Weight Loss = Horrific Numbers

Up until last July my AHI was just under 5 with a mixture of 2.5 to 3 in centrals, 1.5 in obstructive and the rest hypopneas.

Last July, at the young age of 61, my son convinced my to take up mountain biking. What a killer. I knew I had to lose weight and I wasn't even doing any extreme or technical riding.

So I started to lose weight and after 20 pounds (2 months) my AHI is running over 7 with a lot more centrals and obstructives pushing 2.5. I talked to my doctor and decided not to get a study at that time because I had 40 more pounds to go.

I've just about lost 40 pounds (2 more months), I have another 20 to go. However, my AHI is now running at 15+ (hit 22 one night) with my centrals in the 3 to 5 range and my obstructives in the 8 to 10 range.

I have set various pressures on a nightly basis, mid-night also, between 9 and 16 with no AHI difference (CPAP). In fact sometimes my centrals and obstructives are better with lower pressures.

I know I have to break down and do a study, but I don't want another CPAP machine.

Even though I haven't figured out what is going on, I am convinced that I will never-ever-under-any-circumstances be saddled with a straight CPAP machine over an APAP. Without being able to set a range it is a nightly crap shoot. I would hate to revert to buying an APAP off CL.

I've been on CPAP for over 12 years and I am running at about 100% compliance with usually about 7+ hours a night. Leaks are not a problem. I don't feel that bad and I don't come home and collapse like I used to before CPAP, but it is pretty scary looking at the details in ResScan. My wife thinks the machine is honked up, but we'll see.

John

70sSanO wrote:Up until last July my AHI was just under 5 with a mixture of 2.5 to 3 in centrals, 1.5 in obstructive and the rest hypopneas.

Last July, at the young age of 61, my son convinced my to take up mountain biking. What a killer. I knew I had to lose weight and I wasn't even doing any extreme or technical riding.

So I started to lose weight and after 20 pounds (2 months) my AHI is running over 7 with a lot more centrals and obstructives pushing 2.5. I talked to my doctor and decided not to get a study at that time because I had 40 more pounds to go.

I've just about lost 40 pounds (2 more months), I have another 20 to go. However, my AHI is now running at 15+ (hit 22 one night) with my centrals in the 3 to 5 range and my obstructives in the 8 to 10 range.

I have set various pressures on a nightly basis, mid-night also, between 9 and 16 with no AHI difference (CPAP). In fact sometimes my centrals and obstructives are better with lower pressures.

I know I have to break down and do a study, but I don't want another CPAP machine.

Even though I haven't figured out what is going on, I am convinced that I will never-ever-under-any-circumstances be saddled with a straight CPAP machine over an APAP. Without being able to set a range it is a nightly crap shoot. I would hate to revert to buying an APAP off CL.

I've been on CPAP for over 12 years and I am running at about 100% compliance with usually about 7+ hours a night. Leaks are not a problem. I don't feel that bad and I don't come home and collapse like I used to before CPAP, but it is pretty scary looking at the details in ResScan. My wife thinks the machine is honked up, but we'll see.

John

I have also lost some 40 pounds - over five or so years. Along the way my system has dumped the toxens stored in the fat (fat tends to become a kind of dumping ground) slowly. Also along the way I have taken some quality time to learn how to eat well. When you work out you get hungry. What you choose to eat at that time is very very important. If I were doing the exercise levels that I do now those five years ago I would be hitting the foods that made me sick in the first place.

I do not believe it is wise to loose more than 15 pounds a year, for those reasons.

I do not know what to tell you but slow down and learn to better dance with your body. There is a lot out there about "body clense" but I think you need to start thinking long term in terms of making the change and of making the changes permenant.

I have found that spending quality time with the machine during the day, learning to breath quitely again, helps when I am dealing with such things as weight loss changes.

WOW - I would have expected the exact opposite! With weight loss I would have expected the numbers to get better, not worse. I personally want to drop 25-30 pounds over the next year to be at my "good" weight and was expecting everything to get better. Most interesting for sure.

I dropped 86 pounds ten years ago, over the space of a year. My OSA improved to the point where it was so mild it barely registered at all. I went from severe OSA to mild. Unfortunately, I've not kept the weight off. As it has climbed over the last 18 months, so have my pressure needs.

Perhaps your pressure is now too high and is triggering CAs? That is a guess on my part, and an uneducated one at that. If I were you, I'd go ahead in for a sleep study. I'd be surprised if they tell you to get a different machine, considering that you already have one.

Actually I think Todzo has made some very valid points. I don't know what going on in my stomach in the wee hours of the morning. I suspect something and I am actually going to see a gastroenterologist to see if there is some problem going on.

I'm technically not on a diet. I've done diets before and they have only been temporary and pout the weight back on, hopefully this will not. I have made the following changes...

First thing is to not snack. I used to be able to quickly polish off a good portion of a bag of chips, a few donuts here or there, Skinny Cows (If one isn't bad for you, then how much can 2 or 3 hurt), etc.
I also started eating a little better, a little more fruits and veggies, less bread, etc., but I still eat the stuff I like.
And I eat smaller portions, much smaller. On the weekends two meals breakfast and dinner with with dinner at 3 or 4 o'clock.
This doesn't mean that I won't eat a greasy burger here or there or a nice breakfast on Saturday morning.

To be honest, the motivator is grinding up hills and swearing never to eat again. If I didn't see some non-health benefit in losing weight, I wouldn't be doing this. Probably have better numbers.

I don't think this is the norm. I only posted this because it is so bizarre. I think most people loss weight, get a drop pressure and their apnea improves; which was my expectation.

John

70sSanO wrote:Actually I think Todzo has made some very valid points. I don't know what going on in my stomach in the wee hours of the morning. I suspect something and I am actually going to see a gastroenterologist to see if there is some problem going on.

I'm technically not on a diet. I've done diets before and they have only been temporary and pout the weight back on, hopefully this will not. I have made the following changes...

First thing is to not snack. I used to be able to quickly polish off a good portion of a bag of chips, a few donuts here or there, Skinny Cows (If one isn't bad for you, then how much can 2 or 3 hurt), etc.
I also started eating a little better, a little more fruits and veggies, less bread, etc., but I still eat the stuff I like.
And I eat smaller portions, much smaller. On the weekends two meals breakfast and dinner with with dinner at 3 or 4 o'clock.
This doesn't mean that I won't eat a greasy burger here or there or a nice breakfast on Saturday morning.

To be honest, the motivator is grinding up hills and swearing never to eat again. If I didn't see some non-health benefit in losing weight, I wouldn't be doing this. Probably have better numbers.

I don't think this is the norm. I only posted this because it is so bizarre. I think most people loss weight, get a drop pressure and their apnea improves; which was my expectation.

John

John I strongly commend you for the weight loss, quality of eating changes, and exercise. That is great!!

As I worked with a dietitian for over two years I came to understand that the changes I needed to make would take years. But that is good news. By the time those years pass I have developed a completely new way of doing things. I have developed a different lifestyle. I have learned to eat for strength rather than pleasure.

The changes are constant and ongoing. I have three books I am reading which will soon affect what I eat. I am reading to become my own PT since my old PT moved on and no one there right now seems a good fit.

Who knows, perhaps someday I will join my crazy “roadrunner” Facebook friends. To them a twelve mile jog is a simple jaunt. It all depends on what you do regularly.

Hi - if I were you (or your doctor) I'd request a stress ECG to actively see what happens when you exercise while being monitored in the lab. It's one thing to exercise, another to not be sure about what it's doing to you (or how your body is responding to possible 'damage' acquired long ago, or at least beginning in the past and now ensconced (like arterial plaque). I'd want to know the state of my state before doing any more uphill biking.

Keep printing out your detailed reports; and give your doctor copies.
*****Make sure he LOOKS at them.*****
Weight loss may change your pressure requirement--and it can go either way.
If you can get the doc to authorize you a week or two with a rental Autoset, (cheaper than a PSG)
perhaps you can determine a new optimal pressure for your Elite.

chunkyfrog,

That is a really good idea.

Since I got a data machine I have been doing my own on-going titration to get to the best pressure. I've always felt that an APAP allows he user to better dial his/her own treatment.

I have a call into my doctor and will bring that up.

Thanks!

John