Altitude Sickness and CPAP

I've tried searching on this and haven't found exactly what I'm looking for. Namely, if you've had altitude sickness in the past, and you started CPAP, did it help?

I grew up at about 2000' and regularly went to the mountains for vacations and would notice mild altitude sickness as low as 9000-10000' -- usually I'd take it easy the first few days, just feel a little queasy the first or second night, and that was about it. I'd get worse symptoms if I ascended more quickly, and going back a decade or more probably a little worse even around those altitudes. Once I went from sea level to nearly 14000' for the day and tried to sleep above 9000' and I felt like I had the flu. (I ended up driving back to sea level in the middle of the night and was fine when I got there.)

The last few years (roughly the same period where, looking back on it, I started having more severe breathing problems while sleeping) the altitudes where I experience symptoms has dropped. There's a place we used to live and still visit every year or two just above 7000' and I started having the kind of mild symptoms there I used to only have closer to 10000'. Then last year we stayed at 7000' (after staying at 4000' the night before) and I had the kind of full blown flu like symptoms I'd previously only had at much higher altitudes.

I can't help but to think the worsening altitude sickness symptoms could well be related (or worsened by) my worsening sleep apnea, and I'm hopeful the CPAP therapy will help with that as well. But I'd love to hear experiences from anyone else in similar circumstances.

My AHI has increased at altitude. That's my only actual firsthand experience.

My understanding is that bad reactions to altitude can be highly individual. So experiences of others do not always help. And research doesn't always apply.

What I hear (which is just another way to say " 'they' say,") is that it helps to be very well hydrated before heading into altitude. Some I know swear that if they keep their urine clear for three days before, altitude doesn't mess with them nearly as much. But they have to keep electrolytes in a good place while doing that.

Altitude can increase breathing rates to the point that pauses in breathing occur during sleep. For someone with OSA, a pause, even though central in nature, is an opportunity for an obstruction to occur. Untreated OSA can also cause breathing dysregulation to the point that central apneas can result.
Add those factors together, and there can be plenty of interplay between OSA and altitude. But it might be an oversimplification to think of OSA itself as directly increasing altitude problems for the majority or its commonly increasing susceptibility to actual altitude sickness.

True atitude sickness is nothing to play around with. I would have a discussion with my doc who knew all my health issues for suggestions, if it were me.

Sleep apnea reduces air (and therefore 02) intake under any circumstances, so higher alt's should make it worse.

After my sleep study and seeing how low my blood oxygen was getting even here down near sea level I was guessing that couldn't help but to make things even worse at altitude. When you're at altitude and awake and aware you do a better job of compensating for the lower oxygen levels, but when you fall asleep your body doesn't do as good of a job until you're fully acclimated which can take days at a minimum. You add breathing problems on top of that and makes sense that it would make it worse.

I knew I reliably got mild altitude sickness a few decades before sleep apnea caught up with me, I guess I'm wondering if anyone else has had a similar experience and knows if treatment for the latter helps with the former. I'm only a couple weeks into my treatment but it's certainly helped me breath better at night, it's like night and day. I may be doing the altitude experiment myself soon, just wondering what to expect.

Since I have way more experience with altitude sickness treatments than sleep apnea -- yes staying well hydrated helps, but for me that alone doesn't solve the problem. Avoiding anything sedative helps, I avoid alcohol at altitude until I'm well acclimated. I've had mixed results with Acetazolamide, most of the time it seems to help but only at a dose high enough that I get the weird tingling in my fingers and toes. At lower dose I haven't seen much help. Ibuprofen (Advil) helps if you start before you reach altitude and continue until you're acclimated -- more recently that's what I always took when going to 7000 ft, and it would eliminate the moderate altitude sickness symptoms. There's a single limited study about this, more research needs to be done to see if it's actually treating the cause or just helping with symptoms. Last year though I was on both though (after staying at 7000' we planned to stay above 9000') and they didn't really help.

So many meds (can) interfere to some extent with Cpap/Osa, and each person is different... some react to almost any med, others not as much, but it also depends on what your physical problems are, of course, so have you taken your meds into consideration re apnea and sleeping? Sometimes one can be changed by your MD to another, or the time you take them, etc... but in any case, I wonder really why you're looking for others who've had alt. sickness... because (see above ) we're all different and react differently, and while not wanting to feel alone with symptoms is understandable, it won't necessarily help you that someone else with possibly completely diff physiology and a diff. mountain has similar experiences. You need to find your own answers, and we can try to help if you'd like.

Julie wrote: ↑

Sun Oct 28, 2018 5:55 pm

So many meds (can) interfere to some extent with Cpap/Osa, and each person is different... some react to almost any med, others not as much, but it also depends on what your physical problems are, of course, so have you taken your meds into consideration re apnea and sleeping? Sometimes one can be changed by your MD to another, or the time you take them, etc... but in any case, I wonder really why you're looking for others who've had alt. sickness... because (see above ) we're all different and react differently, and while not wanting to feel alone with symptoms is understandable, it won't necessarily help you that someone else with possibly completely diff physiology and a diff. mountain has similar experiences. You need to find your own answers, and we can try to help if you'd like.

Looking for the "metoo's" to jump out, but it's not been 30 years yet. Jim Med's can cause problems, but everyone reacts different to everything, comparing doesn't work well. Jim

I have talked to my doctors about meds, and the altitude sickness, and I'm only on Claritin at the moment. (I was able to get off a couple other things they had me on short term thanks to CPAP.)

Not everyone is the same, but not everyone is completely different either. More data helps.

If you're on 'non-drowsy' Claritin, it will definitely keep you awake, or at least it should be hard to fall asleep.

Julie wrote: ↑

Sun Oct 28, 2018 6:48 pm

If you're on 'non-drowsy' Claritin, it will definitely keep you awake, or at least it should be hard to fall asleep.

It won’t “definitely” keep you awake or make it hard to fall asleep: it may behave differently with different people, but I’ve been using it for 20 years (or the generic equivalent using the same ingredients) and it’s neither here nor there.

What often WILL make it harder to fall asleep is suffering from allergies.

I'm on just Loratadine, not the kind of Claritin that has Pseudoephedrine sulfate (which could keep you up at night). Loratadine in larger than typical over the counter doses will cause drowsiness like many other antihistamines, but at the normal over the counter dose rate it causes much less drowsiness than for instance Benadryl (diphenhydramine).

I live at sea level and used to do alot of hiking in the rockies, well before i was diagnosed. Altitude sickness seems to affect everyone differently, regardless of physical ability. Some elite athletes not used to altitude may struggle with it, while other non-athletes may not be affected at all. The best method I've had to prevent it is to gradually increase altitude during the day, and sleep lower at night. IE, hike to 10K during the day, sleep at 7K that night, then hike to 12k the next day, sleep at 10k, etc. Acetazolamide helps, but isn't without side effects (the weirdest of which is making anything carbonated taste terrible).

On one of the trips, I brought a pulse oximeter along. While hiking uphill at 12K feet, O2 was down in the low 90's, and would peak at around 95 when resting. At 14K, it'd drop down in to the 80's. I would imagine the decreased O2 would only make any apnea symptoms worse.