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Advice: worse AHI during overnight oximeter test
#1
Advice: worse AHI during overnight oximeter test
I have been in a CPAP and now BiPAP trial since April. I have worked through various machines, settings and masks and have done multiple overnight oxygen tests at home.  For some reason my AHI is always worse when I do the tests.

This last time we waited two full weeks where my AHI was usually less than 1 and never more than 2 and then repeated the test.

Last night I did my first of two nights of my most recent home oximeter test.  For some reason I had difficulty getting to sleep, I was tossing and turning for hours.   My AHI was crazy high -- according to oscar I had 20 events in the first 45 mins of not getting to sleep and another 15 in the next 45 mins of not getting to sleep. So in the first 90 mins of not getting to sleep I had 35 events.  Then I had another 45 mins of restless before I actually got to sleep. After I was sleeping my AHI was still 3.5 which is higher than two weeks but I suppose better than the first part of the night.

The only thing I did differently is I used an decongestant spray because I was a little congested before going to sleep. Previously I've found I am very restless getting to sleep with the test unit on my finger and I thought it better to have completely clear nose. 

Based on several tries, it seems like having the test device on is making me very restless and so nights with the tests don't look anything like nights without it.

Any suggestions or advice appreciated.

(I also posted to freecpapadvice - so sorry for x-posting, just not sure the best place to post questions like this)
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#2
RE: Advice: worse AHI during overnight oximeter test
You will need to post OSCAR data.  You can find the info in my signature.  Also post a redacted Sleep Study if you can.

Welcome


Quote:I used an decongestant spray
I hope it wasn't Afrin or something like Afrin.  Bad stuff.

If you are congested.  Do you have ENT issues?  

Try to give us as much history as possible.

Also read the Sleep Tips on the wiki.
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

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#3
RE: Advice: worse AHI during overnight oximeter test
(07-28-2021, 09:39 AM)The congestion is seasonal allergy related.  The nasal spray was an OTC decongestant recommended by the pharmacist.I don\t think the oscar data will show much of use -- I wasn't asleep during all or the majority of the events.  Last night looks nothing like the other nights, it seems like just having the oxygen test on my finger is making it worse.    Perhaps it is as simple as anxiety related to hoping it goes well and I get to sleep like I did the last two weeks.  I will try without the nasal spray tonight as it didn't seem to help.I guess I was just wondering if anyone else had seen experiences about people getting worse results just by having an oxygen test unit on their finger -- seems weird but maybe it is keeping me awake.... Wrote: I hope it wasn't Afrin or something like Afrin.  Bad stuff.

If you are congested.  Do you have ENT issues?  

Try to give us as much history as possible.

Also read the Sleep Tips on the wiki.
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#4
RE: Advice: worse AHI during overnight oximeter test
Just some broad ideas>>


The nightly routine of settling down prior to sleeping is crucial.

One or two nights do not make a trend. Don't underestimate the effects of Randomness. 

You will be surprised at how much the folk here can read from your OSCAR charts. Certainly worth posting if you are worried and looking for help.

I don't believe you mentioned what sort of events: OA CA or other? SWJ maybe?

Did you make any other changes to your therapy?

I use Nasonex nasal spray but only in the morning, not a night. Sleep Doc's advice is there is no long term side effect.

I would steer clear of OTC items. Never know what is in them.

At night I use NaCl nasal spray to loosen any mucus (that would otherwise add to flow limitations, which would drive up pressures.)

I sometimes need to use Ventolin at night but find that induces some level of alertness and difficulty falling asleep.

There are Many Variables that affect my own sleep, not just PAP machine and settings. Having any "new" thing to deal with can cause anxiety such as getting used to pulse oximeter on my finger. That was a hassle but since good therapy I no longer bother with that.

Diet: the wrong type of food at night. The wrong type of fast food, instant cup-a-soup (MSG!!!), Indian food, curries, creamy food all add to my nasal congestion. No food after 7 PM is my rule.
Fatigue: tough day at work, lack of exercise. 
Liquids: too much late at night, not enough during the evening, can effect level of nasal congestion and mucosal thickness.
Stress: work, the world we live in, the weather, all have an effect on my sleep.
Medications can effect my sleep.

Did you mention why you are doing the Oxygen tests: would you be anxious about the results and implications for work/career/other?

As posted above, feel free to give as much information as you are comfortable to divulge.
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#5
RE: Advice: worse AHI during overnight oximeter test
Events are not real if you are not asleep, they are called sleep wake junk and only get reported because these machines are not smart enough to know if you are awake or not. This issue does not sound like it is apnea related but rather insomnia/restlessness or perhaps some side effects from decongestant. An oximeter should not affect sleep unless you are overthinking it.
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