CPAP and heart medications

CreativeChris · Post by **CreativeChris** » Mon Apr 15, 2019 8:40 am

Hello guys-

Unfortunately my cardio has added 2 new drugs to my routine. I have a heart condition and Entresto and Carvedilol alone were not cutting it. I was put on amlodipine and lisinopril-hctz as well. While there are all the fun side effects of all this shit in the beginning one thing I have noticed is my AHI has gone up and I absolutely am not sleeping as well. That being said, going up for me is to around 1 but normally I am around .2-.3 consistently. Not to mention that beta blocker has helped me put on an additional 20 pounds over the past 6 months making my efforts to lose weight a joke.

I know that there have been threads lately on vitamin D, etc. and even though I wish I could just take an herb or two and call it a day I know that will never happen. Anybody else have the same thing happen?

Pugsy · Post by **Pugsy** » Mon Apr 15, 2019 8:51 am

What category of event is slightly elevated?
You already know that your sleep quality has been affected by the new meds. What are the chances you are seeing false positive flagging happening because of arousals?

Julie · Post by **Julie** » Mon Apr 15, 2019 9:07 am

Lisinopril can cause some coughing... so you might want to look at alternatives if it becomes an issue.

jnk... · Post by **jnk...** » Mon Apr 15, 2019 9:16 am

All drugs affect sleep. Especially at first. But taking the drugs and riding out the side-effects can still improve overall quality of life for us, even when sleep is negatively impacted. Although it is true that bad breathing can disturb sleep, it is also true that disturbed sleep can show up in our breathing, which is a different beast completely and often fully unrelated to selected pressures or overall PAP-treatment success.

Sometimes a doc will let us play around a bit with dosage and timing (for example, not taking within hours of bedtime) within certain doc-given parameters when under overall supervision, just in case that seems to lessen some side-effects on sleep.

But making sleep 1 or 2 percent worse in order to improve cardiac health and outcomes 3 or 4 percent is a trade-off I would make in a, um, heartbeat.

This forum is all about the importance of sleep. But there ARE things more important than sleep. MANY things. So sacrificing some sleep quality to keep other things going well is a perfectly valid choice for many people in many circumstances of life. I mean, having a kid, for example, is one of the most detrimental things to sleep there is. But that doesn't mean it ever makes sense to ignore a kid in distress just to get better sleep. The same may be true for our heart or any other vital organ. Life is all about reasonable compromise based on the broad data at hand for us and our medical teams.

Something that makes it impossible to get any restful sleep at all is an emergency to be addressed sooner rather than later. But an increase in AHI or some occasional disturbance of sleep may not be.

Pardon me for stating the obvious in this post, but it is often the obvious that most easily gets short-changed when in the middle of complicated medical decisions.

I truly wish you the best as you and your team navigate your condition(s). It's great you are so involved and on top of what's going on!

Pugsy · Post by **Pugsy** » Mon Apr 15, 2019 9:33 am

jnk... wrote: ↑
Mon Apr 15, 2019 9:16 am
All drugs affect sleep. Especially at first. But taking the drugs and riding out the side-effects can still improve overall quality of life for us, even when sleep is negatively impacted.

How true. I have first hand experience myself.
Sometimes it really is a damned if you do and damned if you don't situation and we just have to make a choice as to which problem is the worst problem to deal with.
I thought my blood pressure medication was rather benign in terms of unwanted side effects and I recently actually did some research on it and I got an ugly surprise. It can mess with sleep and cause insomnia plus it can also cause fatigue. Just what I need...more crap to mess with my already fragile sleep and cause more fatigue that I already get from my already fragile sleep.

Often people look at the AHI when it increases and they notice their sleep quality has worsened and assume that the increase in the AHI is the cause of the poor sleep but in reality the poor sleep is the cause for the increased AHI because of false positive flagging.
They want to tweak the machine settings to reduce the AHI and what they should be looking at is how to tweak whatever it is causing the poor sleep in the first place. Another reason why AHI isn't always going to tell us an accurate or complete story as to what is really going on with our sleep quality. People still tend to want the machine to fix problems that it simply can't fix and can't understand why it doesn't. Probably explains why so many people quit cpap because they don't feel any reduction in unwanted symptoms but the unwanted symptoms aren't always caused by something the machine can fix....but people sure want it to fix them.
Unrealistic expectations....something RobySue and I used to talk about maybe making a post about to refer people to since we see that problem so often and got tired of typing the same response over and over again.

Sleep apnea is but one item on a very long list of things that can and will mess with sleep....unfortunately it is the only item on that very long list that the cpap machine can stand any chance of ever fixing.

jimbud · Post by **jimbud** » Mon Apr 15, 2019 10:01 am

jimbud writes:

Pugsy wrote: ↑
Mon Apr 15, 2019 9:33 am

jnk... wrote: ↑
Mon Apr 15, 2019 9:16 am
All drugs affect sleep. Especially at first. But taking the drugs and riding out the side-effects can still improve overall quality of life for us, even when sleep is negatively impacted.
How true. I have first hand experience myself.
Sometimes it really is a damned if you do and damned if you don't situation and we just have to make a choice as to which problem is the worst problem to deal with.
I thought my blood pressure medication was rather benign in terms of unwanted side effects and I recently actually did some research on it and I got an ugly surprise. It can mess with sleep and cause insomnia plus it can also cause fatigue. Just what I need...more crap to mess with my already fragile sleep and cause more fatigue that I already get from my already fragile sleep.

Often people look at the AHI when it increases and they notice their sleep quality has worsened and assume that the increase in the AHI is the cause of the poor sleep but in reality the poor sleep is the cause for the increased AHI because of false positive flagging.
They want to tweak the machine settings to reduce the AHI and what they should be looking at is how to tweak whatever it is causing the poor sleep in the first place. Another reason why AHI isn't always going to tell us an accurate or complete story as to what is really going on with our sleep quality. People still tend to want the machine to fix problems that it simply can't fix and can't understand why it doesn't. Probably explains why so many people quit cpap because they don't feel any reduction in unwanted symptoms but the unwanted symptoms aren't always caused by something the machine can fix....but people sure want it to fix them.
Unrealistic expectations....something RobySue and I used to talk about maybe making a post about to refer people to since we see that problem so often and got tired of typing the same response over and over again.

Sleep apnea is but one item on a very long list of things that can and will mess with sleep....unfortunately it is the only item on that very long list that the cpap machine can stand any chance of ever fixing.

You said that so well.
I have to take several meds that have detrimental sleep side effects.
When I look closely at my FR I have many arousals every night, with accompanying CA's and HA's. I first did not know what was going on and kept raising my pressure to knock them down. Little luck. Finally after being on this forum, all the reading I did and your good advice about SWJ my common sense kicked in and I realized exactly what you are talking about. I am tweaking my therapy in a much more calm manner now, knowing that the machine can only do so much and the meds have to do their thing no matter what.
JPB

chunkyfrog · Post by **chunkyfrog** » Mon Apr 15, 2019 10:05 am

If CC is in the northern hemisphere, seasonal sunrise times could also be a factor.
Just maybe not a big one.

CreativeChris · Post by **CreativeChris** » Mon Apr 15, 2019 10:08 am

jnk... wrote: ↑
Mon Apr 15, 2019 9:16 am
All drugs affect sleep. Especially at first. But taking the drugs and riding out the side-effects can still improve overall quality of life for us, even when sleep is negatively impacted. Although it is true that bad breathing can disturb sleep, it is also true that disturbed sleep can show up in our breathing, which is a different beast completely and often fully unrelated to selected pressures or overall PAP-treatment success.

Sometimes a doc will let us play around a bit with dosage and timing (for example, not taking within hours of bedtime) within certain doc-given parameters when under overall supervision, just in case that seems to lessen some side-effects on sleep.

But making sleep 1 or 2 percent worse in order to improve cardiac health and outcomes 3 or 4 percent is a trade-off I would make in a, um, heartbeat.

This forum is all about the importance of sleep. But there ARE things more important than sleep. MANY things. So sacrificing some sleep quality to keep other things going well is a perfectly valid choice for many people in many circumstances of life. I mean, having a kid, for example, is one of the most detrimental things to sleep there is. But that doesn't mean it ever makes sense to ignore a kid in distress just to get better sleep. The same may be true for our heart or any other vital organ. Life is all about reasonable compromise based on the broad data at hand for us and our medical teams.

Something that makes it impossible to get any restful sleep at all is an emergency to be addressed sooner rather than later. But an increase in AHI or some occasional disturbance of sleep may not be.

Pardon me for stating the obvious in this post, but it is often the obvious that most easily gets short-changed when in the middle of complicated medical decisions.

I truly wish you the best as you and your team navigate your condition(s). It's great you are so involved and on top of what's going on!

Thank you. This is actually sobering and makes sense to me. Truth be told it is very nice to not huff and puff while walking so I guess it is a small sacrifice.

jnk... · Post by **jnk...** » Mon Apr 15, 2019 11:00 am

You are very welcome. You dignify us by discussing your questions here, sir.

CreativeChris · Post by **CreativeChris** » Mon Apr 15, 2019 11:05 am

chunkyfrog wrote: ↑
Mon Apr 15, 2019 10:05 am
If CC is in the northern hemisphere, seasonal sunrise times could also be a factor.
Just maybe not a big one.

I am right outside of Manhattan. I would agree with you but I wear a sleep mask. I am really a looker when I hit the sack.

Vinny V · Post by **Vinny V** » Mon Apr 15, 2019 6:37 pm

I learned beta blockers can really mess with sleep and melatonin production
I was out like a light 8,9 hours until I started a beta blocker. Been off it 6 months and my sleep is still highly fractured and not the same

SDBud · Post by **SDBud** » Mon Apr 15, 2019 7:26 pm

CreativeChris wrote: ↑
Mon Apr 15, 2019 8:40 am
Hello guys-

Unfortunately my cardio has added 2 new drugs to my routine. I have a heart condition and Entresto and Carvedilol alone were not cutting it. I was put on amlodipine and lisinopril-hctz as well. While there are all the fun side effects of all this shit in the beginning one thing I have noticed is my AHI has gone up and I absolutely am not sleeping as well. That being said, going up for me is to around 1 but normally I am around .2-.3 consistently. Not to mention that beta blocker has helped me put on an additional 20 pounds over the past 6 months making my efforts to lose weight a joke.

I know that there have been threads lately on vitamin D, etc. and even though I wish I could just take an herb or two and call it a day I know that will never happen. Anybody else have the same thing happen?

Those 2 drugs shouldn't have any effect on your sleep, but everyone is different.

Amlopipine helped bring down my morning BP, now that I'm off it (don't KNOW why, see Cardiologist in a few weeks),
my morning BP is higher than I'd like, even with excellent CPAP numbers.

Lisinopril is known to cause weight gain as a side effect, ask your Doc for any possible replacement (there are several).

raisedfist · Post by **raisedfist** » Mon Apr 15, 2019 7:39 pm

I don't know what any of those drugs are, but what is the schedule for taking them? The only medication I take is diltiazem (cartia xt) which is a 24-hr extended pill that helps my BP/heart rate/chest pain (angina). I take mine as soon as I wake up. I had swelling of the feet for a few weeks but that seemed to have gone away.

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