Do I need a CPAP?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Greendirt
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Re: Do I need a CPAP?

Post by Greendirt » Sat Dec 13, 2014 4:31 am

Please explain how the cpap helped before the pacemaker. How did blowing air down your throat take care of the problem if it was not obstructive sleep apnea.
I've answered that above as best I can. Air is good, and very welcome when there's not enough. I have said I had disordered breathing, so air being blown down helped. But only to an extent.
Do you realize that obstructive sleep apnea does not mean there is an obstruction while awake? The doctor isn't going to find an obstruction just looking down your throat.
Yes.
It sounds like your doctor has given you a false idea of sleep apnea where there must be an obvious physical obstruction.
No. I understand that, and so does my doctor. The point is the symptoms departed following a change that had nothing to do with obstructions.
and please post those sleep studies, especially the one proving you don't have sleep apnea.
Ok.

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Last edited by Greendirt on Sat Dec 13, 2014 6:16 am, edited 4 times in total.

Greendirt
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Re: Do I need a CPAP?

Post by Greendirt » Sat Dec 13, 2014 4:54 am

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Greendirt
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Re: Do I need a CPAP?

Post by Greendirt » Sat Dec 13, 2014 4:58 am

Those scans will be available for 29 days only. They'll drop off the server then.

If I am in error, glad for illumination.

This was a titration study when I was having trouble with pressures. You can see I responded well to CPAP: 6cm of pressure was the outcome. I recall the CPAP was a Phillips.

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Tatooed Lady
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Re: Do I need a CPAP?

Post by Tatooed Lady » Sat Dec 13, 2014 6:54 am

Greendirt wrote:All I can say is that is what happened to me.

My doctor could find no cause of an obstruction. High BMI is a common cause of obstruction. In the absence of that, unusual anatomy is a potential cause. I don't have that either. No other cause for an obstruction was found. It was anomalous until I got the pacemaker and the symptoms went and a sleep study found normal AHI. The Dr was reluctant to order that study since I had no symptoms, but did so in view of the prior diagnosis.

So, the cause for me was not an obstructed airway. Maybe others without an identifiable cause of an obstruction have SA symptoms for another reason too (apart from CSA).

A sleep study report is just a report. It is not true that high reported AHI always means the only diagnosis can be OSA / CSA.
I'm behind here...but a doc was hesitant to do a sleep study...but was OK with a pacemaker?

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zoocrewphoto
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Re: Do I need a CPAP?

Post by zoocrewphoto » Sat Dec 13, 2014 7:04 am

Interesting sleep studies.

I see that you did not sleep on your back during the second one, but you were worst on your back the first time. Perhaps part of the change is that with the pacemaker, you are sleeping differently and staying off your back. You may have positional sleep apnea that is well treated with sleeping off your back. That would explain why the cpap worked for you (because you needed it), but sleeping off your back has allowed you to not need it now. Some people are lucky that way. Do you feel like you sleep in a different position than before the pacemaker?

Also, it looks like almost all of your events were hypopneas, so perhaps shallow breathing was mistaken for flow limitations. Your actual obstructive events were well under ahi of 5, and your oxygen desaturation never went under 90%. So without the hypopneas, you never would have been diagnosed with sleep apnea.

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Who would have thought it would be this challenging to sleep and breathe at the same time?

Greendirt
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Re: Do I need a CPAP?

Post by Greendirt » Sat Dec 13, 2014 7:10 am

but a doc was hesitant to do a sleep study...but was OK with a pacemaker?
After the pacemaker went in there were no sleep apnoea symptoms, so the sleep doc needed to justify doing a sleep study in the absence of symptoms. It wasn't an issue in the end given the prior diagnosis, but it was a fair point on the doc's behalf.
Last edited by Greendirt on Sat Dec 13, 2014 6:20 pm, edited 2 times in total.

Greendirt
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Re: Do I need a CPAP?

Post by Greendirt » Sat Dec 13, 2014 6:16 pm

You may have positional sleep apnea that is well treated with sleeping off your back.
Makes sense. But not sure if that's the whole answer, as you say there is no measurement of the effect of back sleeping post pacemaker.
Do you feel like you sleep in a different position than before the pacemaker?
Yes, I'm like a log on my right side now. I used to move all over the place.
Also, it looks like almost all of your events were hypopneas, so perhaps shallow breathing was mistaken for flow limitations. Your actual obstructive events were well under ahi of 5, and your oxygen desaturation never went under 90%. So without the hypopneas, you never would have been diagnosed with sleep apnea.
How about 'Sleep hypopnea secondary to cardioinhibitory vasovagel syncope presenting as sleep syncope''? LOL! Serious point being that despite a diagnosis of OSA and CPAP helping symptoms, classic OSA wasn't really the problem. Not sure how many others might have other conditions partly masked by an OSA diagnosis and treatment.

Greendirt
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Re: Do I need a CPAP?

Post by Greendirt » Wed Dec 17, 2014 4:03 am

I've taken the limited comment since I posted the sleep studies to indicate there was no particular objection to my view that I never had sleep apnoea, despite the explicit diagnosis 'Severe OSA is evident'. The last study with 0.0 being the main reading for disordered breathing (AHI 1.3 overall) proves I don't have apnoea now. And the only relevant change was the pacemaker.

As was pointed out by zoocrewphoto, the original study showed 8 apnoeas, 1 central and 367 hypopneas in 7:50 of sleep - that's an AHI of 48, 47 of which are hypopneas. And maybe shallow breathing due to a slow heart rate led to those hypopneas being recorded.

I asked the original doctor if the there could be a link: I still remember his eye roll. He did concede that being tired could make anything worse, including syncope. But, it seems, quite possibly, syncope was the cause.

Since this came up here I had a chance to look at a pacemaker forum and I searched for sleep apnea. There were a few similar tales of 'apnea' symptoms disappearing post-pacemaker, especially amongst syncope (fainting) sufferers with a cardiac element.

Thus, I think it is reasonable to say that where someone suffering syncope who is also exhibiting sleep apnoea-like symptoms with mainly hypopneas evident, then it s worth considering if cardioinhibitory vasavagal syncope is the culprit not OSA, and a cardiologist is needed.

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zoocrewphoto
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Re: Do I need a CPAP?

Post by zoocrewphoto » Wed Dec 17, 2014 4:28 am

Greendirt wrote:I've taken the limited comment since I posted the sleep studies to indicate there was no particular objection to my view that I never had sleep apnoea, despite the explicit diagnosis 'Severe OSA is evident'. The last study with 0.0 being the main reading for disordered breathing (AHI 1.3 overall) proves I don't have apnoea now. And the only relevant change was the pacemaker.

As was pointed out by zoocrewphoto, the original study showed 8 apnoeas, 1 central and 367 hypopneas in 7:50 of sleep - that's an AHI of 48, 47 of which are hypopneas. And maybe shallow breathing due to a slow heart rate led to those hypopneas being recorded.

I asked the original doctor if the there could be a link: I still remember his eye roll. He did concede that being tired could make anything worse, including syncope. But, it seems, quite possibly, syncope was the cause.

Since this came up here I had a chance to look at a pacemaker forum and I searched for sleep apnea. There were a few similar tales of 'apnea' symptoms disappearing post-pacemaker, especially amongst syncope (fainting) sufferers with a cardiac element.

Thus, I think it is reasonable to say that where someone suffering syncope who is also exhibiting sleep apnoea-like symptoms with mainly hypopneas evident, then it s worth considering if cardioinhibitory vasavagal syncope is the culprit not OSA, and a cardiologist is needed.
I suggested the possibility of shallow breathing, but honestly, I believe you do have sleep apnea and still have it. I believe you have positional sleep apnea and it was not found during the second sleep study since you didn't sleep on your back. As long as you don't sleep on your back, then you are fine. But only you know for sure if that is how you sleep now. And you don't seem to believe that this is the reason, so we can't agree.

I suspect that very few have responded since it is pretty clear that you are sure you don't have sleep apnea, and we can't convince you otherwise. The main point of responding is to really discourage other new people not to dismiss their diagnosis. We are used to seeing new people all the time hoping to find any reason to stop using a cpap machine. You may not need yours now, but your explanation does not currently make sense, and we have to be careful about giving people an excuse if they are looking for one. There will be other newbies who read your posts and figure they may have been misdiagnosed. They may quit and really mess up their health.

You have not come up with a valid explanation for the cpap WORKING without sleep apnea present. There is no reason for air pressure in the throat to help a heart condition. The machine was helping your sleep apnea. You did admit that you sleep on your side more now, and that could be an improvement caused by the pacemaker. But that doesn't mean that you didn't have sleep apnea, or that you won't have it again if you sleep on your back.

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Who would have thought it would be this challenging to sleep and breathe at the same time?

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Julie
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Post by Julie » Wed Dec 17, 2014 7:11 am

I think we're badgering this OP and expecting him to justify what even his MD cannot necessarily put into words - not because he's not knowledgable, but because some things may not lend themselves to easy explanation without e.g. knowledge that may only come clear to (even) experts in 10-20 yrs. The point though is that he seems now to be doing fine, and whether or not he had apnea prior to getting the pacemaker (or even whether he still has it at some latent level) should not be belabored. He's not a doctor and his doctor apparently gave the only explanations he could... but in the end he's doing well and is probably sorry to have ever started this thread!

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Re: Do I need a CPAP?

Post by grayghost4 » Wed Dec 17, 2014 7:28 am

sorry to have ever started this thread!

amen to that
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zoocrewphoto
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Re:

Post by zoocrewphoto » Wed Dec 17, 2014 9:15 am

Julie wrote:I think we're badgering this OP and expecting him to justify what even his MD cannot necessarily put into words - not because he's not knowledgable, but because some things may not lend themselves to easy explanation without e.g. knowledge that may only come clear to (even) experts in 10-20 yrs. The point though is that he seems now to be doing fine, and whether or not he had apnea prior to getting the pacemaker (or even whether he still has it at some latent level) should not be belabored. He's not a doctor and his doctor apparently gave the only explanations he could... but in the end he's doing well and is probably sorry to have ever started this thread!

I'm sorry, but he was specifically telling people that if they have heart problems, they may not really have sleep apnea. Considering that sleep apnea is known to lead to heart problems, there are bound to be new people coming along with sleep apnea and heart problems. Many of them looking for any reason not to use their cpap machine. Do we really want to discourage them from using their machine? What are the odds that many of them will have the same issue and solution as this one person?

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Who would have thought it would be this challenging to sleep and breathe at the same time?

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ChicagoGranny
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Re: Do I need a CPAP?

Post by ChicagoGranny » Wed Dec 17, 2014 9:19 am

Julie wrote:I think we're badgering this OP
Pay attention Julie. The OP left immediately.

We are actively and enthusiastically badgering GreenDirt.

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Julie
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Re: Do I need a CPAP?

Post by Julie » Wed Dec 17, 2014 10:15 am

Equal opp. badgering - luv it!

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OkyDoky
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Re: Do I need a CPAP?

Post by OkyDoky » Wed Dec 17, 2014 10:50 am

zoocrewphoto wrote:
Greendirt wrote:I've taken the limited comment since I posted the sleep studies to indicate there was no particular objection to my view that I never had sleep apnoea, despite the explicit diagnosis 'Severe OSA is evident'. The last study with 0.0 being the main reading for disordered breathing (AHI 1.3 overall) proves I don't have apnoea now. And the only relevant change was the pacemaker.

As was pointed out by zoocrewphoto, the original study showed 8 apnoeas, 1 central and 367 hypopneas in 7:50 of sleep - that's an AHI of 48, 47 of which are hypopneas. And maybe shallow breathing due to a slow heart rate led to those hypopneas being recorded.

I asked the original doctor if the there could be a link: I still remember his eye roll. He did concede that being tired could make anything worse, including syncope. But, it seems, quite possibly, syncope was the cause.

Since this came up here I had a chance to look at a pacemaker forum and I searched for sleep apnea. There were a few similar tales of 'apnea' symptoms disappearing post-pacemaker, especially amongst syncope (fainting) sufferers with a cardiac element.

Thus, I think it is reasonable to say that where someone suffering syncope who is also exhibiting sleep apnoea-like symptoms with mainly hypopneas evident, then it s worth considering if cardioinhibitory vasavagal syncope is the culprit not OSA, and a cardiologist is needed.
I suggested the possibility of shallow breathing, but honestly, I believe you do have sleep apnea and still have it. I believe you have positional sleep apnea and it was not found during the second sleep study since you didn't sleep on your back. As long as you don't sleep on your back, then you are fine. But only you know for sure if that is how you sleep now. And you don't seem to believe that this is the reason, so we can't agree.

I suspect that very few have responded since it is pretty clear that you are sure you don't have sleep apnea, and we can't convince you otherwise. The main point of responding is to really discourage other new people not to dismiss their diagnosis. We are used to seeing new people all the time hoping to find any reason to stop using a cpap machine. You may not need yours now, but your explanation does not currently make sense, and we have to be careful about giving people an excuse if they are looking for one. There will be other newbies who read your posts and figure they may have been misdiagnosed. They may quit and really mess up their health.

You have not come up with a valid explanation for the cpap WORKING without sleep apnea present. There is no reason for air pressure in the throat to help a heart condition. The machine was helping your sleep apnea. You did admit that you sleep on your side more now, and that could be an improvement caused by the pacemaker. But that doesn't mean that you didn't have sleep apnea, or that you won't have it again if you sleep on your back.
I think zoocrewphoto says it very well. I also wanted to add that on the one study page http://circ.ahajournals.org/content/107/23/2987 that greendirt linked to where the wife reported he no longer had SA, there was a scientific study linkhttp://circ.ahajournals.org/content/115/13/1703.full where people with pacemakers and no SA symptoms were tested with 59% found to have SA.
I didn't reply because his health is his concern (and his eye rolling doctor), and others need to do their own evaluations for their health.
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