OSA and high altitude

Hello Everyone!

I am a new user and just got diagnosed with Obstructive Sleep Apnea. The machine has not even arrived yet (I am not even sure what machine Kaiser Permanente is sending me, they said it was a self adjusting CPAP but wont tell me the make or model... or what type of mask or size or really any information).

I got a 19.5 on the Apnea Hyponea Index score, my oxygen saturation decreased down to 85%, and they recommend an air pressure level of 8 cm of water. That was all via a private message from my doctor on kp.org and I have not spoken to my doctor yet. I have no idea if that is minor, or sever, or life threatening, or nothing to worry about. This whole process I have been through seems to be one hurdle after another with me only knowing the tinyest amount of information.

Anyway, I enjoy camping have a backpacking trip planned in 3 weeks that will have me sleeping 2 nights up at 10,000 vertical feet in the snow with hikes up to 11,500+. This obviously has me concerned after hearing my O2 saturation level dropped to 85% in my sleep at sea level. Do anyone have any experience with this? I have not even found one CPAP that is rated for that altitude, what happens when one pushes a machine higher then it was designed for? Is it really risky after seeing my test information I listed above?

You are on the medium level. Pressure as no relationship with severity.

The big issues is how do you plan to use your machine while camping. You will need batteries unless where you are staying has power. The elevation can be dealt with by increasing the pressure a bit. You may want to rethink this trip until you are comfortable using the cpap machine and have had a chance to figure out how you will power it.

An AHI of 19.5 is considered moderate.

The scale goes
mild - 5 to 15
moderate - 15 to 30
severe - above 30

In this topic - viewtopic/t42831/Altitude-equivalent-of ... ssure.html

Wulfman says: If you have the REMstar Pro 2 (as listed in your profile), it DOES have altitude compensation.
Rule of thumb......
All of the "data-capable" machines in the Respironics and ResMed lines have altitude compensation......and probably most of the other manufacturers lines, too.
Non-data-capable machines do not have that feature and have to be manually adjusted.

To h--l with apnea; Where we going hiking? Sequoia, Whitney, Rea Lakes Loop?

I always woke up with a headache at altitude prior to CPAP, now I don't. Just so you know what to expect if your cpap isn't just right.

BlackSpinner wrote:The big issues is how do you plan to use your machine while camping. You will need batteries unless where you are staying has power. The elevation can be dealt with by increasing the pressure a bit. You may want to rethink this trip until you are comfortable using the cpap machine and have had a chance to figure out how you will power it.

I agree I need to figure out the power, but I can't do that without figuring out the CPAP machine first (12v vs 19v vs 24v along with the amp required will make a big difference in battery choice). However I am really stuck on machines at this point, see my response to Sleepy Pete below.

Rethinking this trip is pretty much why I am here, just want to make sure I can do it safely. During the sleep study, 1 night in a center, I had no issue falling asleep with the mask and CPAP on, so I am less concerned with comfort then technical logistics at this point. But it is a concern since that is the only time I have ever used a CPAP.

Sleepy Pete wrote:An AHI of 19.5 is considered moderate.

The scale goes
mild - 5 to 15
moderate - 15 to 30
severe - above 30

In this topic - viewtopic/t42831/Altitude-equivalent-of ... ssure.html

Wulfman says: If you have the REMstar Pro 2 (as listed in your profile), it DOES have altitude compensation.
Rule of thumb......
All of the "data-capable" machines in the Respironics and ResMed lines have altitude compensation......and probably most of the other manufacturers lines, too.
Non-data-capable machines do not have that feature and have to be manually adjusted.

Thank you for the information on my AHI, I find it comforting to know where I stand. With Kaiser not even talking to me about the results, other then a short email/message, is pretty frustrating and disconcerting. I now have an appointment to chat with my regular doctor tomorrow.

The problem I am running into when looking at them is that every machine I look at seems say "Altitude Adjustment" or "operating altitude" in the range of 8,000-9,000 ft (example: Transcend Auto says "Auto Altitude Adjustment : Up To 8000 feet"). What I don't know is if I can exceed their value through manual adjustment, since on the trip I will be sleeping at 10,000 ft, or if doing so is simply unsafe.

hobbs wrote:To h--l with apnea; Where we going hiking? Sequoia, Whitney, Rea Lakes Loop?

Heading to Rock Creek Lake area of the Eastern Sierras as part of the Sierra Club WTC course. 3 day, 2 night trip. I have never been there before but the trip sounds fun!

I love the sentiment! I am just not sure if I am feeling cautious about it because having OSA is all new to me and that has me concerned, or if doing something like this is really risky.

Based on my limited experience with kaiser I think you will get a Philips Resperonics System one 560P Auto.
You can now Google that machine for altitude specs. Everything I have seen suggest 8,000 to 8,500 feet. I have never seen what happens if you use it above that elevation.
I don't know your age or physical condition, but the combination of being new to CPAP, the elevation, cold and snow would cause me to reconsider. My son on the other hand would probably consider it an easy weekend, he is 48.

There have been many threads about battery power for the PRS one series 60 units. I haven't read much past the headlines.

Most likely you will get the PR System One 60 Series Auto CPAP as that seems to be what Kaiser is dispensing lately.
https://www.cpap.com/productpage/pr-sys ... ations-tab
It has automatic altitude compensation up to 7500 ft. To my knowledge there is no way to manually adjust it for higher altitudes.
I will share this with you though. Last summer I took my PR S1 Bipap (also says up to 7500 ft) to the mountains in Utah and I slept at a little over 10,000 feet without any issues at all in terms of therapy or sleep. The machine still seemed to work perfectly and my reports were pretty much what I expected to see and had been seeing at home.

Now where I was camping at we had electricity at the campsite so I didn't have to worry about that aspect of things but I suspect that even if I had used a battery that things would have still worked out just fine.

Camdiggy wrote:

BlackSpinner wrote:

hobbs wrote:To h--l with apnea; Where we going hiking? Sequoia, Whitney, Rea Lakes Loop?

Heading to Rock Creek Lake area of the Eastern Sierras as part of the Sierra Club WTC course. 3 day, 2 night trip. I have never been there before but the trip sounds fun!

I love the sentiment! I am just not sure if I am feeling cautious about it because having OSA is all new to me and that has me concerned, or if doing something like this is really risky.

Go for it! I was diagnosed in 2003 and had always spent 5-6 nights a year hiking the Sierras on trails that went above tree line, 9K feet +. I did not know I had SA, but always knew I felt better at higher altitudes. It looks like they will show what it took me 30+ years to learn.

My favorite part of the Sierras with Mt. Whitney in the background;

http://www.wildernesstravelcourse.org/the-course

Camdiggy wrote:

BlackSpinner wrote:The big issues is how do you plan to use your machine while camping. You will need batteries unless where you are staying has power. The elevation can be dealt with by increasing the pressure a bit. You may want to rethink this trip until you are comfortable using the cpap machine and have had a chance to figure out how you will power it.

I agree I need to figure out the power, but I can't do that without figuring out the CPAP machine first (12v vs 19v vs 24v along with the amp required will make a big difference in battery choice). However I am really stuck on machines at this point, see my response to Sleepy Pete below.

Rethinking this trip is pretty much why I am here, just want to make sure I can do it safely. During the sleep study, 1 night in a center, I had no issue falling asleep with the mask and CPAP on, so I am less concerned with comfort then technical logistics at this point. But it is a concern since that is the only time I have ever used a CPAP.

You also have to consider that you will be backpacking several pounds of brand new electronics worth at least $1000 + dollars plus battery along with all your other stuff up that mountain in any sort of weather. It could pour all day and night. Many of us have older, back up machines we use in that sort of condition.

Thanks all for the replies!

Kaiser finally actually talked to me about the report rather then just send me a summary via email! (I have liked Kaiser a lot in the past but the hoops and jumps and lack of information given for this this sleep study has been ridiculously bad). I vented hard to my regular doctor yesterday and he got one of their sleep specialists to call me. It was a good conversation but I am still slightly annoyed that they ordered me a mask without ever sizing me for it or going over mask types with me.

It sounds like they are sending me a PR System One REMStar 60 Series Auto CPAP Machine with some type of PR mask.

She sounded fine with the trip as long as I was using the CPAP on it, was comfortable wearing it, and hydrate well. So that is at least hope for the trip yet and has me more calm about it. At least I have a game plan and the REMStar 60 Series Auto looks like it has pretty easy power requirements even if it is a bit of a heavy machine.

Thanks for the encouragement everyone and that is a great picture Hobbs, we will have to go backpacking there sometime!

Electrical equipment can have issues at high altitude due to the way electricity is conducted or insulated against. If you're interested you can learn more about this at http://www.frontdoor.biz/HowToPCB/HowTo ... arance.pdf. This is why electrical medical devices are certified to a standard that includes limits for altitude, as well as other things such as humidity, any expected exposure to flammable liquids or gases, etc. Generally device manufacturers meet the requirements of industry / regulatory standards and don't test outside those ranges, although if a significant portion of their intended users do they may test and certify to limits beyond the standards.

On a different note - I live at 7200 feet elevation and despite my machine having altitude self-adjustment, I do find I need to adjust pressure slightly down when I travel to sea level or somewhere in between. I also must use humidification here, whereas someplace fairly humid I not only don't, but can't.