Very weird AHI readings and booze

[gilbo]

I began using a Bi-Pap machine April 19, 2011 (I = 12, E = 7). Between then and January 24, 2012, my daily AHI readings fell between 0.7 and 2.1, with a single day maximum of 2.5 and an overall average for the period of 1.4. On January 25, 2012, my AHI for that night was 10.6. Between January 25 and today (March 18, 2012) my AHI never fell below 8.8. The average for this period was 15.6, with numerous peaks in the 20-50+ range. The average has consistently been increasing throughout this period. This huge jump in AHI readings happened literally overnight, and I have no idea why. One thing that's interesting is that I stopped drinking January 24, and the jump in AHI values started January 25. I was a heavy drinker, drinking consistently throughout the day, everyday, as opposed to going out and getting drunk at night. My period of total abstinence from alcohol corresponds identically with the period of the huge increase in AHI readings. Is it possible that there is a connection? Drinking kept my AHI down, and not drinking caused it to increase significantly? If it's not the abstinence from booze causing this to happen, I have to think there is something wrong with the machine (about one year old). I have a hard time believing such a drastic increase in AHI is normal. I'd appreciate any ideas as to why this significant jump in AHI happened, and is still happening. Gilbo

[underpressure]

Any other medications? Mask leaks , but it does seem odd , it usually goes the other way. Is it an auto bipap or a fixed pressure machine? Steve

[MaxDarkside]

Congratulations! Good for YOU ! Since we know that alcohol affects sleep, and since your body may have adapted to the alcohol, making a big life change likely creates a "disturbance" from the old normal and you may need to make some adjustments as you venture into the "new normal".

[gilbo]

It's a fixed pressure Bi-Pap. I use nasal pillows. As far as I can tell there aren't any leaks. But the readings the next day say there are leaks, but no "large leaks". If a significant leak happens because the pillows have dislodged, there is an alarm beeping from the machine to wake me up. Do leaks normally happen regardless of how well the pillows/mask is fitted? What are the highest AHI values people have experienced, and how often per night?

[underpressure]

Hey one more question.. what was your weight before stopping drinking and now? Weight gain could explain an increase in ahi at fixed pressure. but if your weight is unchanged or less then probably not an issue. There can be some leaks but its not usually that big of a deal especially if its not waking you up. I usually turn off the mask leak alarm. just a pain. Ahi can be very high on cpap and i have seen as high as 40 events per hour but its usually when you have central sleep apnea. I don't think you are at all in that category . If you are more tired now and your numbers are not quite right i would go back to your dr. and give him a heads up.. I work for a cpap company so i would do a home test in coordination with your download. If i couldn't figure things out and it looks suspicious I would get you back to a sleep dr. I am from canada so it may work diff in the US.

[Pugsy]

Alcohol is known to mess with sleep architecture. Messes with the sleep stages. Wonder if you happen to be worse in REM sleep (more OSA events in REM) and are having more REM stages without the alcohol to mess with sleep stages. Are you using software to monitor therapy? If so, do you see any clusters of events which might correspond to REM stages?

[HoseCrusher]

It may be that your initial pressure set up is optimized for your body on alcohol. When you remove the alcohol, you may need to tweak your pressures a little. As others have mentioned alcohol effects sleep stages, and you may now be experiencing deeper sleep and may need an adjustment to control your obstructive apnea's during these deeper sleep stages.

[Kairosgrammy]

I'm not sure what would be considered a normal response to stopping drinking would be. I commend you for stopping drinking. That is definitely a step in the right direction!!! I would also say that since this pattern has gone on for 2 months, you might need a new sleep study. Honestly though, I would have thought the apnea would have improved rather than gotten worse although someone's theory about REM sleep might be a good answer. I think you really, really need a new sleep study though right after you have your dme's RT check your machine.

[-tim]

There are only two chemical reactions that can feed the brain, one is glucose and oxygen and the other is ethanol. Your brain chemistry gets used to running on ethanol which bypasses three quarters of the Kerbs cycle and is a more efficient way of feeding the brain but it has lots of other drawbacks. When you switch from one to another there will be short term issues and this is one of them. Cutting alcohol from an every day habit does require medical attention or it can be fatal. At lower levels, it can have all sorts of other bad side effects.

[Captain_Midnight]

Gilbo, one suspects that since you are sleeping more deeply now, your AHI correspondingly increases. Perhaps it's time to re-eval your therapeutic pressures.

I notice the same phenomenon, btw, but not as large of a swing. On those nights where I have an adult beverage or so, my AHI is typically, slightly less.


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