AHI soars after surgery

[golfergal]

This is my first post here. I've used Cpap for about a decade with success, and my AHI hovers between 3-6 nightly. I don't know how to access more information than the AHI and number of hours used and cannot change any settings on my own so cannot provide more information than that. I use the Dream Maker (???) machine.

I had a total hip replacement about two weeks ago and since then my AHI has soared to as high as 28. I had a spinal with sedation and am taking Tramadol and Tylenol around the clock, along with Nerontin and Meloxicam. I anticipate being able to get off the Tramadol in another week.

Is a heightened AHI to be expected after major surgery? I'm forced to sleep on my back so is that part of it? Is this alarming or something that will resolve on it's own as I recover and am in less pain?

[Julie]

Yes, it's very possible the anesthetic is still affecting things, but why do you say you can't change settings yourself? We can help with that - 3 to 6 is actually on the high side of 'good', even if MDs are happy with being under 5.

[Pugsy]

Higher usual AHI is very common post surgery of any kind.
Your meds can sometimes cause central apneas for one thing and sleeping on your back can of course potentially make the obstructives worse and cause a need for more pressure but most doctors wouldn't want to change the pressures just for potential post surgical changes.

What is the event category of the AHI breakdown. If mostly centrals/Clear airway events...more pressure wouldn't help those anyway.
And if you aren't sleeping well in general there can also be a lot of awake/arousal related flagging of events and if you aren't asleep they don't count anyway.

If it were me I would chalk it up to meds and overall sleep quality related to the surgery and wait until I was off the meds and see what happens.

[chunkyfrog]

I agree with the others.
Post-surgery drugs and residual pain can affect your sleep immensely.
Those of us with diabetes have the additional "delight" of crazy blood sugar levels-
-both highs, but especially lows.

[golfergal]

Thanks for the reassurances and responding so quickly!

I've not been shown how to change or get into the settings (beyond the simple AHI easily accessed) and don't see my machine listed to get to those instructions when I poked around this site.

I'm okay with not being able to change the settings but I'd like to be able to answer the specifics you asked for.

Meanwhile, tonight I may try doing without the painkillers. I'm getting to the point where that's increasingly a possibility.

I have the Philips Respironics Dream Station.

[Pugsy]

If you ever want to change something and need to get into the clinical menu set up area it's just a combination of a little button pushing.
The provider/clinical manual explains how.
Go here and request the manual for your machine via email. It's good to have anyway because it explains some of your machine's features in a little more detail. Instructions are about 2/3 down the page on where to email and what to say in the subject line. You will likely get a combo manual that covers several models but how to get to the setup menu area is the same with all Respironics machines.
It's set up for an auto response kind of thing which is why the Subject line of the email you send requesting the manual is important.
So word the subject exactly like it shows on the list of manuals they have available. I always just copy then paste it so I don't spell something wrong.

https://www.apneaboard.com/adjust-cpap- ... tup-manual

Bear in mind that if your AHI is still a bit high when off meds but you didn't sleep so great that some of what is flagged could be false positive awake/arousal flagging happening. I had it happen a couple of months ago...AHI 9.4 which is unusually high for me but I happened to sleep worse than usual that night because of a lot of back pain from overdoing it out in the garden that day. 90% of the AHI was false positives.

[chunkyfrog]

Pugsy needs a bobcat.

[golfergal]

@Pugsy, You are speaking a foreign language to this confused senior, but I do know enough that I can request and download the manual and see where that brings me. Thank you for that. I've always been a bit miffed I couldn't get 'into' the machine and they wouldn't trust me to not mess with the settings. For goodness sake, during Covid and me being high risk, they wouldn't trust me to adjust it with their guidance?

Having a bad day with some unsettling (but minor) hip complications - can you say BLEEDING we couldn't stop? - so after a trip to the hospital and pending PT visit, this may end up waiting until tomorrow.

I did forgo the Tramadol last night without too much additional pain. AHI (only number I can access until I get that manual) went from a 28 to a 12.8 so I'm hoping that will continue to improve as my pain level goes down and my meds can be decreased. I'm never much better than a 5 (which my doctor is fine with) but I feel I can maybe do better than that eventually.

[chunkyfrog]

We are all miffed--hence the forum.

Strength in numbers . . .

[nicholasjh1]

Am I the only one who gets less AHI when they sleep badly? any time I am awake my AHI is 0.