AHI increasing each day - need help!

[mcs2015]

UPDATE:

Readings worse, feel worse.

After about 11 days @ 8.0 pressure with AHIs averaging in the mid 3's, but with stable sinus rhythm and minor PB/CA levels, I decided to, once again, titrate up a notch to 8.50. My AHI dropped dramatically (see below) which inspired me move forward at this pressure. I held steady and moderately felt a better sense of well-being.

After only 3 days @ 8.50, my AHI started creeping up incrementally again. At the same time, I started noticing a slight rise in ectopic beats (PVCs) again, followed by a noticeable sudden spike in PB as detailed in the snapshots below.

There seems to be a pattern of increasing AHI and PB emerging and is of concern since this is now the 2nd surge. I have had a history of benign ectopic beats (PVCs) over the last couple years with no evidence of heart failure (recently had a normal echo other than moderate mitral valve prolapse and regurgitation, so no CHF).

But I noticed an onset of ectopic beats precede the increase in AHI/PB in both instances. I am also noticing an increase in blood pressure and fasting blood glucose - all can be dead ringers for hypoxia.

I was doing so well at first with really good AHIs and no or little ectopic beats. This would indicate to me that the apparent cause of the PVCs is not due to reduced pressure. It's so hard to tell. I do not feel as well when my AHI is >2.0. I start to feel more irritable and tired.

If the slight increase in pressure from 8.0 to 8.50 didn't produce an increase CAs, then it can't be triggering CSA, correct?

I don't know which caused what- the arrhythmia causing the increase in AHI or vice versa.

Thoughts?










Here's last 2 days - dropped pressure to 8.0 for fear the added pressure was causing all this:

[Pugsy]

Please keep to one thread. It's impossible to follow you the way you are doing things.

[mcs2015]

Sorry. Thought it got buried in my original thread because no one responded so re-posted.

[Pugsy]

You could at least link to the previous thread to help people out.

If no one responded....they didn't have anything to offer.

You need to be getting with your doctor with these concerns. You are asking about heart related issues and we can't possibly speculate on heart related issues.

[Pugsy]

viewtopic/t179975/PROGRESSIVE-RECENT-IN ... THING.html

your previous thread and you did have responses.

[mcs2015]

Wow, I just checked this thread and didn't know I had messages. I did not get any alerts in my inbox this time which is strange.

I see that there are a few past posts on PVCs and palpitations going back to 2007.

Will have more to report after doc appt. tomorrow. Between that and research, will report back my findings.

[mcs2015]

Update:

So as my pulmonologist goes by symptoms and not readings which, based on my latest readings/symptoms (as in my post above), he felt I was not optimally treated via CPAP 8.0 or higher (yah think?) and advised to do yet another titration study to trial BIPAP and failing that, ASV. Again, he emphasized that readings are mostly for insurance cos. I know this is contrary to the advice I've previously received, but don't know where that puts me. Only thing I can say is although I hate overnight studies as I never can sleep well, I pay zero, as insurance covers it all. I cannot pinpoint what has changed recently to cause such disruption in my AHI and accompanying heart rhythm. Only thing I can think of is a slight increase in weight over the last few months.  

My cardiologist is out of their league when it comes to other than the basics of OSA. For heart issues - in the absence of any CHF, she feels strongly that it's all about hypoxia during sleep, especially during REM. For CPAP pressure/settings and changes in AHI, PB, CA, etc. is where she will defer everything to the pulmonologist and he, as already stated, which will default everything to a titration study.

Thoughts?

[Julie]

Believe it or not, even 10-15 lbs can make a difference and it also will change mask fit to cause new leaks, or discomfort that keeps you sub good sleep, etc. etc.