Central & Obstructive - AHI always around 10 with ASV. Tweak Settings?>?

[metsfan302]

Just found it odd that with oxygen added/ run thru the machine my AHI would lower to a level it’s never been

[ajack]

Just found it odd that with oxygen added/ run thru the machine my AHI would lower to a level it’s never been

I don't think adding o2 alters the obstructive apneas, it alters the o2 concentration
They may have got your mask fit right, or your head position.

[palerider]

Just don't know if it would be covered by insurance etc..... kind of weird needing it at only 42 years old

I just bought a concentrator for my brother. Made life simpler.

[ajack]

Just don't know if it would be covered by insurance etc..... kind of weird needing it at only 42 years old

I just bought a concentrator for my brother. Made life simpler.

I have 2 concentrators for my father. one in his bedroom and one in the living area. I don't know how either your or my post is relevant to metsfan

[palerider]

I don't know.

Ftfy

[Okie bipap]

Just found it odd that with oxygen added

They did the same thing to me when I had back surgery three years ago, and when I had a hip replaced last year. They may just routinely add oxygen to all patients who use a machine.

[Okie bipap]

Just found it odd that with oxygen added

They did the same thing to me when I had back surgery three years ago, and when I had a hip replaced last year. They may just routinely add oxygen to all patients who use a machine. I remember they put an adapter on the end of the hose where it hooks to the mask, and the oxygen hose kept getting tangled up in the call button cord.

[metsfan302]

Will have to see what the Pulmonoligist says in a couple weeks about adding Oxygen to the ASV during the night...

Well saw the ENT, she was great! Believe it or not, she said I do not need to do anything, no surgery etc!!! She numbed each side of my nose first then used this scope type thing to take pictures of all parts of the inside of my nose. While I do have a Large hole in the middle (Cocaine use in the early 2000's, lots of it), all other parts are perfect and there nothing limiting flow. She said I could repair the hole, but she thinks the repair would cause more issues then its worth.

So this must be different and pulmonary related - will find out next month.

I did look back on Sleepyhead. Prior to March 2018, my AHI was always well under 5. Mostly under 1-2 most of the time.

Looking back in my Pharmacy records I wanted to see what the heck changed. I did find one thing. The first week of March 2018, I was prescribed and started Testosterone for my Extremely Low T (was a level of 32 vs normal 900-1200). Did not think there would be any connection to AHI and the Testosterone Gel but for me it has seemed to increase my AHI.

[Okie bipap]

I just did a quick Google search on testosterone therapy and sleep apnea. It appears the jury is still out about testosterone therapy making sleep apnea worse, but a few small studies say it does. Maybe you are one of the people that it affects that way.

[metsfan302]

Leave it to me to be the odd ball

[Okie bipap]

We can't all be normal, and to be truthful with you, I have never tried to be normal. Abnormal is much more fun.

[metsfan302]

Looking back on my SleepyHead data, my numbers show I was in the 0.5 - 2.0 range (I do not remember them being that low) all the way up in till I started to take Testosterone. For some reason it only shows summary data pre-march, then when my numbers go up it shows more detailed info like graphs etc, odd. The only thing that has changed for me was adding Testosterone Gel and the very next night, my AHI jumps to the 8-11 range.

My Endocrinologist, while a nice lady she definitely wont let me get too high of a level of Testosterone.

I am only 42 years old. When I started this venture back in march my numbers looked lower then most women and 90 year old men, i even started knitting My Cortisol levels are normal.

Testosterone, Free (Direct) = 2.2 pg/mL Standard = 6.8 - 21.5 pg/mL
Testosterone,Total,LC/MS/MS = 30 ng/dL Standard = 264 - 916 ng/dL (Lowered from like 1350 a year or so ago)

After taking 2 packets of gel for a few months I tested again and it was

Testosterone, Free (Direct) = 6.1 pg/mL Standard = 6.8 - 21.5 pg/mL
Testosterone,Total,LC/MS/MS = 257 ng/dL Standard = 264 - 916 ng/dL (Lowered from like 1350 a year or so ago I have been told)

She wrote me and said she was thrilled with the results and to continue the 2 packets. I wrote her back saying its still really low - she said to double up to 4 packets and retest in few months. These are the results -

Testosterone, Free (Direct) = 22.8 pg/mL (High) Standard = 6.8 - 21.5 pg/mL
Testosterone,Total,LC/MS/MS = 842 ng/dL Standard = 264 - 916 ng/dL (Lowered from like 1350 a year or so ago)

While that one number is just over the standard range, My Endocrinologist writes me freaking out saying I need stop taking 4 packets. My results were HULK LIKE NUMBERS and I needed to lower my dose to 3 packets. Retested again after a month or so and below are the results on 3 packets. (A little overboard if you ask me, I wanted to be in the high end of the range, heck she was ok with me at 257!).


Testosterone, Free (Direct) = 12.4 pg/mL Standard = 6.8 - 21.5 pg/mL
Testosterone,Total,LC/MS/MS = 584 ng/dL Standard = 264 - 916 ng/dL (Lowered from like 1350 a year or so ago)

Above is with 3 packets and its what I continue to take today. My drug/rehab counselor said I should look into getting the a different method of Testosterone delivery. He, while not having Low-T, gets a pellet implanted into his thigh like once every 6 months and his T Level is always in the 1000 range. I don't think my insurance covers that, heck the gel I get now retail is like $2000 a month! I know there are also injections you give yourself but she has never said anything about it. Testosterone has been like finding the fountain of youth, has really improved my quality of life that is for sure! Not sure if I should go to a diff doc or diff type of doc like a urologist?.... Since I have been to the Endocrinologist I have also discovered I have a tumor on my Pituitary Gland and also an empty sac on it as well. Have learned that the Pituitary Gland is known as the Master Gland and controls all hormones.

[Jas_williams]

Looking back on my SleepyHead data, my numbers show I was in the 0.5 - 2.0 range (I do not remember them being that low) all the way up in till I started to take Testosterone. For some reason it only shows summary data pre-march, then when my numbers go up it shows more detailed info like graphs etc, odd. The only thing that has changed for me was adding Testosterone Gel and the very next night, my AHI jumps to the 8-11 range.

If you only have summary information SleepyHead does not calculate the AHI correctly and it can be wildly wrong or in my case anyway. You need to use Resscan to correctly analyse the summary only data.

It may be that your AHI was still high which is why you don't remember it being low ?

[metsfan302]

Went back to the sleep Doc for the 2 week follow-up after she bumped up the EPAP to 14 and leaving it on non-auto. I showed her the 2 nights I was in the hoaspital how my AHI was 1.3 and 1.1 and said how they were giving me oxygen also. She ordered another ASV Titration and stated to add o2 if it does drop that way insurance would approve it if needed? Not sure how it would work if indeed I need added oxygen at night like is it with tanks etc or some machine that I hook up to the ASV?

Pretty weird too as I was informed from my sleep doc that I indeed had a successful ASV Titration back in 2016, I have no memory of it but hey here it is lol.

She can't figure out what changed from then to now...... ugg I am out of idea's too lol

I am able to swap my Resmed if I want to the Philips Dreamstation bipap auto sv with my DME. However, not one person has said I would like it, you should switch etc, seems everyone likes the Resmed Aircurve ASV and ontop of that I have pretty much sold my 2 year old Resmed Aircurve ASV so I would not have that to fall back on if I hated the Dreamstation...

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[beautifuldreamer]

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