Waking in the night

[Alsacienne]

I am monitoring my AHI level very closely. If I'm waking in the night - which I often do because of tendonitis in the knee or a hot flash/flush - being of a 'certain' age! - are these likely to show up as AHIs in my data? Is it possible to wake because of other things than an AHI? Sorry if this seems a silly question, but I'd just like to have a bit more knowledge as even with a gentle nudge in increased pressure, the number of AHIs has only decreased a tad ...

(Ultimately I suppose it's time for another 'nudge' but I'd just like to discount other reasons before I do so!)

[JDS74]

I am monitoring my AHI level very closely. If I'm waking in the night - which I often do because of tendonitis in the knee or a hot flash/flush - being of a 'certain' age! - are these likely to show up as AHIs in my data? Is it possible to wake because of other things than an AHI?

Yes, if you have spikes in blood pressure and / or heart rate like I do, you tend to wake up several times during the night. I get spikes that send my BP from a normal range of 120/70 to 150+/100+ and heart rate from 65 to 120. They last only for about 30 seconds or so but it gets me going. In my case, I see occasional clusters of CA's just after such an episode. That raises your AHI somewhat.

[robysue]

I am monitoring my AHI level very closely. If I'm waking in the night - which I often do because of tendonitis in the knee or a hot flash/flush - being of a 'certain' age! - are these likely to show up as AHIs in my data? Is it possible to wake because of other things than an AHI? Sorry if this seems a silly question, but I'd just like to have a bit more knowledge as even with a gentle nudge in increased pressure, the number of AHIs has only decreased a tad ...

(Ultimately I suppose it's time for another 'nudge' but I'd just like to discount other reasons before I do so!)

It's certainly possible to wake up for many reasons not related to OSA events. Pain (from the knee or anywhere else in your body), hot flashes due to menopause, congestion due to a bad cold, the need to turn over in bed, a bad dream that's not triggered by OSA, old fashioned insomnia triggered by stress in your daytime life, a random unexpected noise that's over by the time you reach full consciousness, and many other things can trigger waking up at night.

Will these things show up as apneas or hyponeas in the machine generated data? Probably not most of the time, but maybe so if you routinely either hold your breath briefly or have long pauses between exhale and inhale in your wakeful breathing patterns.

So how can you tell? Well there's no way to tell for certain, but here is one idea you could try for sorting out whether the wakes you think are caused by specific non-OSA things like knee pain may be causing the machine to misinterpret your breathing pattern and recording events when you are in half-conscious state while you are waking up:

If you have the ramp set up appropriately, you could just hit the ramp button every time you wake up.* Then when you look at the data in ResScan, you'll be able to see the decrease in pressure in the pressure curve and see if it happens right after a cluster of events. And if you remember the wake being caused by something specific such as the knee pain, but there are also events right before the wake, then you have some evidence that your breathing pattern as you are starting to wake can be (mis)interpreted by the machine as sleep disordered breathing. On the other hand, if you don't remember any specific trigger for the wake and there are events right before it, then the events are likely real and it is likely they triggered the wake.

*NOTE: An appropriate set up for the ramp in this situation is as follows: The starting ramp PRESSURE should be CLOSE to your therapeutic pressure level and the ramp TIME should be relatively short, but long enough for the rate the pressure increases to not be enough to keep you awake. For example, if your prescribed pressure is 11cm, set the starting ramp pressure at 9 or 10cm instead of the default 4cm. And the ramp time should be set for something between 5 and 15 minutes. Most people won't notice a 1cm rise in pressure over the course of 5 or 10 minutes. And if the ramp pressure is close to your therapeutic pressure, the number of events that might slip through during the ramp time is minimized.

Of course, on the Resmed side, you do have to get into the clinical menu to reset that starting ramp pressure.

[Alsacienne]

Thanks for the idea of using the ramp. I don't use it and go straight to pressure which is currently 14.6.

My AHIs are starting to drop from 7 to 5.6, my AIs are respectable - between 0.3 and 1.0 - but my HIs are still showing above 5.

I intend to spend another week at this pressure and then go up 0.4 or 0.6 to see if I can get the magic 5 or less AHIs. The tendonitis is starting get better but another problem has suddenly arisen ... off to the OB/GYN as soon as I can get an appointment.

[Hawthorne]

As far as your data goes, your profile shows an S8. I understood that the S8 line of Resmeds score HI higher than other machines. With an AI 0.3 to 1.0 you are doing well.

In my opinion, these other issues are not affecting your data.

[Mary Z]

I used to have a lot of arousals during the night due to leg and back pain. I find a tylenol (or any brand )of a PM medicine with benadryl, or a mild pain pill helps me sleep through the night. Good luck.

[Alsacienne]

Thanks for your continuing advice and encouragement. I'd just like to get my AHIs down to 5 or less to comply with the British standards ... in France under 10 is considered good!

[Trinsor]

Walking in the night is a good habit.It is good for better health.You walk in the night it is really good for you.There are lot of benefits of it. With walk we can digest our meal easily and walking is the source of energy and fitness.Everyone should do walk in the night after dinner.