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Cortisol Level Changes After Starting CPAP
#1
Cortisol Level Changes After Starting CPAP
I got my OSA/sleep apnea DX after I had an afib event about a month ago.   I'm newly on a CPAP starting this week.   I had bloodwork done in anticipation of one-month follow-up with my cardiologist for the afib event that was the red flag that I needed to be checked for sleep apnea and my cortisol PM level was at 19.   The max normal is 16.    Since starting down this road, I've been doing a fair amount of self-guided reading on cortisol levels due to sleep apnea and it's likely that mine is high because of sleep apnea (I've probably gone undiagnosed for 5-7 years).  

I guess what I'm wondering is how long it takes for cortisol levels to come down after you start with the CPAP?  

All other bloodwork was fine/normal except I'm anemic (I'm a woman so this isn't a surprise) and my WBC count is elevated due to stress but I recently had my 2nd Moderna shot and I'm just now at 2 weeks from that 2nd shot and also the adrenal havoc that sleep apnea is causing, so I don't think there's cause for concern.  My A1C was also elevated (5.8 - the normal is 5.7) and I think there are also contributions here too but it's also diet-related and I've tightened up a lot on sugar and processed food in the last month.

I'm mostly putting together the puzzle so I can advocate for myself with my doctors and make appropriate decisions to fight for a better quality of life for myself.
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#2
RE: Cortisol Level Changes After Starting CPAP
There are far too many factors that affect cortisol levels and you already mentioned a more probable reason that your cortisol level was elevated (stress).

It will take months to completely adapt to PAP treatment and get its full benefits.
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#3
RE: Cortisol Level Changes After Starting CPAP
A few comments...

Cortisol is a marker for stress, so stress reduction is where I would start. 
Are you "compulsively" monitoring your heart for afib?  A known stress inducer. 
Are you taking anti-arrhythmic drugs like amiodarone which can have vicious side effects?
Did you visit an endocrinologist for a complete workup as some of the common blood tests are insufficient for borderline cases? 

I noticed your profile indicates a ResMed device, why are you using Smartlink?  You may want to download and install OSCAR to be able to post results and more effectively communicate with experienced forum members. Also, you might want to check with your sleep doctor to determine if a bi-level device would be more beneficial to your therapy.

The best advice I can give, do not obsess over the numbers, you are treating a patient, not a machine. Likewise, it is the trendline that is important as individual numbers can vary widely. As do blood tests from session to session. 

Wishing you the best of luck on your quest.

Quote:Atrial fibrillation and managing stress

Stress can contribute to heart rhythm disorders (arrhythmias) such as atrial fibrillation. Some studies suggest that stress and mental health issues may cause your atrial fibrillation symptoms to worsen. High levels of stress may also be linked to other health problems. Coping with your stress is important for your health. 


Quote:Is obstructive sleep apnea associated with cortisol levels? A systematic review of the research evidence

The pathophysiology of obstructive sleep apnea (OSA) has been associated with dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis; however, a relationship between OSA and altered cortisol levels has not been conclusively established.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#4
RE: Cortisol Level Changes After Starting CPAP
Thanks for the reply.
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#5
RE: Cortisol Level Changes After Starting CPAP
I'm not "compulsively" monitoring for afib. I'm not particularly stressed about this at all.  In any event, I'm not anti-arrhythmic drugs.   I don't have a history of afib.   The only episode I've had was due to sleep apnea.  This was my cardiologist's determination.  It hasn't since re-occurred.  That doesn't mean it won't or can't but he feels the overall chances of it are trending downward, now that I'm working on diet and lifestyle changes and using a CPAP.  Nothing in my bloodwork indicates an endocrinology-related issue.  My hormone levels other than cortisol are normal and there's no thyroid dysfunction detected, so that's been ruled out.

I'm considering OSCAR.  

My sleep doctor has stated that she doesn't believe a bi-level device is appropriate for me because I have OSA, not CSA.   My insurance wouldn't cover a bi-level for that reason as well.  The auto is working just fine for me, so far.


Just to be clear, I'm not obsessing about numbers.  I'm not sure if I'm "giving off" this idea but that's not at all where I'm at.   I am just looking for comparative experiences.  
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#6
RE: Cortisol Level Changes After Starting CPAP
Welcome to the forum. Which Airsense 10 model do you have? It will be on the front of the machine to the right of the round knob and near the bottom. It will say CPAP, Elite, Autoset, or Autoset for Her. Hopefully you have one of the two autoset models. If you have the CPAP is is not data capable and you can't use OSCAR software. The other models are all data capable and you will benefit from using the free OSCAR software which provides detailed information on your therapy. It is available here: https://www.sleepfiles.com/OSCAR/

You will need an SD card to collect data for OSCAR. Your machine may have come with one but it has been become less common. Any SD card from 8-32GB will be fine. Above 32GB won't work. If you can use OSCAR and post data here we can advise you on your machine settings. It's not unusual for the prescribed settings to be less than optimal
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#7
RE: Cortisol Level Changes After Starting CPAP
Glad to hear all is well and this might be one of those random transient episodes. Glad it is all hand;ed on the medical front.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#8
RE: Cortisol Level Changes After Starting CPAP
"My sleep doctor has stated that she doesn't believe a bi-level device is appropriate for me because I have OSA, not CSA."

either your doc said something a little more nuanced than that or she's confused. a straight bilevel like resmed vauto is not designed to treat central apnea. you'd want asv for that. a bilevel like the vauto is a more versatile machine than apap and is for treating obstructive issues.
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#9
RE: Cortisol Level Changes After Starting CPAP
(04-29-2021, 02:19 PM)Melman Wrote: Welcome to the forum. Which Airsense 10 model do you have? It will be on the front of the machine to the right of the round knob and near the bottom. It will say CPAP, Elite, Autoset, or Autoset for Her. Hopefully you have one of the two autoset models. If you have the CPAP is is not data capable and you can't use OSCAR software. The other models are all data capable and you will benefit from using the free OSCAR software which provides detailed information on your therapy. It is available here: https://www.sleepfiles.com/OSCAR/

You will need an SD card to collect data for OSCAR. Your machine may have come with one but it has been become less common. Any SD card from 8-32GB will be fine. Above 32GB won't work. If you can use OSCAR and post data here we can advise you on your machine settings. It's not unusual for the prescribed settings to be less than optimal

Hi there!  I have the Autoset For Her.  The machine does have an SD card but my insurance sent me kind of a scoldy introduction to your machine note and told me never to take the SD card out?
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#10
RE: Cortisol Level Changes After Starting CPAP
The SD card needs to be in when your using the machine to collect data. It does no harm to take it out to transfer data to your PC for OSCAR. And there is no way your DME would know it was taken out. Your DME, insurance, or Dr. cannot see data on the SD card unless you physically take it to them. I've never has that request. In fact my Dr. does not want to see my card because she doesn't have software to read the data. Glad you have the autoset for her. it's the best machine.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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