Allergies and AHI

For my fellow allergy sufferers I wanted to share my results during a typical allergy season. I live in Georgia and we are just entering our spring season, which is a bit of an oxymoron as it lasts 3-4 months or more, but our cars do take on a lovely yellow tinge from the pollens. I'm entering my second year of CPAP use and have seen similar results in winter, summer, spring, and fall allergy seasons.

I usually have an AHI of < 0.5, primarily CA's. However, you'll see here it is much higher due to nasal congestion occurring during the night. It is not something I overreact to as it goes back to normal once the allergy meds do their job, which takes a few weeks for them to really kick in. Medical folks like SouthernDoc can explain it much better from a medical perspective, but my layman's experience as a lifelong Southerner and allergy sufferer is that radical CPAP changes do not help other than in increased frustration.

I do increase my min EPAP by 1 cmH2O to help with the congestion (I usually am at 4 over 5-20 but now am using 4 over 6-20), but not sure if it really makes much difference. My flow limits are good, so the main issue I consider is allergy related. So my message is, don't overreact and give it time. Use your nasal sprays and allergy pills, and things will work out over time.

As always other thoughts are most welcome!

I'm trying to think how a congested nose could lead to central apneas. Are the CAs preceded by little wake-ups? And maybe the wake-ups are caused by the congestion??

If it were me, I'd try a minEPAP of 7, and see if you could smooth out the pressure line a little more, and I'd completely ignore those few centrals.

Miss Emerita wrote: ↑

Mon Mar 28, 2022 11:20 am

I'm trying to think how a congested nose could lead to central apneas. Are the CAs preceded by little wake-ups? And maybe the wake-ups are caused by the congestion??

Spot on ma'am. The congestion and post-nasal drip wakes me up, which causes the centrals as I try to breathe through it. I should have explained it better.

palerider wrote: ↑

Mon Mar 28, 2022 11:24 am

If it were me, I'd try a minEPAP of 7, and see if you could smooth out the pressure line a little more, and I'd completely ignore those few centrals.

Thanks, I didn't consider that. I'll give it a try tonight.

Jlfinkels wrote: ↑

Mon Mar 28, 2022 11:45 am

palerider wrote: ↑

Mon Mar 28, 2022 11:24 am

If it were me, I'd try a minEPAP of 7, and see if you could smooth out the pressure line a little more, and I'd completely ignore those few centrals.

Thanks, I didn't consider that. I'll give it a try tonight.

Since centrals are non stressful to your body, unless there's enough of them that your SpO2 starts dropping, it's best to just ignore them. (I'd say well over 5, maybe over 10CAI before they're worth worrying.

the little exercise I suggest is, hold your breath for 10 seconds, that's a central, nothing to it, right?

Now, pinch your nose and lips together and try as hard as you can to inhale for 10+ seconds, that's an obstructive, and now you can see why I make a much bigger deal about obstructives

Thanks, I live in SC and struggling here due to allergy seasons.

I usually have higher flow limits and now my AHI is uncontrollable way beyond 7-10 AHI. Its tough but think have to hang on.