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Anecdotal experience regarding CPAP and altitude
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wolson Offline

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Post: #1
Anecdotal experience regarding CPAP and altitude
I live at approximately 6000 feet in elevation and have an average AHI of 7.5, with at least a quarter of those being CA's.

This past week, I had to travel to Philadelphia to see a medical specialist regarding an unrelated ailment. I took my APAP with me to test what a change of altitude would have on my sleeping.

On 31 Jan, I was at Salt Lake City at an elevation 4200 feet. That night, my AHI was 8+, not statistically different from my exeprience at 6000 feet.

On 1 Feb, I was in Philadelphia, at an elevation of 39 feet. My AHI was 2.5, the best AHI I ever had on APAP. I had, for the first time, absolutely no CA's. At no time during the night did my hourly AHI ever exceed 5.

On 2 Feb, I was also in Philadelphia. My AHI was 2.7 also well below any data that I had at home. I had a lot of problems this night with leg cramps and was awake and walking around for about five minutes each hour. This was probably due to dehydration. Yet, this did not trigger apneas that I would experience at 6000 feet. I had very minimal number of CA's.

On 3 Feb, I was again in Salt Lake City. My AHI was 4.5: my CA's were again nornal.

Finally, last night, 4 Feb, I was again at home and had an AHI of 8.6 with normal CA's.

The time is not long enough to definitively say that sleeping at near sea level was much better for my apneas but there is a clear indication to this effect. Surprisingly, I noted that it seemed harder to breath against my pressure settings at low altitude than at home.

This is just one data point.

Walt

Walter W. Olson, Ph.D., P.E.
Professor Emeritus
(This post was last modified: 02-05-2016 08:34 PM by wolson.)
02-05-2016 08:33 PM
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richb Offline

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Post: #2
RE: Anecdotal experience regarding CPAP and altitude
(02-05-2016 08:33 PM)wolson Wrote:  I live at approximately 6000 feet in elevation and have an average AHI of 7.5, with at least a quarter of those being CA's.

This past week, I had to travel to Philadelphia to see a medical specialist regarding an unrelated ailment. I took my APAP with me to test what a change of altitude would have on my sleeping.

On 31 Jan, I was at Salt Lake City at an elevation 4200 feet. That night, my AHI was 8+, not statistically different from my exeprience at 6000 feet.

On 1 Feb, I was in Philadelphia, at an elevation of 39 feet. My AHI was 2.5, the best AHI I ever had on APAP. I had, for the first time, absolutely no CA's. At no time during the night did my hourly AHI ever exceed 5.

On 2 Feb, I was also in Philadelphia. My AHI was 2.7 also well below any data that I had at home. I had a lot of problems this night with leg cramps and was awake and walking around for about five minutes each hour. This was probably due to dehydration. Yet, this did not trigger apneas that I would experience at 6000 feet. I had very minimal number of CA's.

On 3 Feb, I was again in Salt Lake City. My AHI was 4.5: my CA's were again nornal.

Finally, last night, 4 Feb, I was again at home and had an AHI of 8.6 with normal CA's.

The time is not long enough to definitively say that sleeping at near sea level was much better for my apneas but there is a clear indication to this effect. Surprisingly, I noted that it seemed harder to breath against my pressure settings at low altitude than at home.

This is just one data point.

Walt

High Altitude Sickness is implicated in sleep disorders. There are studies showing an increase in Central Apnea events in those suffering from High Altitude Sickness. Your numbers are not "high" but might be signalling that you have Complex Apnea. That is you are being treated for Obstructive Apnea and as a consequence are experiencing episodes of Central Apnea and Periodic Breathing. You mentioned that 1/4 of your events were marked as CAs. Were the rest of them mostly Hypopneas? Your pressure settings are not particularly high and should be producing a minimum of CA events, Generally the higher the pressures the more CAs in those with Complex Apnea. It would be helpful if you post some data from your machine. Use Sleepyhead software to look at your data and post a screen grab showing mask pressures etc so that we can help you with some suggestions based on our own experience. You may also want to do a search on Google Scholar to read about Central Apnea aqnd Altitude.

Rich B
02-05-2016 10:33 PM
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PaulaO2 Offline
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Post: #3
RE: Anecdotal experience regarding CPAP and altitude
I typically experience the same thing. I live at about 3000 feet and my AHI is always lower, and less CAs, when I go visit my family in NJ. They live near Philly. Hmm, maybe the alien home base is there so the influence is greater?

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02-06-2016 12:17 AM
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vsheline Offline

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Post: #4
RE: Anecdotal experience regarding CPAP and altitude
Even a small difference in altitude like 400 meters can significantly increase the percentage of people who will experience complex sleep apnea, as demonstrated in the following study:

http://www.aasmnet.org/jcsm/ViewAbstract.aspx?pid=28368

The Effects of Altitude Associated Central Apnea on the Diagnosis and Treatment of Obstructive Sleep Apnea: Comparative Data from Three Different Altitude Locations in the Mountain West

Study Objectives
This study documents both the incidence and effects of central apnea on diagnosis and treatment of OSA at different altitudes in the Mountain West and substantiates the clinical impression that individuals living at altitude with moderate to severe OSA are significantly more difficult to treat with PAP.

Methods
Split-night polysomnography was compared between sites for patients with a diagnostic AHI > 15 living at 1421 meters (Site 1; N = 150), at 1808 m (Site 2; N = 150) and at 2165 m (Site 3; N = 142). ...

Results
... At Site 1, 10.6% had a central apnea index (CAI) > 5.0, while 22% met this criterion at Site 2 and 38.7% at Site 3 ...

Conclusions
This study demonstrates that central apnea becomes significantly more common at increasing altitude in both diagnostic and treatment portions of split-night polysomnography in patients with significant OSA. An apparent exponential increase in the percentage of OSA patients with a CAI > 5.0 occurs with increasing altitude. ...

Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(This post was last modified: 02-06-2016 03:03 PM by vsheline.)
02-06-2016 11:19 AM
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PaytonA Offline
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Post: #5
RE: Anecdotal experience regarding CPAP and altitude
This is very interesting. I spend about 4 weeks a year at about 6000 feet one week at a time. The rest of the time I live within one hundred feet of sea level. My anecdotal experience is that sometimes my AHI is higher and sometimes it is lower at high altitude than at sea level. It has seemed to me to be about an even split, but I have not actually tracked it closely. For me, it seems like there are other things that may take precedence in my therapy over the altitude. I do not know what they are but it seems that way.

Best Regards,

PaytonA
02-06-2016 02:41 PM
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SideSleeper Offline

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Post: #6
RE: Anecdotal experience regarding CPAP and altitude
I'm posting my question here to bump the topic back up. Does adjusting your pressure when traveling to higher altitudes help stabilize your AHI figures? I live at 500' now but will be traveling this summer to areas of up to 5,000' elevation. We will be in our RV but I have my laptop and can load the info into SH daily like now--we do have a generator.
02-27-2016 03:42 PM
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