Okay, what is happening here...

[Paul56]

Hi folks,

I need your advice on what is going on with my therapy...

I went for a period of 7 days where AI was reported as 0.

Then immediately after a day of physical labor and acquiring a sore back my therapy seems to have pretty much gone out the window. For the past nine days I've had apnea events recorded each night. What follows are the # of apneas for each of those nights: 3, 2, 2, 1, 1, 1, 3, 6, 8 <---- these are a count of the # of apneas from the detail charts (NOT AHI, AI or HI)

The most # of apneas (again counted from the chart for the night), 8, were recorded last night after I increased the minimum pressure from 10 to 11 in an attempt to get this back under control... well at least back to where it was.

Leaks, as per the numbers, are very much under control so that is not affecting the numbers.

I know... only one nights worth of data with min set at 11... but it appears that is going in the wrong direction.

My 95th percentile pressure for the last several nights reports as: 12.8, 12, 12.8, 12.4, 12, 11.8, 12.6, 11.6, 11.6.

Maximum pressure bumped 15 for 4 nights of the last 9. Last night when the most number of apneas was recorded the max pressure only hit 12.

Questions:
-Am I right in assuming that this seemingly mild sore back has caused the apnea events to go up over the last few days?
-Why would a sore back contribute to increased airway restrictions?
-Looks like I should put the min number back to 10... agreed?

I will see about posting up the details for the worst night a little later when I get home.

[rstcso]

Questions:
-Am I right in assuming that this seemingly mild sore back has caused the apnea events to go up over the last few days?
-Why would a sore back contribute to increased airway restrictions?
-Looks like I should put the min number back to 10... agreed?

I don't know if the sore back has anything to do with it or not, but mine was bothering me last night and I just looked at the data and had four apneas where I've not had more than one per night in the past week. Being a new guy, I don't have a clue about where your pressures should be, but I'm sure others will know. I hope you feel better tonight. Take care.

[boston]

are you taking anything for the sore back???

[DreamStalker]

CPAP machines are not designed to treat sore backs.

Why don't you post the report with efficacy data plots? They show much more detailed information.

Otherwise, you and everyone else just guesses as to what is going on.

[roster]

.......
I went for a period of 7 days where AI was reported as 0.
........ What follows are the # of apneas for each of those nights: 3, 2, 2, 1, 1, 1, 3, 6, 8

.........

Like DS said, it is best to post the detailed data plot. Your comments are confusing as the first statement mentions AI and the next says apneas per night. If that is really what you mean then you are comparing two very different things.

[Paul56]

CPAP machines are not designed to treat sore backs.

Are you sure?

I can assure you that my expectations are not for the machine to treat the sore back; however, I find it more than a coincidence that the # of apneas have gone from zero to anywhere from 2 to 8 each night immediately after acquiring the sore back... I can only speculate that it is related. Absolutely nothing else has changed... oh wait... I did have a haircut.

Currently not taking anything for the sore back because it is not bad enough to keep me from sleeping.

[DreamStalker]

THe haircut may actually have a greater influence on your AHI since it can affect the stability of your mask headgear

[ozij]

THe haircut may actually have a greater influence on your AHI since it can affect the stability of your mask headgear

How true!

O.

[echo]

THe haircut may actually have a greater influence on your AHI since it can affect the stability of your mask headgear

That was my first reaction too (great minds think alike ha ha)

No seriously - about the back pain - if you strained your abdominal muscles then they will be the same muscles that are involved in breathing (and if it's the back muscles that you strained - don't the back muscles connect to the abdominal muscles ). I wouldn't discount the possibility that the pain is affecting your sleep (look at the OSA-fibromyalgia connection), but I don't have a clue as to the actual mechanism. In the end the machine is marking an event as a flow reduction, and if for some reason you're "whincing" (sp?) from pain while breathing, you might not be taking normal breaths during sleep, and those are getting marked as events. or some such!

[Snoredog]

1. Nearly impossible to maintain a AHI=0 on a nightly basis.
2. If you increased Minimum from 10 to 11 and AHI went up, obviously you went the wrong way.
3. AHI is the SUM of both AI and HI. If you had a AHI=0 at 10 and it went to AHI=8 it could have went
there because of a higher HI count seen which don't mean anything on that machine.
4. 95% pressure is described in your manual.
5. That machine will only increase pressure at or above 10 cm if the event seen is a Flow Limitation or Snore. If it is an apnea it won't do anything in response to it, so if it was an apnea the AHI will rise as a result. It will also rise if it was a central apnea.

You are already 2 cm higher than your PSG titration, you don't win any prizes for using a higher pressure.

[rested gal]

I wouldn't discount the possibility that the pain is affecting your sleep (look at the OSA-fibromyalgia connection), but I don't have a clue as to the actual mechanism. In the end the machine is marking an event as a flow reduction, and if for some reason you're "whincing" (sp?) from pain while breathing, you might not be taking normal breaths during sleep, and those are getting marked as events. or some such!

Makes sense to me.

You could also be sleeping in a different position because of the back pain. Perhaps tilting your head down more than usual, cramping the airway a little more.

While I understand your curiosity about why a few events are being marked when you had been getting zero before, those nights of "3, 2, 2, 1, 1, 1, 3," are as good as "zero", imho. I wouldn't change the pressure from what had been working well for you before (the minimum pressure set at 10) while giving your back time to heal.

[jnk]

My guess, and it is nothing but an uneducated guess, is that you are changing positions often during the night because of the pain. Changing positions can cause you to hold your breath, especially if you are, for example, rolling over slowly and carefully from the back pain.

[Julie]

I think we're a bit confused because first you talked about AHI (being at 0), then gave numbers for # of events in the following days. The two things are not the same and you can't compare them at all, which is why it's a little hard to advise you. Give the AHI's for the other days and maybe we can figure out what happened. I do know from some research papers I read recently that pain can make OSA worse, whatever the reasons.

[DreamStalker]

Well if you look at the sequence of those apneas for those nights, they correlate very well to the alignment of a certain set of stars during each of those nights ... that may be what is at the root of the problem.

Post the plots! ... more data, less wank!

[Paul56]

Argh... such as it is here are the charts from last night.