Moved to altitude, AHI tripled, Central AHI skyrocketed

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
thebearproofsuit
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Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by thebearproofsuit » Mon Nov 22, 2021 3:18 pm

I moved to 5,000 feet elevation from 1,000 and even though I've lost weight (30 pounds) my AHI's are way higher. I was hitting 3-4 on average and felt pretty good as long as it was below 5. Now I'm probably averaging 14 AHI and routinely hit 15-20 and even hit 70 one night. My sleep study test showed 25, so it's almost like my CPAP is hardly doing anything a lot of the time.

I'm brain fogged almost everyday with headaches that last all day a 2-3 times a week.

Any ideas?

My average pressure readings haven't changed much...been about 12...was maybe 10.5-11 before. I think I'm set to 8 low 20 max now. I was set to 8-17 but tried a max of 20 as a test and it didn't seem to change anything.

I need to get a card reader to get my Oscar readouts since I moved (3 months ago), but I do see on my Airsense10 info it shows average AHI 14.5 and CENTRAL AHI at 12.

So I'll have to dig into the numbers once I can download to OSCAR, but any ideas what could cause Central AHI to jump so dramatically? Anything to try for those?

Before I was about 2 central/ 2 airway. Now it's 2 and 12.

Is the Air sense central AHI data reliable?

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Pugsy
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by Pugsy » Mon Nov 22, 2021 3:34 pm

The AirSense 10 data is reliable for sure.
It is also common for central apneas to pop up when people go to higher altitudes...either for a visit or permanent move.

Higher pressures can't prevent central apneas and could conceivably make them worse but I suspect it's the altitude and oxygen levels at the higher altitude that is the culprit. The machine can't/won't increase the pressures to try to prevent central apneas because it is specifically written into the auto adjusting algorithm to ignore central apneas.

I don't know if you are using EPR or not but about all you can do is try turning off EPR (if you are using it) and see if it makes any difference in the number of centrals or not. It probably won't but it is something worth trying if you can.

You probably should notify your doctor about this occurrence and see what he/she might want to do...if anything.
They may want to wait and see if this resolves on its own with time as your body gets more use to the altitude or they may want to consider a different machine that can actually deal with both obstructive sleep apnea and central sleep apnea.
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ChicagoGranny
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by ChicagoGranny » Mon Nov 22, 2021 3:47 pm

thebearproofsuit wrote:
Mon Nov 22, 2021 3:18 pm
I need to get a card reader
Are you sure your device doesn't contain a built-in card reader? It's a small slot that is easily overlooked. https://answers.microsoft.com/en-us/win ... d09971af88

thebearproofsuit
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by thebearproofsuit » Mon Nov 22, 2021 4:11 pm

yeah I'm on a mac book air, so no built-in reader.

Looking deeper into my Central AHI reports, they certainly do seem to jump up exactly when I moved to altitude. My 90 day central AHI average is 15 and total AHI is only 16.8...so it looks like my weight loss has maybe helped my obstructive numbers some but has been replaced 10 fold by an increase in central.

I moved about 100 days ago.... even with averaging 15 the last 3 months my year average of central is only 4....so yeah I'll confirm it once I go get a card reader, but it's looking more and more like those numbers jumped at exactly the same time I moved.

thebearproofsuit
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by thebearproofsuit » Mon Nov 22, 2021 4:21 pm

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227706/

this study tested 150 sleep apnea patients each at 1400m , 1800m and 2100 m and their average Central AHI scores were 3, 12, and 19 respectively. Certainly seems that altitude plays a role!

I'm about 1650m, so in the range where it looks to have an effect.

I guess it's good to have a potential answer....but a bit disheartening that the solution might be to move.

colomom
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by colomom » Mon Nov 22, 2021 5:23 pm

thebearproofsuit wrote:
Mon Nov 22, 2021 3:18 pm
I moved to 5,000 feet elevation from 1,000 and even though I've lost weight (30 pounds) my AHI's are way higher. I was hitting 3-4 on average and felt pretty good as long as it was below 5. Now I'm probably averaging 14 AHI and routinely hit 15-20 and even hit 70 one night. My sleep study test showed 25, so it's almost like my CPAP is hardly doing anything a lot of the time.

I'm brain fogged almost everyday with headaches that last all day a 2-3 times a week.

Any ideas?

My average pressure readings haven't changed much...been about 12...was maybe 10.5-11 before. I think I'm set to 8 low 20 max now. I was set to 8-17 but tried a max of 20 as a test and it didn't seem to change anything.

I need to get a card reader to get my Oscar readouts since I moved (3 months ago), but I do see on my Airsense10 info it shows average AHI 14.5 and CENTRAL AHI at 12.

So I'll have to dig into the numbers once I can download to OSCAR, but any ideas what could cause Central AHI to jump so dramatically? Anything to try for those?

Before I was about 2 central/ 2 airway. Now it's 2 and 12.

Is the Air sense central AHI data reliable?
As others have stated, many experience an increase in central’s at elevation. You also later mentioned you have lived at higher elevation for 100 days, that is a long enough time period for most to acclimate to the altitude.

An important thing you shouldn’t overlook is that you have new symptoms, brain fog and headaches. If I were in your shoes I would ask my doc to order overnight oximetry to see what my O2 levels are at night.

Before you pack your bags up I would try to get an appointment with a sleep doctor who lives and practices at the elevation you are currently living. Perhaps you could benefit from a extra O2 at night, or maybe your Cpap settings need to be tweaked a little.
Either way overnight oximetry or even another sleep study at elevation may in the long run be cheaper than moving.

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ChicagoGranny
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by ChicagoGranny » Mon Nov 22, 2021 9:19 pm

thebearproofsuit wrote:
Mon Nov 22, 2021 4:21 pm
but a bit disheartening that the solution might be to move
There is a good chance you will eventually adjust to the altitude. In the meantime, ask your doctor about treatment with acetazolamide.

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Pugsy
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by Pugsy » Mon Nov 22, 2021 10:48 pm

There is a machine that can deal with the centrals should be it be decided they are a problem that won't go away.
Easy fix....you don't necessarily just have to move unless you want to.

Talk to your doctor about your options.
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chunkyfrog
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by chunkyfrog » Mon Nov 22, 2021 10:55 pm

Note: thebearproofsuit has an Airsense 10 Autoset.
Resmed Airsense 10 Autoset FOR HER, p10 mask

D.H.
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by D.H. » Tue Nov 23, 2021 11:16 am

Really, you should call a doctor, preferably the one who prescribed CPAP. If that's not possible (since you've moved it might not be), find a sleep doctor at your new location.

Probably, you'll need different settings. Most machines will adjust for the altitude change. However, they will only adjust to deliver the set pressure. No machine can calculate that you have different needs at different altitudes.

thebearproofsuit
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by thebearproofsuit » Tue Nov 23, 2021 11:29 am

I'll have to check insurance before I go back to a doctor. I thought I read somewhere in my paperwork for new insurance that it specifically excluded any coverage for sleep apnea but I need to double-check. For now I'm going to buy an oximeter and see what I can learn from that.

I turned off my EPR on my Airsense 10 and my Central dropped from 15 to 9.....only one night but that's promising. Obstructive was still under 2. Still brain fogged but at least the numbers are better.

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Pugsy
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by Pugsy » Tue Nov 23, 2021 11:32 am

D.H. wrote:
Tue Nov 23, 2021 11:16 am
Probably, you'll need different settings.
And what settings available on this current machine do you think might probably need to be changed that might reduce the central apneas that only cropped up with the move to higher altitude???
The only thing available that might help is EPR reduction or elimination.

I do agree that he needs to talk to his doctor or a doctor about this new occurrence which is why I said this.
Pugsy wrote:
Mon Nov 22, 2021 3:34 pm
You probably should notify your doctor about this occurrence and see what he/she might want to do...if anything.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
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I may have to RISE but I refuse to SHINE.

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Pugsy
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by Pugsy » Tue Nov 23, 2021 11:35 am

thebearproofsuit wrote:
Tue Nov 23, 2021 11:29 am
I'll have to check insurance before I go back to a doctor. I thought I read somewhere in my paperwork for new insurance that it specifically excluded any coverage for sleep apnea but I need to double-check. For now I'm going to buy an oximeter and see what I can learn from that.

I turned off my EPR on my Airsense 10 and my Central dropped from 15 to 9.....only one night but that's promising. Obstructive was still under 2. Still brain fogged but at least the numbers are better.
Is that 9 the total number of events over the night or the hourly index/average?

What kind of insurance??? Most insurance today aren't allowed to exclude pre-existing conditions from coverage.
Mask: Bleep no headgear mask.. https://bleepsleep.com/
Machine: AirCurve 10 VAuto

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colomom
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by colomom » Tue Nov 23, 2021 6:08 pm

thebearproofsuit wrote:
Tue Nov 23, 2021 11:29 am
I'll have to check insurance before I go back to a doctor. I thought I read somewhere in my paperwork for new insurance that it specifically excluded any coverage for sleep apnea but I need to double-check. For now I'm going to buy an oximeter and see what I can learn from that.
How long have you had your current insurance? As Pugsy pointed out, for most if us in the US insurance companies can no longer deny coverage for pre existing conditions (I’m no expert on this subject but I believe there may be some “grandfather” exceptions to really old insurance plans). I’ld definitely look at your paperwork or better yet call the insurance company to find out for certain that they won’t cover sleep apnea.

Your short term plan to purchase an oximeter sounds like a great first step, be sure to get a oximeter that can record and monitor your O2 levels throughout the night. Good luck!

thebearproofsuit
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Re: Moved to altitude, AHI tripled, Central AHI skyrocketed

Post by thebearproofsuit » Sat Nov 27, 2021 1:00 pm

Thanks for the feedback everyone!

Some potentially good news: I replaced my hose and my Central AI dropped from 15/hr to........1/hr. Any physical was less than 1!

I wasn't showing any major leaks or anything but the hose was getting up there in age and I wanted to try everything.

I have only used it fr two nights and unfortunately took my mask off early both nights because I woke up for unknown reason (2-3 hours usage) each night.....so I don't know how I feel yet after a full nights sleep or if the AHI will rise as I go into deeper sleep but this is really hopeful! maybe I don't have o move after all......As long as my AHI is under 5/hr or so I feel functional and feel normal under about 3.....so if they are at 1 for first 2-3 hours then even if they rise a bit later should be good!