medicine messing with number?

[w7sot]

OK - so wondering if taking certain medicines tend to have an effect on my AHI - I talked to my doctor about my insomia again, I asked to be put back on my Ambien CR (because I know it works) - but he decided he wanted to increase my amitriptyline dose from 50 MG to 75MG - and it with looking at the calendar, that was about the time my AHI went from .4-.6 and feeling great, to an AHI of 5-7 and feeling crummy all day, but I am not laying in bed for hours before I get to sleep anymore.

Think it may be time to not take the amitriptyline tonight, and see what happens - the ONLY reason why I take it is because I can't take any narcotic pain meds at night - or they will keep me away, so I take this to at least help out with my back pain - and one of the side effects is it makes you tired, so it is not going to hurt anything to goo off it, and see what happens?

How common is it for different meds to have an affect on both your number and how feel the next day?

[PaulaO2]

I don't have a data capable machine but I do have an oximeter. I started amitriptyline a while back for my headaches and I wore the oximeter a few days before I started it and ten days after. I noticed on day 3 with the med, that my O2 was dropping a lot. More times and lower each night. Then, by the end of the ten days, they were not as numerous. I was on 25mg each night and now I take 50mg. I did not re-use the oximeter but I am sure there were more dips as I again adjusted. Then I added baclofen. I forgot to wear the oximeter but I haven't noticed any difference with it at all.

Is your pressure being increased by the machine or maxing out? You could try taking it (the pill) earlier in the day so that you sleep off the grogginess. It does not make me sleepy but it does make it hard as heck to wake up.

So the short of it is, yes, some medications can affect your apnea. Any medication with a sleepy side effect is going to. You relax more, which means your airway is more relaxed which means, the machine has to work harder.

Have you tried anything other than medication for the insomnia?

[Clay L]

I had hip replacement surgery last September. I was on pain meds the first two weeks afterwards - Oxycontin at night and hydrocodone day and night.
My AHI numbers were much higher than usual during that time and also quite a bit higher for about eight weeks after that.
The higher AHI after the pain meds were stopped may have been because I couldn't sleep on my right side for a while and as a consequence spent more time sleeping on my back.

[TorontoCPAPguy]

All sorts of medications will have a major effect on your sleep hygiene and efficacy. Pain meds will create arousals as most contain caffeine or cause the body to generate chemicals that create arousal. No REM = No sleep. Sleeping pills, sedatives and the like will cause the breathing to become more shallow if one does manage to reach L4/REM sleep and, while you are sleeping like a log, you may not be oxygenating your blood nor getting well oxygenated blood to your extremities and vital organs. As a result of this, the CO2 level in the blood rises and, again, arousal. No REM. If you are taking several meds as I am, it would be silly not to expect the unexpected as well as interactions and side effects. All add up to no REM, poorly oxygenated vital organs, drastic effects on your body's electrolytes and such, and.... NO REM. Or less than ideal health and nutrition. 80% of the population over 40 is dehydrated, short of intracellular magnesium and low on Potassium (mine is kept at 4.5+). I supplement - the one a day pills simply do not do it and are, in all honesty, a fraud and a sham. I take Vitamin D, Vitamin C Time Release, B Complex Vitamins, Taurine, Co-Enzyme Q10 (UBIQUINOL), and such. As an experiment of one I tried stopping for a couple of weeks and wound up feeling pretty poopy... low energy and tired.

So, for whatever meds you are taking, know their side-effects and interactions. Take time to sit down with your pharmacist and learn how they work and use them properly (diabetic? Do you know that if you do not take your Metformin and/or Gluconorm at the right times you are just as well to skip the dose? Did you know that there are meds you may be taking (like statins) that will rob your body of serum insulin?)

My ultimate goal is to return to good health and that takes education, advocacy with the MD's and a dogged determination to know and get the right medical care, whether provided by your doctor or by yourself (and I am NOT advocating that you plod right along without medical supervision; only that you know what you want and what you need and advocate for it). I spent three weeks in lala land on total life support three years ago this past week. I was absolutely not expected to survive and at one point my wife was asked to pull the plug (I woke up a few days later with my eyes taped shut and two doctors at the foot of my bed suggesting they remove me from the ventilator and see "if this SOB can breathe on his own").

Good luck.

[Sleepster]

My doctor told me that amitriptylene, like all sedatives, will make OSA worse. If I were you I'd look at what it is that's making the AHI go up. Is it the OA, CA, or HY indices?

Be careful going off amitriptylene. When I lower the dose by even the smallest amount I get headaches. I've used clonopin in the past to get over these temporary side effects, but you have to be careful with it, as it's very habit forming.

I used to be on 50 mg for years, then it was raised to 100 mg for a couple years. Last year it was droped to zero, but now I'm back on 25 mg. Originally it was prescribed for chronic tesnion headaches, then the dose was raised to 100 mg for anger management. They even tried raising it to 150 mg a year ago for anxiety, but that lasted only a week as I couldn't tolerate it.

Now that I've been on CPAP therapy for over seven months, all these symptoms are fading away. I suspect that soon I won't need the 25 mg anymore, either.

[mjbearit]

I've used clonopin in the past to get over these temporary side effects, but you have to be careful with it, as it's very habit forming.

I use Klonopin for RLS and sometimes to shut my brain off and it also tends to slow the nerve impulses so it works wonders in conjunction with pain meds at certain times. However, I asked them to lower the dosage so that now I have .5 mg tabs. This way I can take as little or as much as I need (not to exceed the prescribed 2.5 mg or whatever it was, I never go over 2 tabs anyway). I think Klonopin gets a bad rap a lot. I use it from time to time when I need that extra little bit, and it works great. Using it in this way I have never had any sort of an addiction type reaction to it. I might go 2 weeks between uses and I am definitely not craving it! LOL! I also use Vicodin which has a rap as another highly addictive med. Again, I am on the 5/250 I think it is...might be 5/500 I can't remember...but I use it most nights for my hips. In the dead of summer I can go for extended periods without it. My Rx is for 2 pills every 4 hours I think, but I just take one at night and leave it at that. In my opinion...and it is nothing but my opinion....a lot of drugs that claim they are habit forming are because people take them prophylactically for chronic pain. Take it prophylactically for surgery and such, but when it comes to chronic pain take what you need. You don't need something that is going to keep you from feeling pain. There is nothing wrong with a little bit of pain...it let's you know you are alive! I think where people get into trouble is where they think that they should not experience pain at all. News flash! Pain is okay. It is not the end-all. Some of the things my doctor has done to me he cringes at and says "How can you just sit there and watch? I would have passed out!". My response "Because it feels better than it did before" Pain is relative. My doc shakes his head at me a lot! LOL! He's young, he'll learn. But when you drug yourself up so much to avoid pain, not only do you leave yourself open to addiction, but you miss out on life! If you miss out on life, why are you using a CPAP? Quality of life is so that one can experience life and CPAP is to extend your life. Enjoy it. It will be over way too soon!

[Sleepster]

I think what some people do is take the medicine when they don't really need it. If you're in pain, or feeling axious, you take it to feel better. If you're not in pain, or not feeling anxious, you talk yourself into thinking maybe you are, and you'd feel better if you took it. The next thing you know, you're hooked.

Like you, I can go weeks without any klonopin, and just take a little when I need it. I, too, have the 0.5 mg tabs.

[zimlich]

I have problems at L1 and L2 that result in a pinched nerve and severe back, hip and leg pain. I take morphine and oxycodone and could not function without them. I could not sleep without them. I keep the doses to minimum, but found that really cutting the doses and dealing with more pain did not decrease my AHI, probably because my sleep was so fragmented from pain. I am physically dependent on them now as I have taken them long term and do suffer from withdrawal if I don't take them on a schedule.
I am on other meds- psych meds and my AHI has never been normal- my doctor, and I agree with him that these cause the high AHI. I was taking them long before I had the back problems. The psych meds are a matter of life and death for me as I have bipolar disorder with major, suicidal depression. The particular meds I take since being on CPAP- and these have changed, but remained in the same class of drugs are lamictal, zoloft (cymbalta, Pristiq), 1 mg of clonopin twice a day, aricept and zocor. The narcotics did not increase my AHI. I went on ASV to try to decrease my ahi which averaged 28-mostly hypopneas and now average an ahi of 11- 14. Meds certainly interfere with sleep architecture.