AHI MUCH HIGHER AFTER EXERCISE

[Eddi]

Hi-apologies in advance if I am doing something wrong. I tried searching and got nowhere.

Last night my AHI was 0.6. I did not swim yesterday as was still very tir4d from previous day's swim. The measurement for the night of the swim was just under 5.0 and, it has been as high as 7.

My readings average under 2.0 frequently under 1 but mostly between 1-2.

I was wondering why exercise, swimming almost 1 mile, would cause a higher AHI.

Also, I have stuck rigidly to my therapy since I was put on it back in Nov 2019. I love it. I love that the fatigue has gone.

I wonder why I now get many CA but very few if any HiPops and OAs.

I have CHF and I take opioids plus gabapentin and have done over years.(major spinal issues/brain damage)

Have not had follow up cos of Covid but are asking me to go in hospital again but have said no. I am a wheelchair user so they book my husband in too. Saves them a nurse! He has COPD and I do not want him put at risk tho we have both had it 2 yrs ago and since had all the vacs.

I will get a phone consult soon I hope so I can ask about the CA. I know my readings being well below 5 mean all is well but I have an enquiring mind and want to know.

I use an Airsense 10 with humidifier set to auto 12-20 with F30 mask which is the only mask I have used that works and is comfortable.

I also this time last year, trained myself to sleep on m y right side. Prior to that I had for years slept in the 'astronaut' position due to major spine issues. It was agony for weeks but now it is good and of course my AHI went down.

[Julie]

Hi, before worrying too much, please post Oscar results from last night here according to info in app and wait for experts to interpret... things may be better than you think (but do wait).

[Pugsy]

Can you post a low AHI night detailed report and a high AHI night detailed report?
It's not clear which category of events seems to increase after exercise/swimming.
Do you know about OSCAR software to see the details?
If not..
OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

Do you sleep soundly the night after exercise? Or do you wake frequently during the night?

As for occasional central apneas happening....actually it's normal to have a few here and there.
Like it's normal to have what is called a sleep onset central apnea when transitioning from awake to asleep.
If we have a lot of awakenings during the night then that increases the chances of more sleep onset centrals.

I don't know why apnea events would increase after some form of exercise unless maybe sleep quality itself might be impacted and what you are seeing is a reflection of sleep quality and maybe poor sleep itself for some reason.
Like what happens to me when I overdo things during the day and I hurt more and don't sleep soundly and I get a lot of tossing and turning false positives.

You might what to learn to distinguish between asleep flagged events and arousal related false positive flagged events.
See this for how to learn about the difference.
http://freecpapadvice.com/sleepyhead-free-software
If you aren't asleep they really don't count except to point to not sleeping so soundly for some reason.

[Julie]

This is interesting because remembering being new here (too long ago!) I read more than once about not exercising before bed and always wondered why (should've asked) so if it's part of 'sleep hygiene' I'd also like to know more.

[Eddi]

This is last night. I did not swim yesterday. I had to go downstairs at around 4am. Other than that I don't recall waking.

Screenshot 2022-01-12 at 22.02.09.png

This Sunday night after a 13:30 to 14:15 swim.

Screenshot 2022-01-12 at 22.12.13.png

I only swim lunch times. I swam less than mile on Sunday. I wake to pee. Usually twice, maybe 3.

I am n ot worried. I am just curious. Have been all of my life. I always want to know why.

[Eddi]

Are these graphs not good enough?

[Julie]

They're fine except you don't need the calendar (or pie chart if it comes up). Someone more knowledgable re graphs should be by soon.

[Pugsy]

viewtopic/t158560/How-to-post-images-for-review.html

Do you sleep soundly the night after exercise? Or do you wake frequently during the night?

[Eddi]

This was last night. I had swum. One thing I had noticed was that I was waking with a blocked nose. I took spray for it, waited till my nostrils were clear and went bck to sleep. I now wear a clip when swimming. I am also about to buy a full face mask with snorkel so I can breathe thru both nose and mouth and not have to keep lifting my head which with my spine issue would be better not to have to.

Has to have a drugs review and one my drugs has been reduced by 600mg as the FDA and UK equivalent have decided that Gabapentin /Morphine, whilst being he best combo for chronic pain, is nad for respiration and people have died during their sleep because of it. Good way to go. I would have thought that using the APAP tho would stop that happening? A long painful life is not what I want. I want to still be able to do as I am doing and if that isn't the best for longevity, so be it.

I HAVE NO IDEA WHAT FLOW LIMIT MEANS NOR MASK PRESSURE.

Screenshot 2022-01-14 at 17.11.22.png

[Julie]

Also need to show the whole left hand column beside the graphs...

[Miss Emerita]

For a night after swimming, that looks better. Using a nasal clip may be just the ticket. Kudos to you for a good hypothesis and experiment. Let's see whether it holds up.

Your machine can't force you to breathe if your breathing stops, but please make your priorities clear to your doctor if the new dosage doesn't work well enough for you.

Reading your thread, I had vaguely wondered whether swimming caused extra pain that led to broken sleep. CAs are common after short arousals. The arousals wash out some CO2, which reduces the drive to breathe, resulting in a CA. During the CA, the CO2 builds back up, and breathing begins again. It's usually all over quickly, and the CAs themselves are usually unproblematic, but those arousals can make for non-restorative sleep.

Flow limitations are limitations on airflow within your airway that usually result from either nasal congestion or relaxation of the tissues lining the airway in the pharynx. They aren't a medical issue, and for many people they have no impact on getting a good night's sleep.

[Eddi]

Hi Julie-didn't show left hand column this time because I understood Pugsy to tell me not to.

Miss Emerita-thank you. My reading last night over 9hr 39m was 2.17. 1 OA at beginning and the rest were all CA. I did swim 1 mile but no pain during night and no blocked nose. I have also notice that worst time is between 5-7am and I am daad asleep.

As far as I understood a CA is when the brain, the lower, primitive part, forgets to tell one to breathe which is why I thought the machine would force me too as I understand that is what it is doing with the CAs. I have also read that CNS depressants such as those I take are respiratory depressants. Hence the concern. Weirdly, Valium, although supposedly a CNS, cuts back or stops the CAs!(Proven in medical studies.) Last night I took slightly less and I had more CA but I have also had more on the normal dose.

The drop by 600mg doesn't seem to be a problem. I'd feel better the less I take. Itr took a lot of persuading me to go onto pain meds in the first place until myb Dr showed me a paper which concluded than untreated pain damaged nerves, thus making pain worse and pain management harder-i.e.more drugs were needed to control the pain.

I also had nightmares last night which did wake me. I also always wake 1-3 times for a pee. Only 1 last night. I definitely feel rested after sleep and do not drop off during the day or evening tho if my swim was particularly hard, I do get drowsy in the evening but snap out of it.

I have a lovely letter from my consultant. I was rather shocked to discover than when admitted to the sleep/respiratory clinic at the Royal Papworth I was dying and he didn't think I would survive long. I had no idea! My husband knew I was seriously ill but even he didn't think I was that ill. The reason my consultant told me all this is because of how well I have done through weight loss and swimming. Got my EF up from <40 to 53. I am glad they didn't tell me at the time.

I have two days of rest now.

[Pugsy]

Hi Julie-didn't show left hand column this time because I understood Pugsy to tell me not to.

No where have I ever told anyone to not show the left side.

Did you read the link I provided?
This one?
viewtopic/t158560/How-to-post-images-for-review.html

Now sometimes we do end up zooming in on something and getting snippets BUT we always start with the original detailed report in its entirely minus the calendar on the left.

[Eddi]

I misunderstood what you meant by not not wanting the calendar. This was last night's.

Screenshot 2022-01-15 at 16.12.09.png

[Miss Emerita]

What an amazing story -- you were thought to be nearing death but had a resounding triumph! It looks to me as though you are doing just fine vis-a-vis sleep breathing. I suppose you could use a recording oximeter if you have any residual concerns, but I don't see a reason to recommend that except your peace of mind.

If you have occasion to post a chart again, include all and only these graphs:

Events
Flow rate
Pressure (not mask pressure)
Leaks
Snores
Flow limitations.

CAs can result from various factors, e.g., opioid use or high altitude. By zooming in on your flow rate, you can figure out for yourself whether you are having arousals that are washing out CO2 and leading to CAs. I'm attaching an example from a chart of mine showing this phenomenon.

CA after arousal.png

See the deeper and less regular breathing before the CA? That's an arousal. It ends when enough CO2 accumulates to trigger breathing.