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Altitude and Sleep apnea
#2932 03/11/10 10:41 PM
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As I gear up and start shaping up for my next attempt on Whitney, I am finding myself with new partners. Due to a knee injury sustained two years ago on our last attempt, Mom won't be hiking with me this year.

However, I have managed to garner myself a new partner (both on the trail and in my life wink ). However, this particular partner suffers from sleep apnea and uses a CPAP machine at home when he sleeps at night. This is a new realm for me as I've never really dealt with apnea before.

I am looking for any information pertaining to experience that any of you guys have had with apnea at altitude. We're looking at a multiple night trip and short of packing his CPAP and a solar charger up the mountain... I'm basically wondering if altitude makes things worse or effects it at all....

Thanks guys (and gals)!

Re: Altitude and Sleep apnea
SoCalGirl #2933 03/11/10 11:08 PM
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Hah! I have a mild case myself, but I got the dentist to make me a mouthpiece that I wear when I sleep. I haven't actually done a test to see if it really helps, but my wife tells me I don't snore as violently, so I think it's working. (There was just no way I was going to sleep the rest of my life wearing a CPAP mask.)

I find that sometimes I take the mouthpiece out of my mouth in my sleep, too. But nothing bad happens.

This may be dangerous advice, so for what it's worth... How bad is his case? If not too severe, what happens if he just goes without the machine while camping? My snoring and apnea occurs while I am on my back, so if he's like me, maybe he can work at staying on one side.

Re: Altitude and Sleep apnea
Steve C #2934 03/11/10 11:19 PM
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Steve... he snores no matter how he's laying.. thankfully I've never witnessed an episode of his apnea... would probably scare the pants off of me!

He has slept without it (refused to wear it when we first started dating)... but he doesn't sleep worth anything when he doesn't have it on. So I know that he can sleep without it.... I'm just worried about how altitude is going to affect teh apnea...

Re: Altitude and Sleep apnea
SoCalGirl #2935 03/12/10 12:43 AM
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Then he has a different scenario than me -- I never knew I had a problem, usually felt rested no matter what. It was my wife who told me about it. I'd be snoring, then just stop breathing for half a minute, gasp a little, then start breathing again. Not a real big deal.

Since it helps him get the necessary rest, I'd drag the thing along for car-camping, but forget it on the trail.

Re: Altitude and Sleep apnea
Steve C #2941 03/12/10 10:13 AM
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I qualify the following response by saying that I am not a doctor, and that this response is from my own experience as the spouse of someone with sleep apnea who wears a CPAP, and from the "homework" we have both done concerning this condition (but not at altitude).

Quote:
I'd be snoring, then just stop breathing for half a minute, gasp a little, then start breathing again. Not a real big deal.

30 seconds is a big deal, esp. if it happens regularly. If you're having 10- to 30-second episodes throughout any given night, then you should seriously consider having a sleep study done, Steve.

See the information contained here. It will take some time to read, but is well worth it.

My wife has sleep apnea and has been using a CPAP since last September. She had a sleep study done just before then. During the sleep study, if you have a certain number of apneas during I think it's a one-hour period, they will wake you up and put you on a CPAP machine for the rest of that night. This happened to my wife very early in during her overnight stay for the study.

The primary consideration with sleep apnea is the low oxygen level that occurs in your body each time you have an "apnea" (defined as 0-25% air intake for longer than 10 seconds). Given the primary importance of oxygen to the body, the cumulative consequences of a low oxygen level during the sleeping hours every night can be significant.

While I can't speak from personal experience concerning sleep apnea at higher altitudes (perhaps Ken may have something more authoritative he could add), given the lower overall amount of oxygen available at altitude (and I understand that it's the same oxygen/nitrogen ratio at any altitude), I would not be surprised if sleeping at altitude exacerbates any existing apnea episodes, absent the use of the CPAP at altitude. I don't have sleep apnea myself, but I know that when I sleep at altitude, I have the same experience many others have at altitude of flying up out of bed in the middle of the night every once in a while, gasping for air. I can only imagine what effect sleep apnea might produce in an already oxygen deprived sleeping-at-altitude environment. At the least, it would probably make for a restless and uncomfortable night; at the worst, it could probably exacerbate the already low oxygen levels caused by the sleep apnea condition itself.

As for the mouthpiece Steve mentioned, it may be useful in mild non-apnea snoring; but I doubt it would be of any real help with actual sleep apnea. The CPAP machine forces air into the airway to keep open the part of your airway that is obstructed (in Obstructive Sleep Apnea -- one of three kinds of sleep apnea). If the CPAP air pressure levels are set correctly for your individual needs, then the snoring and low oxygen levels caused by sleep apnea should resolve. A mouthpiece can only mechanically modify your jaw position; it cannot provide the added air pressure needed in true sleep apnea.

Quote:
Since it helps him get the necessary rest, I'd drag the thing along for car-camping, but forget it on the trail.

Yes, although if I'm not mistaken, CPAP machines can be run on some kind of a battery operation for at least one night at a time (with recharging each day), if you have that kind of an accessory (I'm not sure whether or not that is standard equipment or optional).

CaT


If future generations are to remember us with gratitude rather than contempt, we must leave them more than the miracle of technology. We must leave them a glimpse of the world as it was in the beginning, not just after we got through with it.
- Lyndon Johnson, on signing the Wilderness Act into law (1964)
Re: Altitude and Sleep apnea
CaT #2943 03/12/10 10:22 AM
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> 30 seconds is a big deal, esp. if it happens regularly. If you're having 10- to 30-second episodes throughout any given night, then you should seriously consider having a sleep study done, Steve.

BTDT. (Been there, Done that) I had 5 episodes during the sleep study. Fun, by the way -- trying to sleep with about 20 wires hooked up to your body and scalp, including sticky gooey stuff to keep them attached in the hair.

That's how I got the oral appliance from my dentist. Cost ~$1500, but insurance paid for most of it.


> As for the mouthpiece Steve mentioned, it may be useful in mild non-apnea snoring; but I doubt it would be of any real help with actual sleep apnea.

The mouthpiece pulls the jaw forward and thereby pulls the tongue and tissues forward as well. It seems to be enough, for me anyway, to alleviate the blockage that results in the breathing obstruction.

That being said, I still need to do a subsequent sleep monitor night to see if it prevents the low-oxygen episodes. Before the sleep study, I wore a recording pulse-oximeter one night supplied by my doctor. It showed a number of low-oxygen episodes, so then the doctor prescribed the sleep study.

But like I said, I've never felt like I needed more sleep ...except for the normal drowsiness that I experience when I don't put in enough hours in bed. wink

Re: Altitude and Sleep apnea
Steve C #2944 03/12/10 11:16 AM
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Quote:
except for the normal drowsiness that I experience when I don't put in enough hours in bed.

BTDT ... doin' it now, until this musical I'm involved in is over at the end of next week.

CaT


If future generations are to remember us with gratitude rather than contempt, we must leave them more than the miracle of technology. We must leave them a glimpse of the world as it was in the beginning, not just after we got through with it.
- Lyndon Johnson, on signing the Wilderness Act into law (1964)
Re: Altitude and Sleep apnea
SoCalGirl #2949 03/12/10 02:15 PM
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Day hike it. In, out, burger, T shirt. Train for a day hike and execute as a day hike. With training and the right attitude, Mount Whitney can be tamed and safely bagged as a day hike. By pretty much anyone. I took two rookies up last year, one the year before and have two more scheduled this year. Think DAY HIKE, embrace it and do it. If you don't make it the 1st time, train harder and return. I can think of 5 or 6 people who would drop everything to get on your day hike team.

Sleep? Over rated...................................DUG

Re: Altitude and Sleep apnea
DUG #2950 03/12/10 02:24 PM
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Quote:
Sleep? Over rated

Until the lack of it bites you in the a$$.


If future generations are to remember us with gratitude rather than contempt, we must leave them more than the miracle of technology. We must leave them a glimpse of the world as it was in the beginning, not just after we got through with it.
- Lyndon Johnson, on signing the Wilderness Act into law (1964)
Re: Altitude and Sleep apnea
CaT #2951 03/12/10 02:29 PM
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Originally Posted By: CaT
Until the lack of it bites you in the a$$.


Amen! Poorly rested = poorly prepared, at least for myself.

Re: Altitude and Sleep apnea
CaT #2955 03/12/10 05:31 PM
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Odd, I've never slept on a day hike. I thought maybe one would sleep PRIOR to the hike.

It's getting so you can't sneeze on a Whitney board without being judged.

Chrissy - ANY time you and your man want to make a day hike attempt LMK and I'll be there.

Steve - feel free to nuke me completely off here. These folks don't know me, they don't understand me and .......................

Doug

Re: Altitude and Sleep apnea
DUG #2956 03/12/10 06:17 PM
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DUG, these guys know you. I think they forgot to add the smirk after their posts.

We all know you're the master of the "start at midnight, all-day and all-night marathon" hikes.

Re: Altitude and Sleep apnea
Steve C #2959 03/12/10 06:55 PM
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Last summer, there was some discussion about challenging DUG & Moose on some epic day-hikes. We have not forgotten...


Verum audaces non gerunt indusia alba. - Ipsi dixit MCMLXXII
Re: Altitude and Sleep apnea
wagga #2962 03/12/10 07:12 PM
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(my money's on Laura)


Mike
Re: Altitude and Sleep apnea
Mike Condron #2963 03/12/10 07:18 PM
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Remember when the "Jaws" character in "Butch Cassidy & the Sundance Kid" challenged Butch & agreed "No Rules". No rules.


Verum audaces non gerunt indusia alba. - Ipsi dixit MCMLXXII
Re: Altitude and Sleep apnea
wagga #2964 03/12/10 07:40 PM
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Laura has the edge then.


Mike
Re: Altitude and Sleep apnea
Mike Condron #2965 03/12/10 07:52 PM
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What about the chocolate factor?


Verum audaces non gerunt indusia alba. - Ipsi dixit MCMLXXII
Re: Altitude and Sleep apnea
wagga #2969 03/13/10 10:24 AM
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Not taking sides here but DUG is the origional Marathon hiker man. As in "da man".Midnight to Midnight it would be hard to take anyone over DUG.
That whole challenge thing was by our good friend Richard.We never did figure out what the hell he wanted out of challenging DUG

Last edited by Rod; 03/13/10 10:24 AM.
Re: Altitude and Sleep apnea
Rod #2972 03/13/10 10:58 AM
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Re: Altitude and Sleep apnea
DUG #2973 03/13/10 05:02 PM
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DUG -- Apologies. No offense intended. My comment was more aimed at a cumulative lack of sleep over a long period of time, not related at all to just individual dayhikes. If I misinterpreted your post, I'm sorry.

Sneeze away, my friend.

CaT


If future generations are to remember us with gratitude rather than contempt, we must leave them more than the miracle of technology. We must leave them a glimpse of the world as it was in the beginning, not just after we got through with it.
- Lyndon Johnson, on signing the Wilderness Act into law (1964)
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