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[CPAP] jump in AHI
#1
Hi all, I have a Resumed S9 Elite. I take opiates for a failed back surgery, but usually take my last dose 6 hours before sleep. It has worked OK, my AHI is usually in the 3 to 8 ranges with most of my apneas now being centrals. I always noticed that for the first 6 hours of the night things go very well. Very few events. For the final two hours of my sleep I always had a bunch of centrals. Usually in the 10 to 14 second range. Over the last few nights I notice the amount of centrals in that final two hours has increased dramatically. They also are in the 10 to 14 second range. Taking those out for the first 6 hours my ahi would be about 8. There has been an increase in obstructive also, but not dramatic. However, the final 2 hours pushes the ahi up to 30 or a little more. Yes its time to contact sleep doc. She has never been worried about the short centrals. But this is a dramatic increase. If I wake up after 6 hours I feel tired but OK. After falling back a sleep for the 2 hours where the centrals are peaking I feel like crap when I wake up. Nothing has changed except I do have a stuffy nose. Could the unit be mistaking obstructive for centrals? I do use a full facemask and have a heated humidifier. I guess if this goes on like this I need to let the sleep doc look at the data.
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#2
Of course the increase has scared the pants off of me since it happend overnight. And nothing medical wise or medicine wise has changed.
And yes I am using the Resmed software to look at this.
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#3
(05-16-2013, 03:34 PM)kenf Wrote: Hi all, I have a Resumed S9 Elite. I take opiates for a failed back surgery, but usually take my last dose 6 hours before sleep.
There is a link between opiates and central sleep apnea

Reduction of opioid medications
If opioid medications are causing your central sleep apnea, your doctor may gradually reduce your dose of those medications.
http://www.mayoclinic.com/health/central...-and-drugs

Welcome

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#4
Hi kenf,

Welcome

I strongly suggest getting a copy of SleepyHead (free software) going so you can get an itemized breakdown of what's going on.
Folks here can help you interpret the results. Wink
This is not to override a check up with the sleep lab though but should complement your therapy.

Cheers & Good Luck!

"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#5
I have the software. That's how I see the large number of centrals.

I realize that opiates can cause centrals. If I take them before bed I see a big jump in centrals. That is why I stop 6 hours before bed. Not being snippy but stopping them is not an option. If you ever had to live with an 8 out of 10 pain level and nothing else works you would understand. We have tried everything else. Without the meds I would be in bed 24 hours a day. So lets not get on our high horses about opiate use. This jump occurred for the last few nights and for the last year nothing has changed including the way I use pain meds.

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#6
And just want to reiterate that I am not being nasty about the pain killers. But I have had many non pain sufferers telling me I should stop. I can not control pain any other way. And up to a few days ago all was well.
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#7
Hi kenf,
WELCOME! to the forum.!
Hang in there for more responses to your post and best of luck.
trish6hundred
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#8
No offence taken.
I am only here to inform. Smile
My understanding of the way the unit discriminates between an OA, and CA is by
sending an ultrasound pulse down the hose.
If your airway is closed (OA) then the round trip time of the returning ultrasound echo is
greatly shortened.
If your mask has a bad leak then we don't know how accurate this technique is
and a large leak will sometimes score as a central (CA) or an Unknown during this leak event.

So check your leaks graph against your OA/CA graphs and you might have found a leak problem.
I am aware too of the opiates issues but if that becomes a problem the doc might want to put you on
something a bit more heavy duty than a CPAP machine.

Best of Luck!



"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#9
(05-16-2013, 09:18 PM)Shastzi Wrote: My understanding of the way the unit discriminates between an OA, and CA is by sending an ultrasound pulse down the hose. If your airway is closed (OA) then the round trip time of the returning ultrasound echo is greatly shortened.

Is this ultrasound thing really true? Maybe not all machines? Does anyone have more details or official facts about this from manufacturers?
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#10
(05-16-2013, 09:18 PM)Shastzi Wrote: No offence taken.
I am only here to inform. Smile
My understanding of the way the unit discriminates between an OA, and CA is by
sending an ultrasound pulse down the hose.
If your airway is closed (OA) then the round trip time of the returning ultrasound echo is
greatly shortened.
If your mask has a bad leak then we don't know how accurate this technique is
and a large leak will sometimes score as a central (CA) or an Unknown during this leak event.

So check your leaks graph against your OA/CA graphs and you might have found a leak problem.
I am aware too of the opiates issues but if that becomes a problem the doc might want to put you on
something a bit more heavy duty than a CPAP machine.

Best of Luck!

I was wondering about that. I think there is more to this story then the opiates. But I can post a graph here if I can figure out how to do that. I don't see any large leaks but will investigate more. I can be a very slow and shallow breather even when awake. Is it possible that a small leak with a shallow breath may show up as a central? What kind of machine is used for people with centrals? It would seem you would need a respirator. I put a new mask and hose on so will see what happens tonight. While I have had a good life and deal with disabling pain, I am not quite ready to die in my sleep. I just had an echo and my heart is in great shape but I know this stuff can change that fast. I really appreciate the advice.
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