Losing weight - increased AHI

[Dansworth]

Hi

Over the past 4 or so weeks, my AHI has been creeping up as I have been losing weight. I've lost about 15 pounds and hopefully I'll be in the healthy BMI range within 5 weeks. However, a weird side effect of this has been an increase in AHI. My pressure had been 14.5 for a long time, but I recently increased it to 15, which has resulted in little change.

Weirdly, I'm seeing an increase in Hypopneas and Central Apnoeas, rather than Obstructive Apnoeas. Could someone look at my data below and see if I should make any changes please?

Also, I know weight loss is no guarantee of curing sleep apnoea, but is it possible to see from your AHI/data whether you're 'cured or getting better'? Or would I just have to record myself asleep and/or get my partner to observe me? I'd obviously get a test done at some point, but it's tricky given covid-19 at the moment.

I just find it peculiar that weight loss has resulted in my CPAP detecting more apnoeas.

[Lifeisabeach]

I actually just went through this myself. You likely will need to reduce your EPAP pressure to eliminate those. I'm not really comfortable giving more specific advice, but just to give you some hope/perspective, take a look at the charts I posted recently to make sure I was on the right track. My AHI, centrals, and large leaks were waaaay up after losing weight (among other factors in play). Dropping the pressure DOWN, particularly the EPAP level, got me back on track. Before you do anything though, let someone more qualified chime in for specifics.
viewtopic/t179631/Need-an-opinion-on-my ... lease.html

[Julie]

Try lowering the min. pressure to 12 or 10 for a few nights to see if it helps. And are you now back-sleeping vs e.g. side sleeping prior to losing weight?

[Pugsy]

Please post more optimally organized graphs. You've shared a bunch of graphs that are not helpful at all and omitted the most basic and most helpful graphs. Examples explained here in this thread.
viewtopic/t158560/How-to-post-images-for-review.html

How is your sleep quality? Waking often or sleeping soundly for the most part?

[Dansworth]

I'm not sleeping well at the moment. A mix of general higher levels of stress cos of this pandemic, the weather in England has been a bit hotter recently so harder to stay asleep. My increased numbers/higher AHI is a little worrying for me too, thinking with all this weight loss, my numbers should be going in the opposite direction!

I've tried rearranging the information, hopefully this is better. Thanks.

[Dansworth]

A couple more images.

[Pugsy]

If you know you aren't sleeping well it is possible that some of that increasing AHI numbers are just a reflection of not sleeping soundly.

Go here and watch the videos and learn how to distinguish awake/arousal related flagged events from asleep events.
http://freecpapadvice.com/sleepyhead-free-software

While it is talking mainly about central/clear airway apneas false positive flagging isn't limited to central apneas.
It can be any category of flagged events. My own AHI is almost always around 75% false positive flagged events. I don't sleep so great because of some chronic pain issues and a lot of tossing and turning so it's not a big surprise. A few weeks ago I had an AHI of 9.4 one night...way high for me but when I went and looked I saw 90% of it was false positive flagging. It was also a night where I slept horrible due to back pain because I had simply over down things in terms of my work in my garden the day before and my back hurt like hell and I slept like hell as well.

It might ease your mind to know that some of that AHI isn't real. We have to be asleep for the flagged events to matter in terms of sleep apnea treatment. Now what might be causing the poor sleep....that's a different can of worms to be opening but it wouldn't be impossible for the AHI elevation to be a reflection of the poor sleep and not the cause of the poor sleep which of course means we have to address the cause of the poor sleep differently.

[chunkyfrog]

Congratulations on the weight loss.
Hopefully, the odd numbers are either a coincidence or the "fat demons" just messing with you.
We do get used to poorer health, and the body sometimes needs time
to get the idea things are improving.

[Miss Emerita]

It is at least possible that the weight loss means you are breathing more efficiently at night. In some ways, that's great, but for you it may mean that you are washing out just enough CO2 to mess with the signals that tell your body it's time to breathe -- which yields an increase number of CAs following little bits of heavier breathing that in earlier days would not have resulted in a CA event.

But what about those little bits of heavier breathing? They may be mini-arousals, which you don't really want whether they are followed by CAs or not.

After you educate yourself using the video Pugsy has linked to, really think about whether you are sleeping worse because of the increased AHI or because of other stuff. Then decide if you want to experiment for a week or two. By dropping your minimum pressure to, say, 12, you could see whether that reduced CAs at all -- and if so, whether it also increased OAs. You would then have more information, and the experts could offer more advice.