AHI affected by Arthritis?

Just started using a new resmed auto cpap and I've had each morning when I wake up a summary of my sleep on the cpap screen. The AHI score varies from night to night but what is interesting is one night I took an NSAID called Naproxen, one tablet and noticed the next morning that the AHI score was below 1. The next night I did not take Naproxen and noticed the score elevated to 5. Not too bad but still a variation.

Back story, I went to my primary dr with some back pain that only happened when I laid down....CT scans suggested that I have a condition called Ankylosing Spondylitis. I think it is a type of arthritis that usually affects the spine. NSAIDS are used to alleviate the symptoms of this condition and honestly I've kinda felt better the nights I take an NSAID med.

Its been recommended that I see a rheumatologist to treat the Ankylosing Spondylitis. I have yet to do this.

Just wondering if anyone has any similar experiences or insight to Ankylosing Spondylitis and its relationship to sleep.

abcd1234 wrote: ↑

Wed Apr 26, 2023 6:09 am

The next night I did not take Naproxen and noticed the score elevated to 5.

Breakdown of AHI? A, H, CA?

The pain might have caused you to be more restless and have more awakenings. During those brief awakenings, the machine might have recorded events. The machine is not accurate when we are awake.

Just a thing - AS often has the patient's neck/chest progressively bending/curling forward a bit, and I wonder if you've noticed any of that, because I hope it wouldn't affect your apnea by compressing your neck etc. Doubtful unless it's quite progressed, but maybe something to keep in mind.

I just put memory card into oscar, and it actually shows a a higher ahi last night than 5. Also i am wearing a full face resmed mask because i open my mouth during sleep. bad thing right now i have a short beard and it shows an air leak most of the time. i guess i'll need to shave the beard to get this working better.

resmed airsense 10 autoset

Last Night: 7 hr 36 min used
AHI 11.71
LL: 100%
CA: 0.00
OA: 0.00
UA: 0.39
H: 11.32
RE: 7.76

Monday Night took naproxen: 8 hr 30 min used
AHI: 1.53
LL: 99.74%
CA: 0.00
oa: 0.00
ua: 0.47
H: 1.06
RE: 6.00

Back pain can cause either full awakenings or partial awakenings that you may or may not remember.
These awakenings/arousals can cause irregular breathing which the machine can/will interpret as some sort of air flow reduction and end up flagging as some sort of apnea event. It can be a false positive flag in any category and it will increase the overall AHI but if we aren't asleep they don't count in terms of OSA treatment or therapy.

I suspect that the bulk of your AHI on the non NSAID nights is likely just false positive flagging....commonly called SWJ or sleep/wake/junk.
The nights where you do take the NSAID with lower AHI just means you probably slept a little more soundly and less arousals happened.
Impossible to know for sure without seeing some detailed reports of that flow rate though because other issues can be a factor like sleep position or amount of REM sleep or just overall sleep in general.

It is a fairly safe assumption though that NSAID use helps reduce pain issues which in turn helps improve overall sleep quality and that means less false positive arousal flagging and ends up with a lower AHI because of less SWJ.

What mask are you using?
When you have the time can you please add your equipment to your profile so we can see at a glance what you are using?

How about an OSCAR report showing that leak (as well as the other details) so we can see just how bad it is.
Was it 28 L/min most of the night or was it 58 L/min most of the night????
You will likely have to host your image somewhere on the web because the forum attachment thing is full and we can't add attachments here.

http://www.cpaptalk.com/viewtopic/t1585 ... eview.html

The amount of large leak or how deep into large leak territory you may go can affect the accuracy of your reported results.
We can let a little large leak slide as long as you sleep through it but it depends on how deep you go into large leak territory and for how long.

Please do see a rheumatologist soon. You want to slow the progression of the disease as much as possible, as quickly as possible, and that is best done by a rheumatologist. In the meantime, here's some information about diagnosis and treatment:

https://www.mayoclinic.org/diseases-con ... c-20354813

https://www.niams.nih.gov/health-topics ... pondylitis

Miss Emerita wrote: ↑

Wed Apr 26, 2023 11:45 am

Please do see a rheumatologist soon. You want to slow the progression of the disease as much as possible, as quickly as possible, and that is best done by a rheumatologist. In the meantime, here's some information about diagnosis and treatment:

https://www.mayoclinic.org/diseases-con ... c-20354813

https://www.niams.nih.gov/health-topics ... pondylitis

PLEASE DO THIS.
Believe me; orthopedic problems only get worse when you wait.
If your doctors are hesitant, ride them--HARD!
But start as early as possible.

Actually AS is often treated by neurologists and/or orthopedic docs... just depends on the individual's knowledge, specialization within their specialty, etc. etc.

I made a pdf of screenshots of oscar from last nights cpap use, this link is hosted by google drive:

https://drive.google.com/file/d/1XV-UbI ... sp=sharing

I also took one tablet of naproxen last night and shaved my beard before going to sleep.

Thank you for the replies.

my first sleep study was done at a hospital about 15 years ago... I did not fall asleep during the study but restless leg was diagnosed. I want to believe why I did not fall asleep was a prior mental illness episode. I think the psychiatrist said I had psychosis at the time while staying about a week in psych ward. Later in the year, I believe is when I had a sleep study done. This all happened in my latter 20s. No prior psychosis before. Currently on psych meds and not experiencing those crazy symptoms.

The sleep dr during my sleep test approved the cpap therapy based on me having prior choking during sleep experienced while digestive fluid traveled back into my throat.

But she never completed a true accurate sleep study.
She also refused to give me a copy of my cpap prescription, which I thought was odd.
So I stopped going to see her.

I am seeing a pulmonologist now who also does sleep therapy.

He approved the new resmed auto cpap machine.

I asked if I could get another sleep study approved, and quickly the reply was No because insurance usually only approves one per lifetime?

Just take a look at the pdf, I don't know much about the various graphs but it looks like the pressure went up to 17? Is that real?

I was also given ambien before the sleep study....did not help a bit. I tried to fall asleep but never felt tired even when closing my eyes.

Yes, your pressure was driven up to nearly 18 by heavy flow limitations. Your leaks aren't bad, and it's good to see you used the machine for almost 8 hours.

How did the night feel to you? Do you think you slept pretty well, or were you waking up frequently or lying in bed awake for long periods of time? And how rested are you feeling today?

You've received lousy care in the past, and I hope that will change. You should check directly with your insurance company to find out whether they'd cover the cost of another sleep study in your circumstances, though I suspect the answer will be "no," since you have a machine and it has gotten your AHI below 5.

About the flow limitations: do you have a stuffy nose?

About the acid reflux: do you still have it, and are you being treated for it?

And several of us would like to hear from you that you've made an appointment with the rheumatologist!