increased AHI

Hello all.
I have been experiencing increased AHIs over the past month. Spoke to my sleep doctor who increased my min Pressure to 8 leaving the max pressure at 12. I had previously been on 4-12 APAP. I have had a procedure done which has caused me a lot of pain and difficulty sleeping on my rt side due to shoulder pain. I am taking Tramadol 50mg 2-3 times a day, but I was taking 50mg Tramadol every evening for over a year. My question is can my AHIs increase due to pain. Nothing else has changed. I know narcotics can effect apneas but I try not to take a pain pill close to bedtime. My AHIs were ranging 1.0-3.5 now they are ranging 9.0-29.0. I am sleeping longer periods since sleep doc increased to 8-12. The high AHIs are scaring me. I will be talking to my doctor soon cause what he changed is not working. I have a mix of CAs and OAs.

The short answer is that lots of things can increase the AHI recorded on an APAP.

We need some additional information before we can say whether the pain is the probable culprit. Or whether it is medication related.

You also write:

My AHIs were ranging 1.0-3.5 now they are ranging 9.0-29.0. I am sleeping longer periods since sleep doc increased to 8-12. The high AHIs are scaring me. I will be talking to my doctor soon cause what he changed is not working. I have a mix of CAs and OAs.

What's gone up the most? The OAs or the CAs? That's kind of important for figuring out what might be causing the problem

Here are two wild guesses about things that might be going on in your case:

1) If the pain is significant enough that it is interfering with the quality of your sleep, you may be waking up a lot more than you realize. And it could be that the machine is scoring more false events as you transition back to sleep. The machine can't tell when you are asleep and when you are awake. And wake breathing can fool it into scoring OAs and CAs. And then it is normal to have a CA or two as you transition from wake to sleep. None of these things would be scored as events on an in-lab sleep test.

2) On the other hand, you could be sensitive enough to the Tramadol that it might be causing you to sleep more soundly and longer than usual. And that the Tramadol might also be causing your airway to be a bit more prone to collapsing now that you are taking more of it for pain. Or perhaps the Tramadol (or other pain mediation) is messing up with your body's CO2 trigger for inhalation once you are asleep.

So how much restlessness does the pain cause you at night? Do you remember waking up a lot in pain? On the other hand, if you do take a pain pill closer to bedtime, do you sleep more soundly? And is the AHI noticeably higher on nights where you take a pain pill "close to bedtime"? And what is your definition of "close to bedtime?"

It would also help if you posted some detailed data so we can see exactly when your events are occurring each night. Without that detailed data, all we can really do is speculate. But if the increase in AHI is mostly due to an increased CAI, increasing the pressure is probably not going to fix the problem.