Very high AHI, yet feel great

[Mary Z]

I have something puzzling going on. I have had a chronic problem throughout my four years on all modes of 'PAP, except ASV, in getting my AHI down. In early January, 2012 the six month average AHI was 18. (This prompted a trial of ASV and now I am wading through getting the order written, given to the DME, and getting insurance authorization to start ASV). This month AHI/AI shot up- today 65.1/26.3, wk 56.4/26.3, month 32.3/8, six month 17.9/4.0, year 17.5/4.2. My pressures have ranged from 9.0- 9.6. These numbers include my attempts to self titrate based on my prescribed pressure of 4/8. I used AUTO and plain CPAP during self titration.
The real mystery is that I feel great, wake up ready to get up, can stay up later at night, have stopped my Provigil, and have more energy, remember dreams, depression abating, much reduced pain and use of opiate pain relievers...I sleep well.
This is all complicated by my being bipolar and in a deep depression, now remitting since I saw my psych doc on Feb 14 and changed some meds around- from Pristiq to Zoloft, stopped Geodon.

I see my sleep doc March 1, hope to have started ASV by then.

What is going on? Has my machine gone haywire in reporting? It's just a year old and all other efficacy data is reported as normal/usual though my Tidal Volume has increased. There is a slight edginess to my energy so I could be in a hypomanic state. Or perhaps I am running on adrenaline from stopping breathing so many times a night?

Any insight into this would be appreciated. I don't have the software and don't want to invest in a card reader right now since I am changing machines and don't know if I'll get a Respironics or ResMed.

crossposted to apneaboard.

[jamiswolf]

Hi Maryz,
You have a very complex situation and it's hard to comment with the data you've provided. It would be very interesting to know the breakdown. How many central or clear airway apneas vs OAs. I assume that since you're being considered for an asv, that there are some significant CAs.

Regarding your adrenalin idea...I think not. It's very rapidly metabolized and so is only in your system for perhaps 30 minutes (max).

So sorry that this has all taken so long for you. I hope the ASV improves things which it should if there's a strong central component to your apnea.
Best wishes,
Jamis

[MaxDarkside]

The only thing I can suggest is that it might be the change in drugs. Maybe you went from feeling horrid to merely miserable and with our relative adaptive perceptions as humans you seem to "feel great". Second, events and feeling good or bad is one thing I'm trying to quantify for myself and it may be the accumulated severity of the events rather than the count or rate which has more bearing on our next-day-feel.

[xm41907]

I am in a similar situation as you. I'm currently on a bipap and having fluctuating AHI. I tried using melatonin for a week and the second night I was on it, was the first and only time I was below 5 AHI. It stayed low for the first few days then back up around 15 AHI. Last night I stopped using it and my AHI was down to a 6. For the most part I feel much better than I did before xpap, but I still have some groggy feelings on occasion. I've noticed that leaks on my Swift FX are fluctuating quite a bit. I suspect the higher pressure I'm on with the biPAP is causing me to open my mouth several times throughout the night. I need to get a chin strap and see if that helps keep it closed and the leaks stay down.

Have you changed anything else in your life that might be causing the changes?

[Mary Z]

Can't think of anything else in my life that may be causing the changes. Thanks for your responses.