Stormy Weather Worsens Sleep Apnea

roster · Post by **roster** » Fri May 01, 2009 4:57 pm

Stormy Weather Worsens Sleep Apnea
By Kristina Fiore, Staff Writer, MedPage Today
Published: May 01, 2009
Reviewed by Zalman S. Agus, MD; Emeritus Professor
University of Pennsylvania School of Medicine.

SEATTLE, May 1 -- Patients with sleep-disordered breathing may find their condition worsens when a storm blows through town, researchers said here.
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Action Points

Explain that measurements of obstructive apnea significantly worsened as atmospheric pressure dropped due to weather-related changes.

Note that previous research had linked sleep-disordered breathing problems to altitude and hypoxia, but weather-related changes in atmospheric pressure and their effects on sleep apnea have not been evaluated.

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Note that this study was published as an abstract and presented orally at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
Obstructive apnea worsened as atmospheric pressure dropped due to weather-related changes, Michael J. Doherty, M.D., of Swedish Hospital here, and colleagues reported at the American Academy of Neurology meeting.

"We saw strong results between weather-related atmospheric pressure changes and sleep-disordered breathing," Dr. Doherty said.

Previous research has found that altitude is linked to worsening apnea, possibly a result of hypoxia or changes in air viscosity.

Altitude changes, however, correspond to central apnea, more so than obstructive apnea, which was most affected in the present study.

"We're not sure why that is," Dr. Doherty said.

To investigate the impact of low-altitude, weather-related changes in atmospheric pressure on respiration during sleep -- which has been largely unstudied -- the researchers retrospectively correlated 30 months of Seattle weather data with polysomnography data from sleep studies of 537 patients at the University of Washington Sleep Disorders Center.

The lab is located 200 feet above sea level.

The polysomnography data contained indices of obstructive, central, and apnea-hypopnea events.

In a multivariate analysis, the obstructive apnea index increased as atmospheric pressure lowered due to weather-related changes (P=0.01).

There was also significant worsening with lowered mean, minimum, and maximum nightly atmospheric pressures.

However, there were no significant changes for central apnea or apnea-hypopnea indices.

Dr. Doherty said the pressure change itself may drive the correlation, but the researchers are still not sure of the exact mechanism by which it operates.

He said there are similar results when patients suffering from sleep-disordered breathing at high altitudes are brought down to lower altitudes. They often experience more obstructive apnea events and fewer central apnea events than before.

Though the mechanism remains a mystery, Dr. Doherty said the obstructive apnea index is clearly altered by changes in weather-related atmospheric pressure.

The researchers reported no conflicts of interest.

Primary source: American Academy of Neurology
Source reference:
Doherty, MJ "Preliminary observations of weather-related ambient atmospheric pressure changes on sleep-disordered breathing" AAN 2009; Abstract IN5-1.007.

http://www.medpagetoday.com/MeetingCoverage/AAN/14020

Kiralynx · Post by **Kiralynx** » Fri May 01, 2009 7:02 pm

OK, looks like, just for the heck of it, I need to start adding the barometric pressure to my daily reports, and whether it was going up or down over the previous 12 hours.

timbalionguy · Post by **timbalionguy** » Fri May 01, 2009 8:14 pm

Very timely. I was actually considering starting a thread this evening on this very subject.

I have noticed over the years since I moved to Reno, NV (Average elevation 4,400 feet, my home: 5,140 feet) that I often felt a little 'out of it' when storm systems would move in. (The rugged mountains here do funny things to the weather.) Last night, night 6 of my xPAP therapy, I noticed my AHI was up sharply from right around 11 to 17.8. I have managed to tame the leaks to almost zero. (Now, if I could tame the cats who do not like all the changes in the bedroom!) and noticing more REM sleep every night, the increased AHI was a surprise. The storm system peaks out this evening, so I expect my AHI to be higher tomorrow as well. This is something I will definitely track, as I already suspected the increased AHI number had something to do with the weather.

Oddly enough, I had less problems falling asleep today than any day since I began therapy.

I do have weather instruments. I will have to look at the barometric pressure history for the past day when I get home.

roster · Post by **roster** » Sat May 02, 2009 6:08 am

There was another post, which I can't find now, where one of the members was saying he did not do as well when the humidity was high. I have long noticed the same thing. It can't be seen in my charts but clearly I don't sleep as well and often feel poorly when the humidity is high. The climate here typically means a low pressure system out of the Gulf brings higher humidity.

I am wondering if the root cause of the problem is lower barometric pressure or higher ambient humidity. What do you think?

BlackSpinner · Post by **BlackSpinner** » Sat May 02, 2009 6:15 am

I have always had sinus headaches when the weather changes drastically and sometimes migraines so it is not surprising it affects the sleep apnea since it is all in the same general area. If your sinuses inflate due to pressure it will affect your breathing ability.

fuzzy96 · Post by **fuzzy96** » Sat May 02, 2009 6:46 am

rooster,

it just makes sense. think about it if we liver in death valley or the dead sea (both below sea level) our osa would be better, the air pressure is higher and with that being more dense,(like some people) (not you, just had to throw that in as ny mind rambles )thus having more oxygen per c.c..

lots of us can tell weather changes in our bones,joints etc. same idea.

i like kyra's idea of adding barometric readings to my sleep journal.

ah but alas- we can't change the weather , we just have to live with it.

being on the lea of lake erie as we say here "if ya don't like the weather , wait fifteen minutes-it'll change"

Julie · Post by **Julie** » Sat May 02, 2009 11:09 am

Do other people here find, as I always have, that rain acts like a sleeping pill? Knocks me out really good!

roster · Post by **roster** » Sat May 02, 2009 12:21 pm

fuzzy96 wrote:rooster,

it just makes sense. think about it if we liver in death valley or the dead sea (both below sea level) our osa would be better, the air pressure is higher and with that being more dense,(like some people) (not you, just had to throw that in as ny mind rambles )thus having more oxygen per c.c..

...........

That's true if you are not using CPAP and I assume the people in the study were not using CPAP.

But for those using CPAP, isn't the pressure entering our lungs the same night after night?

Rooster
CPAP: Keeping my brain dense.

fuzzy96 · Post by **fuzzy96** » Sat May 02, 2009 1:45 pm

rooster,
may be someone can answer this. is the programmed pressure a true pressure or is it the pressure using the barometric pressure at startup as a baseline?

after all it is a pressure increase above the outside air.

so at sea level of about 14 psi mean average a 12cm/h2o would be that 12cm/h2o above the 14.

what is the altitude adjustment logorythm programmed in. i belive it goes in steps. so what if you are in between steps.

i know it's different but efi in cars etc use a map (manifold absolute sensor)to tell what the outside pressure is . i.ve seen none in a cpap circuit board so i'll assume the pressure is a increased differential from that of where it is located.

But for those using CPAP, isn't the pressure entering our lungs the same night after night?

by that line of reasoning no it isn't it would be dependant on the outside(of the cpap circuit) air pressure.

ok experts chime in . this could be interesting! and i may be wrong.

ya got me thinking rooster.

-SWS · Post by **-SWS** » Sat May 02, 2009 2:42 pm

rooster wrote:There was another post, which I can't find now, where one of the members was saying he did not do as well when the humidity was high. I have long noticed the same thing. It can't be seen in my charts but clearly I don't sleep as well and often feel poorly when the humidity is high. The climate here typically means a low pressure system out of the Gulf brings higher humidity.

I am wondering if the root cause of the problem is lower barometric pressure or higher ambient humidity. What do you think?

I personally can't breathe well with heated CPAP humidity or warm and humid ambient air. But some COPD patients don't tolerate warm, humid air, and I might be at the onset or early stage of COPD. I personally haven't noticed any issues regarding barometric pressure... but then again I haven't been watching the barometer very closely.

fuzzy96 wrote:may be someone can answer this. is the programmed pressure a true pressure or is it the pressure using the barometric pressure at startup as a baseline?

after all it is a pressure increase above the outside air.

so at sea level of about 14 psi mean average a 12cm/h2o would be that 12cm/h2o above the 14.

what is the altitude adjustment logorythm programmed in. i belive it goes in steps. so what if you are in between steps.

I haven't looked through the patent descriptions to see what's going on either. But the basic CPAP machines with manual altitude adjustment typically offer three altitude settings or increments to match only three general barometeric pressure zones (manually corresponding to low, medium, and high altitudes).

The PAP machines having automatic altitude adjustment would need to measure ambient barometric pressure to accomplish that task. But my hunch is if they used expensive sensors, then they would boast something like "automatic barometric pressure compensation" in marketing literature instead of "automatic altitude adjustment"---with that latter implying coarser barometric compensation as you already speculated. So my guess agrees with yours. Not to say that it's right...

Kiralynx · Post by **Kiralynx** » Sat May 02, 2009 4:23 pm

rooster wrote:I am wondering if the root cause of the problem is lower barometric pressure or higher ambient humidity. What do you think?

I think I'm going to try to remember to add humidity and barometric pressures to my dailies for a few months and see if any kind of trend becomes apparent. We're coming into summer humidity season, not to mention hurricane season, so there should be ample opportunity to study both.

The Choker · Post by **The Choker** » Wed May 02, 2012 6:57 pm

Today was a great day for me despite only being able to get 5 hours sleep last night due to business schedule. I usually try to get 7 to 8 hours.

I have over the last year or so noticed a very clear correlation between how I feel and the barometric pressure. We had a low pressure system for about 5 days and I was not so energetic. This morning I had to get up early and drive for two hours. A high pressure system moved in over night and I felt great all day despite only getting five hours sleep last night.

This is despite no change in AHI that my machine is recording. The high pressure system just gives me more energy during the day and a low pressure system drags me down.

Why is this? I searched the forum but don't see anything about it except for some people changes cause migraines. I almost never get a headache of any kind.

Do other people notice this higher energy level with high pressure systems?

My machine works equally well during low pressure systems but I just don't have the same high energy level as during high pressure systems.

chunkyfrog · Post by **chunkyfrog** » Wed May 02, 2012 8:43 pm

It would be interesting to compile local pressure trends and humidity,
and compare them to therapy stats, just to see if your experience is repeatable;
and not just a one-off. Imagine being able to set your HVAC to maximize health.

Goofproof · Post by **Goofproof** » Wed May 02, 2012 11:37 pm

Julie wrote:Do other people here find, as I always have, that rain acts like a sleeping pill? Knocks me out really good!

Yes, that's why I play nature sounds all night. I don't thing Stormy Weather worsens Sleep Apnea, unless your tent doesn't keep you dry. The air pressure doesn't have any effect on your airway, without XPAP the pressures on the outside of the body are the same as the insides, it the added pressure provided by XPAP that keep the airway open. Jim

The Choker · Post by **The Choker** » Thu May 03, 2012 5:46 am

The Choker wrote:Today was a great day for me despite only being able to get 5 hours sleep last night due to business schedule. I usually try to get 7 to 8 hours.

I have over the last year or so noticed a very clear correlation between how I feel and the barometric pressure. We had a low pressure system for about 5 days and I was not so energetic. This morning I had to get up early and drive for two hours. A high pressure system moved in over night and I felt great all day despite only getting five hours sleep last night.

This is despite no change in AHI that my machine is recording. The high pressure system just gives me more energy during the day and a low pressure system drags me down.

Why is this? I searched the forum but don't see anything about it except for some people changes cause migraines. I almost never get a headache of any kind.

Do other people notice this higher energy level with high pressure systems?

My machine works equally well during low pressure systems but I just don't have the same high energy level as during high pressure systems.

chunkyfrog wrote:It would be interesting to compile local pressure trends and humidity,
and compare them to therapy stats, just to see if your experience is repeatable;
and not just a one-off. Imagine being able to set your HVAC to maximize health.

ChunkyFrog,

If you are referring to my post then you overlooked one sentence. I have already compared therapy stats and there is no difference between low pressure and high pressure systems.

Clearly I have more energy during the day when a high pressure system is present despite there being no change in AHI.

I wonder if this is unique to CPAPers or does everyone feel better with high pressure systems?

Stormy Weather Worsens Sleep Apnea

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Barometric Pressure Affects Energy Level

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