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Seeing more UA and CA - due to being sick or AFIB med?
#1
Seeing more UA and CA - due to being sick or AFIB med?
This past week, I've been sick with some type of flu-like symptoms/virus. My primary care didn't prescribe anything and said to let it run it's course. Well it seems to be doing that at night, causing me to have a lot of major UA and CA events. Is that possible?

Last night, I didnt see any issues, since I think I'm getting over the virus. But Here are screenshots of two nights ago that really scared me with all the numerous CA and UA events. Some of the UA events lasting up to 30-40 seconds. According to the respiratory rate, looks like it dropped down to 0.

I'm definitely contacting my sleep doctor Monday to review my logs, but he uses ResScan and I don't think he looks much at details of UA and CA events, as long as AHI is good. But this looks concerning to me.

I went back through my logs from last month, and also found a few days showing clustered CA events last 15-25 seconds. Then other days would be normal again.

I'm on Multaq since August of last year for AFIB, which is also the month I was issued my CPAP machine. I'm wondering if maybe the Multaq or a beta blocker I'm taking is depressing my system too much to allow myself to breath at night?


[attachment=4351][attachment=4352]
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#2
RE: Seeing more UA and CA - due to being sick or AFIB med?
It sounds like you normally have a good AHI, While you are sick, it's hard to say what will work best. I couldn't see many CA and the stats bar said 0.1 per hour. some flu/cold meds can cause CA though, so if you do take a med and see some CA, it may be the reason. I think these UA are obstructive OA and aren't being determined because of the leak. Therefor the pressure isn't being raised.
Ask your doctor, You could leave it, or you could try and fix it. I'd be tempted to adjust my mask a bit and put up with AHI in the 5's for a week or 2.
Do you really feel like messing with all this now?
To resolve OA and I think these UA, you fix the leaks and raise min pressure, but you may need to reduce it back after the flu. I could only guess what pressure would work, You could try the 95% number, have min 11, which is close to what would be a fixed pressure on that chart, as a first step and raise max to 15 if it needs it.

There are some significant leaks you could deal with when you feel better and the min pressure may need a tweak. I don't think there is an association with the AF med, but your doctor would know.
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#3
RE: Seeing more UA and CA - due to being sick or AFIB med?
Nearly all those UAs are occurring when the leak is over the redline. Have a look at your non-flu charts and see if leaks are an ongoing issue for you. If so, you need to address the leaks and get them sorted and everything else should come good. It could be that you're having a lot of disturbed sleep because of congestion (with the flu) and that is causing the mask to get knocked around. You're probably aware that the machine can't properly diagnose and treat events occurring during excess leak periods.
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#4
RE: Seeing more UA and CA - due to being sick or AFIB med?
So before going to bed, the only thing I changed was the EPR from 3 to 2. Went back to bed at 1:45am Central. I woke up right before 4am, with my heart racing at 125bpm. I thought I was in AFIB, so took a reading with my Kardia Mobile device, and it was normal. But this racing heart left me scared! It is a symptom I had rarely had up until recently. Checked my Blood Pressure, and it was 152/91. Usually since being on my med's, it is below 120/80. My resting HR a month ago, used to be 50-70bpm, but now it's usually 72-85bpm.

At 1:45am I had coughed a few time, so not sure if that raised my pressure so fast? And it stayed there even though i didnt have any apneas. But then the chart shows I started having RE, then H, and then a lot of OA.

This is concerning my HR is getting so high, no telling for how long. My device doesn't show me how long it was at 125bpm during sleep, but I kept manually taking my pulse, and it took 15 minutes for it to come down to 85bpm.

Machine doesn't show any OA during the long leak period, but I'm suspecting I may have had a lot more OA during that time, which caused my HR and BP to spike.

With all these OA, I am scared to go back to sleep and wonder if i should go to the hospital or ER. But I doubt they could do anything for me.
[attachment=4353][attachment=4354][attachment=4355]
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#5
RE: Seeing more UA and CA - due to being sick or AFIB med?
If I was concerned about about a heart problem or high pulse rate I'd be out the door to the local walk in clinic or Hospital. This is a good place for advice on sleep apnea but no replacement for a Doctor. Go get checked out.
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#6
RE: Seeing more UA and CA - due to being sick or AFIB med?
The current influenza strains have had very severe effects on some individual's respiratory and cardiac health. If you think this is related to the flu, get checked out professionally. The clustering of OA events looks like it may be a positional apnea caused by poor airway alignment, or perhaps congestion from the illness. If positional, it may respond to a soft cervical collar. Since we don't have baseline information for what is normal for you, I'll assume this may be more related to illness and again point out that you should not hesitate to seek help if you feel distress. We can optimize CPAP later.
Sleeprider
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#7
RE: Seeing more UA and CA - due to being sick or AFIB med?
I went to Urgent Care this morning and it was a waste. Doctor tested for strep throat which was negative. He said if I had this for a week already, it should be almost over. Told me to just take some Flonase to open up sinuses and Mucinex for the cough/congestion. He didn't know anything about CPAP machines or sleep apnea. He asked if I called my provider of the CPAP machine to get it tested.  I told him the machine is okay, it's my congestion and sickness that isn't helping.

I was told to call the "on-call" phone of my sleep doctor, but he has none. This is the second sleep doctor I've been to, that doesn't have an on-call phone. Basically if it is an emergency, they tell you to call 911, or go to nearest ER. I'm going this afternoon to another clinic to get a second opinion. 

When apneas occur, like OA, can't this affect people's HR and BP?

I feel like I'm the only one here that has mentioned a racing heart, and high BP, after having a run of apnea events.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#8
RE: Seeing more UA and CA - due to being sick or AFIB med?
Your not the first. But when you throw words around like AFIB it tends to sound alarming. You could always increase your pressure up 1cm or so and see if that helps you sleep.
Download SleepyHead
Organize your Sleepyhead Charts
Posting Charts
Beginner's Guide to SleepyHead
Mask Primer
5
Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies.

Membership in the Advisory Members group does not imply medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.



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#9
RE: Seeing more UA and CA - due to being sick or AFIB med?
ok thanks. I went to see another doctor at a clinic. He said he couldn't do anything for my apneas, but did prescribe something to help clear up my throat and airway. I'm going to try and take a nap for an hour or so and see how it goes with my machine.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#10
RE: Seeing more UA and CA - due to being sick or AFIB med?
So I went to another doctor. He gave me some antibiotics for the cold. But he told me if the racing heart and OA/CA happen again, he recommended I go stay overnight in the hospital or ER, to have them monitor me to find out what is going on. 

All of these OA and CA clustered together are not normal for me. Usually my AHI is well under <5.

I just took an hour and half nap. Didnt go to sleep for first hour, but then in the last 30 minutes, had issues. I woke up again with heart racing, and blood pressure was higher then normal 153/86. Normally I'm well under 120/80.

[attachment=4373]
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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