AHI elevating - food for thought

[kutastha]

Hello to all reading this. I have a scenario that's currently affecting me, and I was wondering about some thoughts on the matter. As for me, I was diagnosed with OSA in 2004. I currently use a REMStar Pro with C-flex. CPAP pressure is at 5.0 and the Cflex is at 2, humidifcation at 4 and a microfilter in addition to the regular filter, both of which are changed on schedule. All equipment is also kept clean. I use a Swift FX that has a good fit. I was titrated in May 2011 at about 1000 ft elevation and I moved to about 5200 ft in October. Even at the elevation, prior to about a month ago the machine had my AHI between 3 and 4 and I was feeling great.

Recently, my AHI was creeping up to 6-7. I downloaded the Sleepyhead software to look more closely at my numbers and am getting nightly AHIs between 7-10. Everything in my routine is pretty much the same as it has been. My diet hasn't changed and my exercise routine is the same (and when I say exercise, I mean workouts like Insanity and P90X), though my endurance is decreasing. Of note, I went down to about 1000' again for five days and my numbers went as low as 1.5. When I returned to high altitude, the numbers shot back up to near 10. I'm having a significant amount of hypopneas and CAs, but not a terrible amount of obstructive events. Nevertheless, I feel like crap.

The only variables I can account for are that the weather has changed recently to the mid 80s, and since our house is insulated for winter, the upstairs bedroom gets fairly warm and a bit muggy. This was not a problem in the winter and early spring.

In all, this will likely be a moot point after two weeks since I'll be moving to where I had better numbers, but I'm curious about some thoughts on the above. I include last night's data for your enjoyment. AHI for this night was 8.5.

[Pugsy]

I would expect that your pressure at the higher altitude is not quite sufficient to prevent the events effectively.
Why now and not when you first moved there? Unknown really.

The increase in CAs might possibly be explained by the presence of the obstructives in that maybe the obstructive events occurring cause some level of arousal and the centrals might be sleep onset from when you go back to sleep after the event causes a mini arousal.

Feeling like crap could be a combination of the increased events and the general oxygen levels at altitude. Already lower and with a few more events might be even lower. Double whammy.

[mikewithe]

Low pressure, warm sleeping environment, high elevation, and high humidity all sound like a recipe for poor sleep to me. I'd turn the humidity down to 2 personally. But I'm a newbie so take that with a grain of salt.

[kutastha]

Thanks everyone. I was considering both. I'm going to go up on the pressure, but the humidifier setting I may try in a few days as it's so dry up here. I'm sure by the time I'll figure it out I'll be back to a normal elevation and environment. Thanks again.