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Likely a non-issue, but....
#1
Likely a non-issue, but....
for the last 3 nights, my AHI has been over 1 (1.3, 1.7, 1.3) for the first times since I started APAP back in November. Pressures are no different than previous, the makeup is almost entirely OSA with the occasional Hypopnea. Leak rates are also not exciting. Flow limitation, though is up but the upper threshold is still 1... is that the range for FL? 0 to 1?

I am not stuffy, didn't drink or use drugs...

and I know that < 2 is still very good treatment - I feel about the same as before. Which is, I still start yawning after lunch, still have high blood pressure, high blood sugar, and have gained about 20lbs Angry Angry Angry although since right before I started PAPing, I reduced my levothyroxine too much due to symptomatic low TSH - am now taking slightly more after TSH raised to 6, and need to check it again (I am thyroid-less due to having it surgically removed)

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum

Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
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#2
RE: Likely a non-issue, but....
Before I started cpap, I could tell a big difference in events with a 10-15 lb weight difference. (woke up more often, and felt even worse)

If the 20 (or part of it) is since November, you may have to bump the pressure up a little bit.
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#3
RE: Likely a non-issue, but....
Daria, your AHI is a non issue - no one consistently has 0-1 AHI nor is it relevant in even healthy people - there is always a bit, especially as one ages or gains weight. So that is not worth your worrying about at all. Less than 5 is good, above it is SA at clinical levels. Consistent AHI night to night is a bit of a grand illusion, as is the idea that you should have a low to 0 AHI - if you do, then you are a freak and the machine is doing something that actually does not happen in nature - so don't worry too much unless you start to consistently go up to 6 or more.

Your greater concern is the other health related problems you mention - high BP, high sugar, and high(er) weight. The levothyroxine has a certain amount to do with this, as does having the thyroid removed, but you can still successfully lower your weight with only a little effort (reduce your sugar intake from carbs, drop your calorie intake by 10%, increase your awareness of not so much what you eat but how you eat). The other aspect is exercise, plain and simple, even if it just walking and above all, standing is vital - don't sit all day at work or when watching TV - stand up from time to time, at least 5 minutes per hour (current clinician's recommendation is 15 minutes, but that is not yet established, however 5 minutes is), same if you are working on your computer. This will have an extreme knock on effect that will be subtle at first but will build up over the years.

And of course, see your doc regularly to get your TSH levels controlled as well as your cholesterol and sugar. If you can keep off of statins, it would be great, but if you have to, you have to. But as for BP, if it is not brought under control by diet and exercise, then you will have to take calcium channel blockers and other forms of BP control meds, of which I am a great fan of a combo of Lisitril and Amlodipne used together. Bilol, a bet-blocker used to bring PVCs under control, also has a strong effect on the diastolic pressure and can lower it significantly, but you really don't want to be on them if you don't have to be. Get thee to thy doc regularly, but don't obsess about your AHI if it stays below 6 (it wiill every now and again go up above 5 if you have a bad night or a cold or any number of things, so only worry if it consistently remains above 5 or 6)
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#4
RE: Likely a non-issue, but....
Oooo you punched one of really touchy buttons! I still have my thyroid way too much of it in fact. It is doing something though not enough so I cannot directly relate.
What I can say is TSH is Absolutely Not the holy grail of thyroid tests. I'm a service engineer (ret) and I want all the numbers but to borrow a phrase around here if a thyroid doc tells me the sky is blue I'm gonna go look.

If the body does not correctly convert T-4 to T-3 or the the pituitary has "corrupted code" you have a serious problem. Nothing short of a full panel is really useful.
If you are old enough to remember the Brit show "The Prisoner" ..... I AM NOT A NUMBER! Treat my symptoms not my numbers!
I fired a lot of MDs until finally finding one who is at least semi- enlightened.

I have learned incremental changes in thyroid meds need time to settle so best to sneak up on the correct dosage.


Rant off.
I use my PAP machine nightly and I feel great!
Updated: Philips Respironics System One (60 Series)
RemStar BiPAP Auto with Bi-FlexModel 760P -
Rise Time x3 Fixed Bi-Level EPAP 9.0 IPAP 11.5 (cmH2O)
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#5
RE: Likely a non-issue, but....
(04-13-2015, 07:39 PM)DocWils Wrote: ... but you can still successfully lower your weight with only a little effort (reduce your sugar intake from carbs, drop your calorie intake by 10%, increase your awareness of not so much what you eat but how you eat).

Ha! easy for you to say Big Grin
I am diabetic and allergic to everything under the sun and have to constantly watch every mouthful. Believe me if it was easy, it would have been done - I am a huge believer in educating myself, and also have a fair amount of stubborn will power (ask anyone Bigwink )

(04-13-2015, 07:39 PM)DocWils Wrote: The other aspect is exercise, plain and simple, even if it just walking and above all, standing is vital - don't sit all day at work or when watching TV - stand up from time to time, at least 5 minutes per hour (current clinician's recommendation is 15 minutes, but that is not yet established, however 5 minutes is), same if you are working on your computer. This will have an extreme knock on effect that will be subtle at first but will build up over the years.

here ya got me. when it comes to exercise i am a wimp. I have a life long issue with hurting when I move, and an addition to all the garbage I already mentioned, my body neglects to make pneumococcus antibodies and is variably low in all classes of IG. I have a long history if catching everything, all the time. I have spent whole years and even the odd decade trying to get the better of my predilection for physical sloth, but I always revert. sigh


(04-13-2015, 07:39 PM)DocWils Wrote: And of course, see your doc regularly to get your TSH levels controlled as well as your cholesterol and sugar. If you can keep off of statins, it would be great, but if you have to, you have to. But as for BP, if it is not brought under control by diet and exercise, then you will have to take calcium channel blockers and other forms of BP control meds, of which I am a great fan of a combo of Lisitril and Amlodipne used together. Bilol, a bet-blocker used to bring PVCs under control, also has a strong effect on the diastolic pressure and can lower it significantly, but you really don't want to be on them if you don't have to be. Get thee to thy doc regularly, but don't obsess about your AHI if it stays below 6 (it wiill every now and again go up above 5 if you have a bad night or a cold or any number of things, so only worry if it consistently remains above 5 or 6)

yeah... we have a regular gig going. I probably give her heartburn - lol. statins make me feel like someone beat the tar out of me, and I told my doc that life aint worth preserving if it feels like that - after an ok stress echo she reluctantly stopped nagging Wink for BP + Arrhythmia am on several meds. Lisinopril makes me cough and go all asthmatic and asthma meds dont play nice with arrhythmia (atrial tachy - not fib) im on an ARB + HCT and metoprolol and propafenone and metformin for the bloodsugar. going to need another something for bloodsugar, i am afraid, its been lousy lately!

(04-13-2015, 07:39 PM)Mark Douglas Wrote: Oooo you punched one of really touchy buttons! I still have my thyroid way too much of it in fact. It is doing something though not enough so I cannot directly relate.
What I can say is TSH is Absolutely Not the holy grail of thyroid tests. I'm a service engineer (ret) and I want all the numbers but to borrow a phrase around here if a thyroid doc tells me the sky is blue I'm gonna go look.

If the body does not correctly convert T-4 to T-3 or the the pituitary has "corrupted code" you have a serious problem. Nothing short of a full panel is really useful.
If you are old enough to remember the Brit show "The Prisoner" ..... I AM NOT A NUMBER! Treat my symptoms not my numbers!
I fired a lot of MDs until finally finding one who is at least semi- enlightened.

I have learned incremental changes in thyroid meds need time to settle so best to sneak up on the correct dosage.


Rant off.

so right. I get all the numbers checked sometimes, but not as often since the surgery, they stay all nice and even and track well with TSH every time we have looked. Not like they were when I had a ginormous goiter spewing out unusable hormone. (for my money i had symptoms of both hyper and hypo until then) I have had a few full panels of all sorts of things with all my malingering hypochondria Bigwink I am also a big fan of lots of data and analytics of same. I fire doctors too - but it takes me roughly 3 years to train em to understand how to treat a person with an immune system defect, so i don't like to Big Grin


هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum

Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
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#6
RE: Likely a non-issue, but....
(04-13-2015, 07:39 PM)DocWils Wrote: .........Consistent AHI night to night is a bit of a grand illusion, as is the idea that you should have a low to 0 AHI - if you do, then you are a freak and the machine is doing something that actually does not happen in nature

Oh great....... Now Doc thinks I'm a freak of nature. But wait! That could be a good thing! I'm not different, I'm a freak of nature! Yeah, that's it!
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#7
RE: Likely a non-issue, but....
its funny... i had 6 months worth of < 1 then 3 days in a row of > 1 I know it's still good. I didn't have a headache, and that is GOOD!
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum

Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
Post Reply Post Reply
#8
RE: Likely a non-issue, but....
(04-13-2015, 05:31 PM)DariaVader Wrote: for the last 3 nights, my AHI has been over 1 (1.3, 1.7, 1.3) for the first times since I started APAP back in November. Pressures are no different than previous, the makeup is almost entirely OSA with the occasional Hypopnea. Leak rates are also not exciting. Flow limitation, though is up but the upper threshold is still 1... is that the range for FL? 0 to 1?

That happened to me, too. After a few months with AHI consistently under one and a few zeros to boot, I had a run of about three weeks consistently over 1 and one three. But the last week or so has gone back to normal, below 1 every night for the last six days. What changed? Beats me! I did feel like I had a very mild cold for much of that time. Toward the end of the "high" run I actually felt better than I have since starting the CPAP.

So I guess I'd advise you not to worry about it too much. Keep your eyes open though (at least when you are awake).
Ed Seedhouse
VA7SDH

Part cow since February 2018.

Trust your mind less and your brain more.


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#9
RE: Likely a non-issue, but....
i wondered if i am finally dreaming more. I've had apnea forever... and CPAP has totally changed my dreams from half awake epics to the jumbled plot-less thing most folk describe Big Grin
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum

Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
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#10
RE: Likely a non-issue, but....
Dreams depend on where you are in the sleep cycle when you wake up - we used to think that you only dreamed in REM sleep, but now we know better - instead, it seems that if you wake up from REM sleep you will relate to having a nightmare or something negative, from deep sleep you will relate something positive, so it is beginning to look like the various levels of dream sleep have to do with how we are processing images and emotions from our waking life. The half waking epic is because you are in a fugue state at that point, still capable of dreaming but your conscious mind is also interacting with that state, and your mind is aware enough of your waking mind to make coherent and impressive dreams, and for your waking mind to remember them at least for a while.

What your current experience would be indicating is that your less wakeful throughout the night, your mind, so long accustomed to getting woken up every few minutes/hours has finally accepted that it can allow you to go down deep into your cycle and so you have indeed started sleeping better. Congratulations.

As for exercise, even a daily walk at a decent clip is enough to start with. And standing, as I have said, is vital.

With so many meds, naturally you have a sheaf of issues to deal with - not just the illnesses but the side effects of all these drugs, and I sympathise, but take heart that at least the CPAP is doing its job and IT HAS NO SIDE EFFECTS!!!! YAY!!!! With any luck, bit by bit you can reduce most of the others (except of course for any replacement drugs for your thyroid), but I am a bit surprised to hear that with a Diabetic diet you have not lost weight. Diabetic diets are really not all that different from effective low carb/low sugar diets and people tend to drop up to 10 kilos pretty easily when going on it, at least here. It seems you need to up your burn rate, and that, again means not being a wimp and getting a bit of the old heart pumping and the old muscles moving. Don't start off big, but work your way up to a good solid walk each day, or a bike ride. Or just plain standing for up to 15 minutes per every hour of your waking day (5 minutes is enough to start with). It really can be a simple as that at the beginning. Start with doing your taxes standing up - after that, who knows?
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