Hydrocodone and increased AHI?
Have been diagnosed with a rotator cuff issue, 'big tear' in shoulder. Trying to decide about having arthroscopic surgery. Pain, mostly while lying down/sleeping. Surgeon prescribed hydrocodone - acetaminophen. (Norcor 5/325) one every 6 hours.
Had not been paying much attention to CPAP Readings, but feeling a little funky (age? pain pills? general ups and downs?) So I checked the S9.
AHI 38.23!
Green smiley face
I have Sleepyhead and Rescan, but never really understood the readings. I ran
* 'mask test' = good, green smiley face (on the S9)
sleepyhead says,
* AHI 38.23
* Clear Airway Apnea Index = 26.28 - looks like I stopped breathing a few times - hydrocodone?
* Obstructive Apnea = 4.99
* Hypopnea Index = 5.39
* Average Leak Rate = 7.12
* 90% Leak Rate = 25.20
* % of time above Leak Rate threshold = 10.66% this is up. Day before it was 3.26% and zero % for all times earlier back to when I started using it.
There is a huge amount of data on both Sleepyhead and Rescan. I am sure there are many other factors, but I don't know enough to interpret them. Is there a "Sleepyhead for Dummies?" I tried to use the 'Beginner's Guide', but got lost in the 'paps'. <put on 'brave face' smiley>
Need help. First, hydrocodone or not?
Second, should I take the SD card from the S9 to my sleep doctor? Could he read it and offer advice?
RE: Hydrocodone and increased AHI?
Hi Bill:
Hydrocodone is a synthetic opioid. Well known to suppress central respiratory drive.
I see your apneas are central, so, I feel fairly sure it's the Norco.
Can you manage without the Norco? I don't know of a pain killer that will work as well, and not have the same effect of respiration.
I guess another alternative is to temporarily switch to an ASV machine which is used to treat people with central apnea.
Kindest regards,
Mongo
RE: Hydrocodone and increased AHI?
(01-05-2015, 09:25 AM)justMongo Wrote: Hi Bill:
Hydrocodone is a synthetic opioid. Well known to suppress central respiratory drive.
I see your apneas are central, so, I feel fairly sure it's the Norco.
Can you manage without the Norco? I don't know of a pain killer that will work as well, and not have the same effect of respiration.
I guess another alternative is to temporarily switch to an ASV machine which is used to treat people with central apnea.
Kindest regards,
Mongo
Thank you. Maybe I'll try Ibuprofen. Have a call into my sleep doctor and the surgeon who prescribed Norco. He knows I have apnea, but maybe he missed it. Bill
RE: Hydrocodone and increased AHI?
I have had a hip replacement and rotator cuff surgery. I used hydrocodone both times. The hip surgeon prescribed Oxycontin at night for 8 days also.
Both times my AHI went pretty high - 8 or over - and dropped back down after I stopped using pain medication.
I didn't worry about it much because I only used the hydrocodone for a couple of days with the shoulder and the hip. As long as I used the Oxycontin - 8 nights - my AHI stayed high so I suspect that many pain killers can affect it.
RE: Hydrocodone and increased AHI?
(01-05-2015, 01:03 PM)Clay L Wrote: I have had a hip replacement and rotator cuff surgery. I used hydrocodone both times. The hip surgeon prescribed Oxycontin at night for 8 days also.
Both times my AHI went pretty high - 8 or over - and dropped back down after I stopped using pain medication.
I didn't worry about it much because I only used the hydrocodone for a couple of days with the shoulder and the hip. As long as I used the Oxycontin - 8 nights - my AHI stayed high so I suspect that many pain killers can affect it.
any narcotic pain meds can do that. oxy is another synthetic opiate and IMO it's actually worse for you than heroin
I think narcotics can induce apnea in people who normally don't have the slightest issue, let alone those who do. I have also read that they can cause an enduring issue in pain med users... I suspect the risks would rise with dosage and length of use, and individual sensitivity
RE: Hydrocodone and increased AHI?
and are we monitoring your O2 levels during opiate use? even with AHI that high if you get SpO2 meter checked out for home use during pain meds - with an alarm for under 88%, you can sleep easier.
Dedicated to QALity sleep.
RE: Hydrocodone and increased AHI?
I think an SP02 would be a good idea. Any recommendations for a brand?
I talked with the surgeon's nurse (BTW he is Dr Orcutt. Normally would not mention names, but I think his name is hilarious for a surgeon LOL). Nurse said that they have Apnea patients all the time and they take the Norco 5/325 or similar.
What bothers me is that I am having a hard time sleeping with the pain, which mainly manifests at night. Doesn't matter if I sleep on either side, back, front. still hurts. Need some kind of pain med. Gonna try and tough it out with anti inflammatories.
Surgeon also said that I should take the hydrocodone only as really needed as he wanted me to be 'naive' to the medication and it would have greater effect after the surgery when I really need it. He also said that I would be taking it regularly for 'several weeks', and might need to be "weaned' off it later.
He has a lot of work to do on my shoulder even though it is arthroscopic out-patient surgery, and my other, right, shoulder is a bit funky also.
The surgery is on January 13th.
RE: Hydrocodone and increased AHI?
(01-05-2015, 04:34 PM)Dolla Bill Wrote: I think an SP02 would be a good idea. Any recommendations for a brand?
Basically, the main recording model numbers are: CMS-50D+, CMS-50F(W), and CMS-50I(W). They all come with PC software to review and create reports form the recorded data. There seem to be several manufacturers that all use the same electronics. The "W" versions have bluetooth capability. The bluetooth allows you to record directly to your computer in real-time. Actually it's faster to connect the USB and forget the bluetooth to download the stored data. The D+ and the F(W) models are sold everywhere. The "I(W) models seem to only be available online from the UK, Australia, and China. I didn't find a supplier in the US when I ordered my "IW" model. The "D" and "F" models only record 1 session. The "I" model will record up to 5 sessions. All of them require that once you start recording, you can't stop it until you're completely finished. They only allow for a continuous session.
(01-05-2015, 04:34 PM)Dolla Bill Wrote: he is Dr Orcutt. Normally would not mention names, but I think his name is hilarious for a surgeon LOL
That is good; It reminds me of the Savannah Law Firm of Dewy, Cheathum and Howe.
Good Luck!
RE: Hydrocodone and increased AHI?
(01-05-2015, 04:34 PM)Dolla Bill Wrote: I think an SP02 would be a good idea. Any recommendations for a brand?
I talked with the surgeon's nurse (BTW he is Dr Orcutt. Normally would not mention names, but I think his name is hilarious for a surgeon LOL). Nurse said that they have Apnea patients all the time and they take the Norco 5/325 or similar.
What bothers me is that I am having a hard time sleeping with the pain, which mainly manifests at night. Doesn't matter if I sleep on either side, back, front. still hurts. Need some kind of pain med. Gonna try and tough it out with anti inflammatories.
Surgeon also said that I should take the hydrocodone only as really needed as he wanted me to be 'naive' to the medication and it would have greater effect after the surgery when I really need it. He also said that I would be taking it regularly for 'several weeks', and might need to be "weaned' off it later.
He has a lot of work to do on my shoulder even though it is arthroscopic out-patient surgery, and my other, right, shoulder is a bit funky also.
The surgery is on January 13th.
5/325 really is not a heavy dose of H.C. They make 10/325 tabs.
I was chewing 10's like candy in 2010 when I fractured my T12 vertebra.
The effectiveness of narcotic pain relievers wears off with use; the opioid receptors down regulate. So, use as little as possible.
BTW -- The FDA just moved the mixed opioids (those mixed with Acetaminophen or Ibuprofen) up one rung on the DEA schedule to Schedule II. Now an Rx must be hand written (no faxes) and carry no refills. Since it's in the same schedule as Fentanyl Injectable, might as well ask for the "good stuff."
(01-05-2015, 05:23 PM)sgearhart Wrote: That is good; It reminds me of the Savannah Law Firm of Dewy, Cheathum and Howe.
Someone has watched the three stooges!
RE: Hydrocodone and increased AHI?
(01-05-2015, 06:32 PM)justMongo Wrote: Someone has watched the three stooges!
I resemble that remark!
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