Why would pain med's drop AHI?

[Cowboy Casey]

SO, I have been trying to stay away from my pain med's as much as possible (tramadol) so I have only been taking them when I really Really needed them.. Everyone always says to watch for trends so I have been doing exactly that and I noticed something... My AHI raises when I do not take my med's... 2 different days I had a .62 AHI and 3 days not taking them, here is the 5 days of data.. I have taken 1 today to test this theory but still wondering why, Could it be I am just in pain and my brain and breathing are telling me i'm in pain??

Any idea?

july 11 pain med
Screenshot 2014-07-16 16.55.16 by cowboycasey, on Flickr
July 12
Screenshot 2014-07-16 16.55.23 by cowboycasey, on Flickr
July 13
Screenshot 2014-07-16 16.55.32 by cowboycasey, on Flickr
july 14 pain med
Screenshot 2014-07-16 16.55.39 by cowboycasey, on Flickr
July 15
Screenshot 2014-07-16 16.55.44 by cowboycasey, on Flickr

[Todzo]

I think that pain is stressful and tends to raise the level of stress hormones – which:

Causes inflammation (and so raises the tendency for obstruction to occur).

Raises respiratory control system gain (and so raises the tendency for unstable breathing the excessive efforts of which can cause arousals).

Lowers arousal threshold (which tends to make for more of them).

Any events as outlined above tend to raise the stress hormone levels even further.

Bottom line more events as you have noted.

[Soundsleepservices]

Your apneas appear to mainly occur during REM sleep, which normally comes about every one one-half hour to three hours, resulting in higher mask pressures and showing slightly elevated mask leaks.

Don't know if this helps any but your increased apneas are primarily in REM sleep and you have less apneas in REM sleep on the nights you are taking the pain medicine. Secondly, your apneas are so low it's almost a moot point. This is where microarousals come in. I wonder if your sleep is more solid during REM when you take your medicine. (Apneas are one thing but microarousals are also important.) Either way, sounds like you need pain management whatever that may be.

[LSAT]

It's only one night..and, it's a very small difference. I wouldn't make a big deal about it.

[archangle]

So many factors figure into apnea that almost anything could make AHI go up or down.