"please keep me updated about oximeters "
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Going to rely on AI rather than AHI
I have been posting for quite a while about my inability to get my AHI below 5. Sometimes I can get my AI below 5, but never the AHI. This has been very hard for me. I'm 100% compliant and two doctors have failed to titrate me to a low AHI- at low to very high pressures. I take a number of psychiatric meds, plus vicodin for back problems and severe leg pain- all very necessary meds and I'm as conservative as possible. A few recent experiences where I received fentanyl and versed (for a lower spine injection) when I was in recovery ( it wears off very quickly- they don't give you much and I'd only stay about 15 minutes afterwards) the apnea monitor kept going off. I have come to the conclusion that my meds are causing hypopnea during the night and as long as my apnea events are under five I'll be happy.
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Replies to This Discussion
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Permalink Reply by Mary Z on
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I have now come to quite a different conclusion. As many members on the forum have told me in the past, the vast number of psychiatric and pain meds that I take may be causing my bad numbers. I have been resistant to the idea, in part because my psychiatrist does not believe my meds are causing my poor results, and in part because I am scared to decrease or change my meds. I have now found a non-narcotic med that helps to control my leg and back pain at night so that I can sleep and hope to top or markedly reduce my use of vicodin. I will systematically go though my meds, starting with the most sedating and make a concerted effort to reduce or stop them.
I also did a very foolish thing- Mike called it "snake oil" when he first came across it, but I have tried an oral herbal preparation for snoring and sleep apnea. It has not made one iota of difference in my numberes. Fortunately it was not that expensive.
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Thanks Mike, I am glad to hear this. I'll try benadryl for sleep instead of the lunestsa, and slowly start working the klonopin down.
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Permalink Reply by Pennywisezzz on
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Have you tried different sleeping positions? Recently I bought a bunch of new pillows so I could sleep on a 45 degree angle (semi-fowler's). I sleep mostly on my side, sometimes my back if I am on an incline. If has made a difference for me, I am waking up less often. No more sore shoulders waking me up. No more repositioning all night long. Sleeping on an incline makes my airway feel less constricted.
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Mary Z
You are probably creating sleep deprivation by worry so much about your AI or AHI. Concentrate more on are you getting the therapeutic results desired for treatment of OSA. Do you feel better during the day, do you have excessive daytime sleepiness, do you have HTN and if so is it controlled, are you still snoring???? if these problems still exist then you need to see your sleep specialist. Thanks
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No sleep deprivation or HTN, just frustration that two sleep doctors and all the sleep tests haven't gotten me properly titrated. The past three nights I had better numbers- I switched to a new medicine that has dramatically reduced my use of vicodin and have decreased my klonipin. I haven't tried sleeping on an incline, but if this present trend doen't continue I'll give that a try. Thansk for your responses Pennywisezzz and Bradley.
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Hi Mary, I dont know what your specific maladies are but having had plenty myself I have found a good phycal therapist and minimising meds to be the most helpful. I hope you find restful sleep,Chris
Mary Z said:
No sleep deprivation or HTN, just frustration that two sleep doctors and all the sleep tests haven't gotten me properly titrated. The past three nights I had better numbers- I switched to a new medicine that has dramatically reduced my use of vicodin and have decreased my klonipin. I haven't tried sleeping on an incline, but if this present trend doen't continue I'll give that a try. Thansk for your responses Pennywisezzz and Bradley.
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Mike C, I don't use fentanyl regularly- just had it once for a back injection. I do take vicodin, but have been able to dramatically reduce my use since finding a NSAID that really helps with the pain. Without it I would not sleep at night. I have also reduced my use of Klonopin by 1/3 and am working on reducing it further.
Thanks for your concern and advice. I know what that one dose of fentanyl in the daytime did to me- and it was just a small amount.
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Permalink Reply by RockRpsgt on
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Why doesn't your psych believe that the medications could be causing the problems? have you researched any of the meds and their effects on sleep?
Mary I know that the process has not been easy for you. I have learned many things from your specific case just by researching the varius problems that you have encountered. Your case presents many of us with unique circumstances that not very many sleep professionals have encountered. You have to admit that OSA, Deep Brain Stimulation, and chronic pain are not very typical for any doc let alone a tech. Fixing sleep is a process that involves both troubleshooting skills and patience from all involved. Despite your frustration with the process I believe that your personal experiences with your therapy have brought you to a good place. If you do not believe me go back and read some of your first post as I have. You are not the same person. I know that it has not been an easy journey, but I envy the clarity I see you obtaining about your personal well being. You are one of my heroes.
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I've researched all the psych meds and the klonopin is the only one that could be causing problems. None of the others cause respiratory depression. Those meds are a matter of feeling suicidal or spending uncontrollably or being otherwise manic in other destructive ways. We're still constantly working on using the minimun doses of these drugs.
I've already seen a difference in my numbers by cutting down the vicodin by more than half. I know it's a trade off, but it took me a long time to even admit to myself that some of my meds could be causing my bad numbers. If I can keep up the trend of the past couple of days I'll be happy- it's a big difference. AHI under 8 and AI under 2. I plan to cut the vicodin by half starting today so that should be a big help.
Thanks for your feedback. I've been pretty stubborn on the meds as I can't sleep due to severe hip and back pain without something (finally found a NSAID that works). I've had ECT and been hospitalized plus gone through a bankruptcy due to my Bipolar disorder so that really scares me. Still I recognize the effects of undertreated OSA.
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Respiratory suppression is only one side effect of certain meds. Apnea is not a a respiratory function. The majority of bad sleep is caused by neuromuscular problems. Look for ways your meds affect this area. Meds that cause problems with certain stages of sleep can also limit or amplify our sleep problems. Anti-depressents and psychotics can greatly manipulate our sleep cycles.
It could also be the specific cocktail that you are prescribed.Very little research has been done on meds and sleep let alone the varius combinations that many people are on.
Mary Z said:I've researched all the psych meds and the klonopin is the only one that could be causing problems. None of the others cause respiratory depression. Those meds are a matter of feeling suicidal or spending uncontrollably or being otherwise manic in other destructive ways. We're still constantly working on using the minimun doses of these drugs.
I've already seen a difference in my numbers by cutting down the vicodin by more than half. I know it's a trade off, but it took me a long time to even admit to myself that some of my meds could be causing my bad numbers. If I can keep up the trend of the past couple of days I'll be happy- it's a big difference. AHI under 8 and AI under 2. I plan to cut the vicodin by half starting today so that should be a big help.
Thanks for your feedback. I've been pretty stubborn on the meds as I can't sleep due to severe hip and back pain without something (finally found a NSAID that works). I've had ECT and been hospitalized plus gone through a bankruptcy due to my Bipolar disorder so that really scares me. Still I recognize the effects of undertreated OSA.
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