but they can.
Things can also get "worse" all by themselves due to aging or whatever and medications may or may not be responsible.

You really need a full data cpap machine to see for sure what's going on.

[OkyDoky]

Pain meds can become a contributing factor in central apneas. With a machine that doesn't report them you have no way of knowing what makes up your AHI. A regular CPAP machine doesn't treat centrals because increasing pressure may make them worse.
Since it has been 5 years, It may be time for talking with a sleep doctor and repeating your sleep study.

Also, if you would type in your machine in the comment section of your profile since it doesen't show now, others would know how to better respond.

[bmanley]

Still have the S9 escape and been on the phone today trying to get the new machine tomorrow. The DME is in my area on Thursdays so they were trying to get things together so they could bring it out to me. Not sure how that is going. Called them this morning and they had not heard from the doc so I got their fax number and called doc office. They sent it to wrong place and now the DME has that but called me back because they didn't send the last sleep study. Not heard back to see if they got it together.

And way my last sleep study was a year ago and they said pressure should be 13 and I was on 11. Have seen pulmonary doc twice since then and he has me up to 15 now. With still having trouble that is why he wanted new machine with better data and the full mask but the mask is out unless I buy since I just got a new complete nasal mask in Dec.
My pain meds have not changed since my last sleep study but a couple others have changed.

[Pugsy]

It's impossible to do anything but make wild ass guesses about what could be going on with you as to what your problem is caused from because we have no way of knowing what the problem is.
It could simply be the pressure is insufficient and you are having obstructive apneas.
It could be that your pain meds are suppressing your respiratory system and some central apneas are happening.
It could be something unrelated to sleep apnea.....it could be a lot of things.

You really aren't going to be able to figure out much until you get that new machine and get the data that is available on a full data machine.

[bmanley]

I know a new machine may not fix and issue but I hope it can give clues to what is happening. If he wrote down what he told me I know my pressure range will be higher so if that is any part of the problem maybe this will help. Just not sure with even with my meds staying the same if they can cause more breathing issues. I know I'm down in weight since my last sleep study but only less the 10 pounds

[kteague]

Just because a machine is new doesn't mean it will give you the needed information. Please do not accept a machine until you know for a fact (not just what they tell you) that it will give you the data you need. Maybe call them and ask the specific and full name of the machine they plan to dispense then check back here. Then check again that the delivered machine is EXACTLY the same. Surprising how much difference a few letters makes. You will have one helluva time exchanging it once you accept a lower end one.

[palerider]

Just because a machine is new doesn't mean it will give you the needed information. Please do not accept a machine until you know for a fact (not just what they tell you) that it will give you the data you need. Maybe call them and ask the specific and full name of the machine they plan to dispense then check back here. Then check again that the delivered machine is EXACTLY the same. Surprising how much difference a few letters makes. You will have one helluva time exchanging it once you accept a lower end one.

avoid anything with the name "escape" "plus" or "CPAP" on the label,

pro and auto from respironics are ok, elite and autoset from resmed are ok.

[MrGrumpy]

I have firsthand experience with this, albeit not as severe as what you describe as I never was on a pain pump.

In 2013, I had a tonsillectomy. As everybody knows about that particular procedure, its very painful and uncomfortable for several weeks afterwards. Of course the surgeon who did the tonsillectomy prescribed me the standard narcotic pain medications for several weeks until my throat healed up. I cant remember the specific pain meds I was on, they were the usual opioid narcotic pills you are prescribed after surgery.

After two or three days on those narcotic pain pills, my Autopap began bottoming out for the first and only time in my life. Im talking 19 or 20 every night for several weeks. At the same time, my Resmed S9 APAP central apnea score went up the most its ever gone up, before or since. I had centrals for several weeks after tonsillectomy and on those narcotic pain meds and I assume the cause was the heavy sedation from the pain meds along with the very high pressures I had every night for several weeks.

Within a couple days of discontinuing the narcotic pain killers, my normal pressures came back albeit slightly lower. And the centrals went away and normalized. Never had an elevated central apnea index on the Resmed S9 Autopap since.

Its pretty common knowledge that sedating pain killer meds (assuming you are on some form of an opiod) worsen sleep apnea and even cause central apneas due to respiratory depression and the opiods pain killers suppress chestwall breathing drive during sleep. Any sleep doc worth their salt will tell you that. And its all over the Internet on reputable patient self education websites.

Just wondering if anybody has issues with sleeping and their pain meds. Not sure how much this could be playing in with my sleep troubles. I can't take as much pain meds before bed or I know I have more issues. First time I though much about it was when I had my cancer surgery and I was on a pain pump. Once I hit the button and a short time later I would get sleepy and when I would start to dose off the apnea alarm they had me on would go off and wake me up. This also was the first time they told me I might need a cpap machine. They would not have released me from ICU unless I had a cpap machine. So after this they sent me for my first sleep study. Turned out I did stop breathing but they said I didn't meet the requirements for medicare to pay for it so I didn't get one. Sent back for another sleep study after another problem in the hospital and this time I was bad enough for them to pay for it.

Now as I've talked about in other posts I'm a little over 5 years into using one but still having issues and stop breathing. With that I'm just trying to figure out if meds are becoming more of an issue. The last few times they have put me under for treatments for my pain issues they have noted I stop breathing which is something I had not had trouble with before. Can the use of pain meds cause my breathing issues to get worse as time goes on? And if so is there a limit to the trouble it can cause? The reason I ask is I'm not going to get off the meds unless something would change and I don't see that happening. But if this is slowly causing my problems I need to figure out what if anything can be done

[RestlessinWoolley]

*Raises Hand* 15+ years on opiates have totally messed my sleep up. If it's not pain it's breathing difficulties and slowly lowering SpO2 levels. Yes they can mess things up.

I'm currently on standard CPAP but need to do an ASV study now after 2+ on CPAP my numbers are not getting better and during the test I had more events on Asv mainly because it woke me up and I was fighting it.

[bmanley]

Been on Oxy since maybe 2008 but my dose has not gone up in several years. I don't take any more meds then I have to and like I said found out early on taking these I could not take the same amount at night. Which in turn causes me to wake up in pain more then anything. Have been wishing for something that could give me a low dose during the night like maybe a implanted pain pump but don't sure that would do what I think I want. There are always pro's and con's to everything and you have the weight them out and figure out what you can live with. Think I'm looking at a surgery sometime this year so a machine with better data would help me keep and eye on how things change during that time. A work injury left me disabled for the rest of my life so I don't see pain levels doing anything but going up to were I may have to increase meds as time goes on.