Oxycodone and CPAP Events - relationship

Posted by rjjacobsen @rjjacobsen, May 11, 2023

Had surgery last week to repair a torn labrum and take out arthritic spurs in the shoulder/collarbone (AC joint). Since surgery and meds (5/325 mg Oxycodone/acetaminophen every 6 hours along with acetaminophen to the total maximum of 4,000 mg), my CPAP AHI events per hour have jumped to over 12 over the past week. - 3 days over 20, 1 over 30! I don't feel exhausted - I usually feel awful after a night with high AHIs.

The CPAP app sent me an e-mail to check with therapist. Therapist didn't know but told me not be concerned with it.

It's not moving from recliner to bed after a few days. It's not related to activity - activity levels are increasing per surgeon's guidance. Pain levels are 4 of 10 with the meds - tolerable, but could be better.

Caused by the oxycodone?
By the residual pain?
CPAP broken in transit between hospital/home?

Thoughts?

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Opiates can work in brains of narcolepsy to reverse symptoms such as fatigue and cataplexy. They tend to promote wakefulness in some of us. Research it there's more than a few papers/studies on this.

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Be cautious. I was prescribed Percocet for kidney stones and my numbers went through the roof. Percocet slowed my system to include my breathing. I would wake up gasping, even with the CPAP. It is in my charts that I can NO LONGER take Percocet as it slows the respiratory system.

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Hi. Do you have access to your CPAP data from your CPAP manufacturer? I have a Resmed, and I can run reports to find out if something is wrong. One example is you can tell if you have leakage which could cause events to go up some. I take opiates for my neck and my events average rarely goes above 2. Of course that's just an anecdote, not a scientific study. I would check the stuff @sleepstate mentioned about studies.

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@timbrownfl

Hi. Do you have access to your CPAP data from your CPAP manufacturer? I have a Resmed, and I can run reports to find out if something is wrong. One example is you can tell if you have leakage which could cause events to go up some. I take opiates for my neck and my events average rarely goes above 2. Of course that's just an anecdote, not a scientific study. I would check the stuff @sleepstate mentioned about studies.

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Thanks.

I have the app which is helpful - I've not tried any reports yet. The last week, the events were down some, but still abnormally high. But the new wrinkle this week is mask leakage. Whenever I go to sleep initially or a return, I do a leak check, but my movements must dislodge it. I replaced the cushion to no effect, so will have to try things to keep that mask in place.

I am working down the percocet frequency down, but also started PT and they said use it if you need it.

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Hi again. I just wanted to share that I was on my eighth mask when I finally got the leaks to stop. I now use a hand held mirror to check the fit for the pillows, and no leaks for months. Hope that helps.

-Tim

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@timbrownfl

Hi again. I just wanted to share that I was on my eighth mask when I finally got the leaks to stop. I now use a hand held mirror to check the fit for the pillows, and no leaks for months. Hope that helps.

-Tim

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Thanks for the tip about the hand held mirror. I usually use my fingers to sense for leaks during the leak test.

I've used this same mask type for years without issue. I did rebalance the strap length and tighten them a bit and that helped last night. Also had tried raising my pillow to ease pain which failed, so went back to the old height.

The problem is more because of a LOT of movement at night (as detected by my fitness tracker) to alleviate pain - both chronic back/neck pain, and pain from the recent shoulder surgery.

Just have to keep adjusting stuff until it works well.

The original problem with high events is still there - last night I forgot the percocet and still had high events.

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