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Allergies and sleep apnea
#1
Question 
i started allergy shots about the same time as cpap therapy. My AHI went down over the first five months. However, last month, my AHI has steadily gone up. Last week every day was over 5.

On the good side, sleep quality improved suddenly, and my allergies (nasal symptoms) have improved.

On the bad side, the AHI increase was mostly CA's and most probably sleep/wake junk. (I am hoping). After 5 months, I thought I had it beat. Now, not so sure.

Question:
Is this logical and do I just have to readjust to a changing body?
Has any one else fought allergies (shots) AND getting used to treatment at the same time?
Any other suggestions?
HuhDont-knowI am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#2
This is the gray area of relying strictly on AHI numbers. What are the duration times of the CA's? Also, did they seem occur at the beginning and the end of a sleep cycle? Are you taking any medications, even to replace the shots?

Hopefully one of my questions may send you in the right direction to find an explanation.
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#3
(08-26-2016, 01:35 PM)Rcgop Wrote: i started allergy shots about the same time as cpap therapy. My AHI went down over the first five months. However, last month, my AHI has steadily gone up. Last week every day was over 5.

How much over 5?

Quote:On the good side, sleep quality improved suddenly, and my allergies (nasal symptoms) have improved.

The is by far the most important fact in your message.

Quote:On the bad side, the AHI increase was mostly CA's and most probably sleep/wake junk.

Are you using SleepyHead? If so showing us the graph for a representative night will be very helpful. If not, why not?

Quote:Is this logical and do I just have to readjust to a changing body?

Facts are neither logical nor illogical. We *all* have to adjust to our changing bodies as we age. When we can no longer adapt we die. The *PAP machine doesn't change this, but it can help you adjust if you educate yourself on how to do that.

We can help you with this, but we need good solid information which your machine can provide. We need rather more than you've provided in this post, though.




Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
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#4
http://imgur.com/a/HssVf
I hope this attachment works. It is the first time i did it.
This attachment should answer most of the questions asked. As for meds, I have stopped meds, Flonase and Alegra. No other changes. Most of the CA's are at the end of the night when i am half asleep. It seems I cannot break the cycle the last 2 hours of the night. The above night, I slept good until about 3:00. Thats the best I have done so far but yet the end is a mess.

The CAs range from 10 seconds to 20 seconds. I oscillate between awake, sleep, CA, awake, sleep, CA, etc.
HuhDont-knowI am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#5
Looks like you're pretty well dialed in, and the CA is no reason to make pressure changes. If you were going to do anything, I might take the minimum pressure to 7.0 or a little more to prevent a couple obstructive events. The CA occurred at minimum pressure as well as in the mid-range of your settings, so I agree with your conclusion this is mostly sleep-wake junk.
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#6
Being half asleep can do it. Your body will be transitioning between regular(sleeping) and irregular(awake) breathing patterns. Try zooming in on your events and see if you didn't take a deep breath prior to recording a CA. I hope this may answer your question.
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#7
(08-26-2016, 03:50 PM)Rcgop Wrote: Most of the CA's are at the end of the night when i am half asleep. It seems I cannot break the cycle the last 2 hours of the night. The above night, I slept good until about 3:00. Thats the best I have done so far but yet the end is a mess.

The CAs range from 10 seconds to 20 seconds. I oscillate between awake, sleep, CA, awake, sleep, CA, etc.

Bear in mind that I am not a doctor.

An AHI of 5.6 is not bad, but it would be nice to go lower. Not time to panic yet, I think.

The fact that your apneas are almost all CA's may be due to too high a pressure or it may mean you need less pressure on exhale. Have you set the EPR? If not it may help. If you need more exhalation relief than your current machine can provide that may mean graduating to a bilevel machine (BIPAP). CAs that occur when you know you were awake should be disregarded but, unfortunately, your machine has no way of knowing when you are awake.

The variations in your respiration rate suggest you are not sleeping deeply at all. It might be better to lower your top pressure even if this increases your OA's slightly (but not too much) and then work back up to the higher pressures as you get used to the machine and the mask on your face.

These machines take some getting used to for most people. They can't help you if you can't wear them, so it may be better to have less effective treatment while you get to the point when you are actually getting comfortable.

I don't think Flonase or the other allergy medications you mention will be likely cause CA events, and you want to keep your nasal passages open. I use Flonase and Ceterizine and my CA's are almost nonexistent on the same machine you are using.

I imagine other people in the forum may have different opinions, and many of them are more experienced than I, so wait for some more input.
Ed Seedhouse
VA7SDH

I am neither a Doctor, nor any other kind of medical professional.

Actually you know, it is what it isn't.
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#8
I agree that too much pressure support (or exhalation pressure relief) can elevate the CA index. That, as well as a heated hose, raises mine!
Sleepster
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
Quote:I agree that too much pressure support (or exhalation pressure relief) can elevate the CA index. That, as well as a heated hose, raises mine!

I have adjusted it to 1 and then 2. Because it looked like it made the CA's worse, I changed it back to off. It is more comfortable but I think it changes HA's to CA's.

The reason I believe this is because I loaded my entire 6 month data into a spreadsheet and calculated my ratio of CA's to Total apneas. Because the data jumped around, I set up another column to record a 2 week moving average.

Looking at the trend, it became more clear to me that the EPR (even at one) increased the CA's and decreased the HA's.

I am looking for a reason to make them go away. I read some other threads and see where some have used the ramp feature to help control them. Starting the night at therapy pressure is not a problem for me. It only takes me a minute or two to get acquainted to the pressure.

Next I will try the Ramp feature and see if that can help break the cycle long enough to get back to sleep.
HuhDont-knowI am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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