Central apnea...moving to sea level

[Apneanderthal]

Hi all,

It's been about five years since I was diagnosed with central (and a little obstructive) sleep apnea. I live in Fort Collins, Colorado at about 5,000 feet. After living here ten years, I think it is finally time to move to sea level to resolve my sleep issues. When I travel to lower cities, I don't bother bringing my ASV since my apnea goes away! Despite using my ASV daily for five years, I still feel terrible all the time, zombie, headaches, high blood pressure, etc.

I'm very hopeful that moving will help. We're looking to relocate to Portland.

My question is, has anyone moved to lower altitude due to central apnea, and did it help?

Thanks so much!
Tim

[palerider]

First I've heard of such a phenomenon.

Sounds like your asv isn't adjusted right...

I'd STRONGLY suggest a sleep test wherever you are thinking of moving, before you do something like that... "because sleep apnea".

[Wulfman...]

Hi all,

It's been about five years since I was diagnosed with central (and a little obstructive) sleep apnea. I live in Fort Collins, Colorado at about 5,000 feet. After living here ten years, I think it is finally time to move to sea level to resolve my sleep issues. When I travel to lower cities, I don't bother bringing my ASV since my apnea goes away! Despite using my ASV daily for five years, I still feel terrible all the time, zombie, headaches, high blood pressure, etc.

I'm very hopeful that moving will help. We're looking to relocate to Portland.

My question is, has anyone moved to lower altitude due to central apnea, and did it help?

Thanks so much!
Tim

How do you know?

In any case, it shouldn't make any difference since your machine auto-adjusts for altitude, and you ain't anywhere near the maximum altitude for the machine.
And, given the relationship regarding Centrals and oxygen, it could be the opposite of what you should be considering.
Carbon Dioxide is the trigger for the drive to breathe.
But, more investigation should be done in your situation.

From:

https://www.emedicinehealth.com/obstruc ... nea_causes

"The brain regulates breathing by monitoring levels of oxygen and carbon dioxide in the blood. If the oxygen level is low or the carbon dioxide level is high, the brain signals the breathing muscles to breathe faster in order to expire more carbon dioxide and inspire more oxygen. On the other hand, if the oxygen level is too high or the carbon dioxide is too low, then the brain slows down breathing to allow for a more normal balance.

In central sleep apnea, this regulatory mechanism is disrupted and the brain's recognition of, or response to, oxygen and carbon dioxide levels is impaired. As breathing stops or slows down, the oxygen level drops significantly lower and the carbon dioxide level increases significantly higher than the levels necessary to trigger normal breathing. This leads to a transient exaggerated over-breathing to compensate for significantly higher levels of carbon dioxide and lower oxygen levels. Subsequently, the over-breathing can result in overshooting the oxygen and carbon dioxide levels, initiating another episode of apnea."



Den

.

[nicholasjh1]

Well it may be worth noting that I only have OSA, and when I have gone to sea levelin the pastI feel a ton better (while still using my machine). That being said, I've optimised my treatment, and now I feel good all the time, so you might want to think about how confirmation bias could be related to your sealevel experience and as others have noted... before you uproot your entire life to "cure" your apnea at sealevel it might be worth taking a sleeping test at sealevel.

[palerider]

From:

https://www.emedicinehealth.com/obstruc ... nea_causes

"The brain regulates breathing by monitoring levels of oxygen

Further studies have shown that the idea of the brain monitoring oxygen level is incorrect in the vast majority of cases. Hypoxia rarely exibits any symptom of "air hunger", though it does affect a small group of people that way.

CO2 is the primary respiratory drive.

[Apneanderthal]

Thanks for the feedback folks.

As for how I know my apnea improves at sea level, over the years I took my ASV with me on many trips (I travel to sea level about 4-5 times a year). I monitor my numbers pretty closely, and as I'd predicted (and as my sleep doc had told me), my numbers improved dramatically at sea level. To the point that there's no discernable apnea at all. My average AHI is 8-12 here at home, as read on my ASV. At sea level it drops to 0.2 or so. After a couple years I just quit bringing it with me any time I travel to sea level.

Going the other way, I can't go higher. I've tried taking weekend trips up to the mountain towns in Colorado (around 9,000 ft) and my apnea is so bad I've sworn off overnight stays.

Additionally, my sleep problems didn't start until I moved to Colorado. I dealt with it for a few years before finally getting a sleep study. At the time, my sleep doc told that that while I may resist (because Colorado is awesome), moving to a lower elevation is likely to be my ultimate answer.

So this isn't just a theory on my part. As an aside, it is pretty well documented that altitude induced central apnea is a thing.

So really just hoping someone has had a similar experience. I know central apnea isn't nearly as common, so probably a shot in the dark.

Thanks again!

[palerider]

My average AHI is 8-12 here at home, as read on my ASV.

That's abysmal! No wonder you feel like shit.

[Apneanderthal]

My average AHI is 8-12 here at home, as read on my ASV.

That's abysmal! No wonder you feel like shit.

Agreed! The best number I've seen since getting on treatment is 7. This certainly is a terrible number if you have OSA and you should be able to get that much closer to zero. But with CSA, unfortunately the ASV is just there to keep breathing happening, it doesn't prevent the apneas to begin with. Which brings me back to the question of "how do I get those to go down? Move to sea level." Then I see numbers almost zero.

[palerider]

My average AHI is 8-12 here at home, as read on my ASV.

That's abysmal! No wonder you feel like shit.

Agreed! The best number I've seen since getting on treatment is 7. This certainly is a terrible number if you have OSA and you should be able to get that much closer to zero. But with CSA, unfortunately the ASV is just there to keep breathing happening, it doesn't prevent the apneas to begin with. Which brings me back to the question of "how do I get those to go down? Move to sea level." Then I see numbers almost zero.

Most people just adjust their machines... But, whatever works for you.

[Apneanderthal]

My average AHI is 8-12 here at home, as read on my ASV.

That's abysmal! No wonder you feel like shit.

Agreed! The best number I've seen since getting on treatment is 7. This certainly is a terrible number if you have OSA and you should be able to get that much closer to zero. But with CSA, unfortunately the ASV is just there to keep breathing happening, it doesn't prevent the apneas to begin with. Which brings me back to the question of "how do I get those to go down? Move to sea level." Then I see numbers almost zero.

Most people just adjust their machines... But, whatever works for you.

Man I wish it was that easy. Unfortunately it's not so simple with CSA. This is the best I can do.

[raisedfist]

Central Apneas at altitude are a real thing - there are research studies on pubmed and other databases.

What are your ASV settings currently? And the breakdown of your AHI at altitude?

[palerider]

Most people just adjust their machines... But, whatever works for you.

Man I wish it was that easy. Unfortunately it's not so simple with CSA. This is the best I can do.

Yeah, no. There's plenty of people with central apnea. Friend of mine, for one... he's on an ASV... frequently gets *zero* AHI.

Post some charts.

[Apneanderthal]

Most people just adjust their machines... But, whatever works for you.

Man I wish it was that easy. Unfortunately it's not so simple with CSA. This is the best I can do.

Yeah, no. There's plenty of people with central apnea. Friend of mine, for one... he's on an ASV... frequently gets *zero* AHI.

Post some charts.

I'm going to venture a guess that your friend doesn't live at altitude? Since you mentioned you've never heard of central apnea and altitude, this is a pretty safe guess. Those with central apnea, especially anyone living at altitude should be very familiar with this. It's not a phenomenon. It is well researched. Plenty of studies nailing down groups of research subjects and how much their AHI went up at set altitudes. In fact, research suggests that nearly all people develop it above 13,000 feet.

I would really love it if someone who has CSA chimed in. I know it's a long shot since it's more rare. Based on equipment on profiles, it doesn't look like anyone commenting so far is in this camp.

Appreciate the feedback though.

[palerider]

Most people just adjust their machines... But, whatever works for you.

Man I wish it was that easy. Unfortunately it's not so simple with CSA. This is the best I can do.

Yeah, no. There's plenty of people with central apnea. Friend of mine, for one... he's on an ASV... frequently gets *zero* AHI.

Post some charts.

I'm going to venture a guess that your friend doesn't live at altitude? Since you mentioned you've never heard of central apnea and altitude, this is a pretty safe guess. Those with central apnea, especially anyone living at altitude should be very familiar with this. It's not a phenomenon. It is well researched. Plenty of studies nailing down groups of research subjects and how much their AHI went up at set altitudes. In fact, research suggests that nearly all people develop it above 13,000 feet.

I would really love it if someone who has CSA chimed in. I know it's a long shot since it's more rare. Based on equipment on profiles, it doesn't look like anyone commenting so far is in this camp.

Appreciate the feedback though.

Ok, Don't post any charts, just complain about how bad it is for you, and move. :shrugs: no skin off my nose.

[raisedfist]

You say your AHI goes down to near zero, less than 1, at sea level. Even at .2 AHI, that is still your treated AHI, using an ASV machine, at sea level. The only way you'd know your untreated AHI is if you had a sleepy study done with zero PAP therapy applied. Have you done that?