Increase in pressure not solving issues. Help please

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
User avatar
HanzT
Posts: 95
Joined: Thu Oct 18, 2012 3:37 pm

Increase in pressure not solving issues. Help please

Post by HanzT » Fri Jul 04, 2014 8:57 am

Some days I truly believe I am the perfect storm for sleep problems. I have allergies, low testosterone, apnea, and my brain is “over active” at night (I wish it was working that well during the day haha). I’ve had allergies that stuff up my nose for most of my life. At night they seem to get worse and almost totally close off my nose. I’ve had surgery to reduce my turbinates twice but somehow it only lasts for a couple of years, so Im pretty much forced to use a full face mask. I have had sleep apnea for over 15 years now and at first I had surgery to that worked well for 5-6 years, then it all came back. After that I used a dental device and all was well for 3-4 years. Since then I’ve been on CPAP and my pressure has gone from 6 to 12 and recently I’ve been seeing an increase in AHI that is puzzling me, so I have tried to ramp it up to see how that my improve things. So far its been difficult to see a pattern. I hope to get some feedback from my friends here that have helped so much when I had previous issues.

My current situation is that I found out one reason I feel so tired (other than sleep issues and allergies) is that my testosterone is low. My total T is 297, so my endo put me on testosterone about 6 weeks ago. Prior to receiving testosterone, my AHI was rising and I believe it is due to my increase in body fat and reduction in muscle, which is part of the testosterone issue. However, since the shots, I have huge variances in AHI. For example:

6/26/2014 AHI 1.3
6/27/2014 AHI 6.5
7/2/2014 AHI 3.6
7/3/2014 AHI 11.1

Also, as I upped the pressure from 11 to 13.5 it seems that my hypopnea, OA and PB may be trending up. Raising the pressure a bit seemed to reduce PB but OA and hypopnea look unaffected or worse. I really don’t understand why my OA would not go down. My charts are below. Any help would be much appreciated.
Thank you!

Image

Image

Image

Image

Image
Last edited by HanzT on Fri Jul 04, 2014 10:25 pm, edited 1 time in total.

JDS74
Posts: 3397
Joined: Sun Jan 23, 2011 2:57 pm
Location: South Carolina

Re: Increase in pressure not solving issues? Help please

Post by JDS74 » Fri Jul 04, 2014 10:37 am

A couple of observations.
1) It appears that you wake up several times each night. Do you know what causes that?

2) Have you started to use a chin strap recently? That can cause increases in both OSA events and Hypopnea events.

3) Testosterone can make apnea symptoms worse. Is there a correlation between the shots and increases in AHI? You are having shots and not a transdermal patch? If a patch, how often do you replace it?

4) It looks as if, like me, the first 90 minutes or so of your sleep is fine and then the first transition to REM sleep occurs and things get a little bad.

How long since your last sleep study? Perhaps it is time to get a new titration to see what a good pressure might be or even, perhaps, a BiLevel machine or an auto machine that can cover a range of pressures.

_________________
Mask: Oracle HC452 Oral CPAP Mask
Humidifier: DreamStation Heated Humidifier
Additional Comments: EverFlo Q 3.0 Liters O2 PR DSX900 ASV
Oracle 452 Lessons Learned Updated
DSX900 AutoSV with HC150 extra humidifier and Hibernite heated hose
Settings: EPAP Min-10.0, EPAP Max-17, PS Min-3, PS Max-10, Max Pressure-20, Rate-Auto, Biflex-1.
Sleepyhead and Encore Pro 2.21.

User avatar
HanzT
Posts: 95
Joined: Thu Oct 18, 2012 3:37 pm

Re: Increase in pressure not solving issues? Help please

Post by HanzT » Fri Jul 04, 2014 11:06 am

Thanks JDS74. Your mask looks intersting, I might give it a try too. Here are the answers to your quesions.

1) It appears that you wake up several times each night. Do you know what causes that?
Usually its to go to the bathroom, or because my stomach is acting up which has also started since I began testosterone.

2) Have you started to use a chin strap recently? That can cause increases in both OSA events and Hypopnea events.
I am using a full face mask.

3) Testosterone can make apnea symptoms worse. Is there a correlation between the shots and increases in AHI? You are having shots and not a transdermal patch? If a patch, how often do you replace it?
I was using Androgel but that made me feel terrible so I started shots. I just received my first one last monday 6/30. I didn't notice an unusual change right after but thanks for the idea. I'll start tracking that.