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Severe Increase in AHI
#1
Ive been a cpap/bipap user for a decade.

I currently have a Resmed S9 VPAP Auto, my normal AHI is usually under 1.

However the last month it has suddenly increased pressure from around 16 to 23cm H20 and my AHI is hovering over 20 and I am having Central Apneas from 12 to 20 AHI depending on the day.

I have been extremely short of breath and had palpitations at times. Was Hospitalized 2wks ago and Nuclear Stress Test was fine---checked my AHI for that night and it was over 50 with a pressure of 22.

Any ideas for such a dramatic increase?

I did have an episode changing a car battery and was shocked and it burned my wedding band off my finger so I'm thinking perhaps the 12V shock could have done something to cause this.
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#2
What is your normal pressure range setting? 4-25 cm/H2O ? What is your pressure support setting?
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#3
Immediate action after a shock, if you are still alive, should be a trip to the ER. Anytime you experience a shock of any magnitude from an energy source, you could do irreversible damage to nerves, cells and heart, not just seared skin. Any damage could affect your breathing, and this sort of damage would exhibit in CAs.

I assume you did tell the docs you had the trauma, and they said you are fine. If not, please do so promptly.

But, you are having these symptoms, so obviously something is wrong. Trauma to the nervous system can also be short lived, and traumatic events also can result in CAs for psychological reasons as well. If the source of the issue is resolved by healing, the apnea conditions should also resolve.

QAL

Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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#4
(03-03-2015, 01:43 PM)jls954 Wrote: Ive been a cpap/bipap user for a decade.

I currently have a Resmed S9 VPAP Auto, my normal AHI is usually under 1.

However the last month it has suddenly increased pressure from around 16 to 23cm H20 and my AHI is hovering over 20 and I am having Central Apneas from 12 to 20 AHI depending on the day.

I have been extremely short of breath and had palpitations at times. Was Hospitalized 2wks ago and Nuclear Stress Test was fine---checked my AHI for that night and it was over 50 with a pressure of 22.

Any ideas for such a dramatic increase?

I did have an episode changing a car battery and was shocked and it burned my wedding band off my finger so I'm thinking perhaps the 12V shock could have done something to cause this.

I have the same machine. Just a guess, but, I think your centrals are pressure induced. Ask your doc about setting IPAPmax to perhaps 18.

The machine should not raise pressure due to centrals; so it must be raising due to flow limitation, snore or obstructive apnea.

I never wear jewelry -- especially rings around car batteries. As you found out, it can melt a ring -- but that's due to its high current capability. I used to test car batteries with a length of 12 gauge solid copper wire held at each end with pliers -- then touch the pliers to the terminals. A good, well charged, battery will heat the wire quickly to red hot, them melt it.

As for 12 Volts causing a shock -- your body impedance limits the current to generally safe levels. Also, the accident you had likley limited current flow in the body to your hand -- not across the body/chest.

Now, for anyone with a cardiac condition or an implanted ICD or pacemaker -- it would be good practice not to pass the current from even 12V DC across the chest.

Now, back to your issue. That burn from the melted ring must have been painful -- are you taking pain meds such a Vicoden? That will up your event rate.

Short of breath and palps does suggest a cardiac issue. I assume you were on a continuous monitor during your hospital stay. If not, you should be on a Holter monitor for 24 hours to check for sporadic A-fib.

Ask for a the report from you nuclear stress test. (I ask for all reports for every procedure I have.)
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
(03-03-2015, 06:07 PM)justMongo Wrote: As for 12 Volts causing a shock -- your body impedance limits the current to generally safe levels.

When I took my Ham license back in 2012 we were told that you need about 24 volts to put a dangerous current through the typical human body.

Quote:Now, for anyone with a cardiac condition or an implanted ICD or pacemaker -- it would be good practice not to pass the current from even 12V DC across the chest.

Agreed! And I'm not going to volunteer myself for at test at 12 volts, either, no matter what the theory says.

Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
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#6
Hi jls954,
WELCOME! to the forum.!
I'm sorry to hear about your accident and I hope you get better soon.
Hang in there for more suggestions and much success to you as you continue your CPAP therapy.
trish6hundred
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#7
(03-03-2015, 06:40 PM)eseedhouse Wrote:
(03-03-2015, 06:07 PM)justMongo Wrote: As for 12 Volts causing a shock -- your body impedance limits the current to generally safe levels.

When I took my Ham license back in 2012 we were told that you need about 24 volts to put a dangerous current through the typical human body.

Quote:Now, for anyone with a cardiac condition or an implanted ICD or pacemaker -- it would be good practice not to pass the current from even 12V DC across the chest.

Agreed! And I'm not going to volunteer myself for at test at 12 volts, either, no matter what the theory says.

It's more of a current and time duration issue. 12 V generally cannot push enough current to be harmful.

GFCI's (RCD's) are typically made to trip at 30 mA for not more that 40 milliseconds.

[Image: 300px-IEC_TS_60479-1_electric_shock_graph.svg.png]
AC-1: imperceptible
AC-2: perceptible but no muscle reaction
AC-3: muscle contraction with reversible effects
AC-4: possible irreversible effects
AC-4.1: up to 5% probability of ventricular fibrillation
AC-4.2: 5-50% probability of fibrillation
AC-4.3: over 50% probability of fibrillation

You missed the HAM radio days when we would operate a class-C CW final amplifier with 750 Volts on the plate and 200 mA plate current.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
How often and how long do you have palpitations? I have been treated for SVT (A faster than normal heart rate beginning above the heart's two lower chambers) which has caused shortness of breath. My stress test did not show it. It was diagnosed in the emergency room when it was happening. I always thought I was having a stress attack but it was SVT. They would come and go, lasting for a couple of hours.

Have you had any new respiratory problems. I recently got a cold which turned into bronchitis and that has screwed up my AHI but not like yours.

What are your doctors saying about your increased AHI. That is a huge jump. You must be feeling awful.
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#9
(03-04-2015, 06:04 AM)car54 Wrote: How often and how long do you have palpitations? I have been treated for SVT (A faster than normal heart rate beginning above the heart's two lower chambers) which has caused shortness of breath. My stress test did not show it. It was diagnosed in the emergency room when it was happening. I always thought I was having a stress attack but it was SVT. They would come and go, lasting for a couple of hours.

Have you had any new respiratory problems. I recently got a cold which turned into bronchitis and that has screwed up my AHI but not like yours.

What are your doctors saying about your increased AHI. That is a huge jump. You must be feeling awful.

SVT is Supraventricular tachycardia. As you describe it, car54, you have paroxysmal supraventricular tachycardia (PSVT.)

SVT is not as serious as Ventricular tachycardia (VT.)

The paroxysmal nature of some arrhythmia is why I suggested a 24 hour monitor. Also, there is a new monitor available called Zio Patch. It can be worn for up to 14 days; has no wires; and one can even shower with it on. It is superglued to the left pectoral area; and removed with acetone.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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