can I stop using CPap

[palerider]

Most people, regardless of treatment or not, will got worse over time.

This is the first time I have heard that even with treatment you will get worse over time. I hope that isn't the case, I thought that treatment stabilizes Sleep Apnea. I realize that with NO treatment it will get worse.

cpap for your throat is like glasses for your eyes, it lets 'em work for you, but doesn't 'fix' the problem, or make the problem better. it does, however, prevent you from walking into walls, tripping over things you can't see, allows you to drive, etc. (figuratively speaking)

[postitnote]

No. It wouldn't be healthy for you.

Personally if they cured my apnea I would just set my machine to the lowest setting and keep it. It rocks me to sleep in minutes after putting on a mask.

[tlohse]

For some people I believe it is possible if you lose weight and that was the cause of the apnea but for most you will probably be on it for the rest of your life.

[Logies101]

Most people, regardless of treatment or not, will got worse over time.

This is the first time I have heard that even with treatment you will get worse over time. I hope that isn't the case, I thought that treatment stabilizes Sleep Apnea. I realize that with NO treatment it will get worse.

cpap for your throat is like glasses for your eyes, it lets 'em work for you, but doesn't 'fix' the problem, or make the problem better. it does, however, prevent you from walking into walls, tripping over things you can't see, allows you to drive, etc. (figuratively speaking)

Understood Palerider, cpap won't cure it. But are you agreeing that even with treatment SA will get worse over time. If so what does the future hold, higher and higher pressures or will treatment become less effective over time?

[palerider]

Understood Palerider, cpap won't cure it. But are you agreeing that even with treatment SA will get worse over time. If so what does the future hold, higher and higher pressures or will treatment become less effective over time?

I'm saying that there's nothing in the cpap treatment that does anything to affect the root cause of your need for cpap, that's going to be whatever it's going to be, regardless of using cpap or not.

if your apnea needs are going to get worse, then you'll need more pressure, if they get better, you'll need less, and all using cpap will do is keep the rest of your body from falling apart faster than it will if you use the cpap.

[Logies101]

Understood Palerider, cpap won't cure it. But are you agreeing that even with treatment SA will get worse over time. If so what does the future hold, higher and higher pressures or will treatment become less effective over time?

I'm saying that there's nothing in the cpap treatment that does anything to affect the root cause of your need for cpap, that's going to be whatever it's going to be, regardless of using cpap or not.

if your apnea needs are going to get worse, then you'll need more pressure, if they get better, you'll need less, and all using cpap will do is keep the rest of your body from falling apart faster than it will if you use the cpap.

Sigh,I hate that falling apart stuff, I want to keep my parts together as long as i can. But thanks for clearing it up for me. It does inspire me to stay as healthy as I can, ie eating right, exercising etc and oh yeah keep on using my Cpap.

[zoocrewphoto]

Most people, regardless of treatment or not, will got worse over time.

This is the first time I have heard that even with treatment you will get worse over time. I hope that isn't the case, I thought that treatment stabilizes Sleep Apnea. I realize that with NO treatment it will get worse.

Most people don't start at severe. They get worse as they age. Cpap treatment at optimum pressure settings will keep you good as you sleep. It doesn't cure you or keep you from getting worse as you age. Most people will tend to have changes over the years that require a change in pressures over the years. You can still have excellent results as you age, but your untreated sleep apnea (what would happen if you don't use your machine) will probably get worse over the years. Your ahi will creep up, your pressure needs may creep up, your events may get a little longer, etc).

Consider people who wear glasses. They tend to have updated prescriptions over the years, and many seniors wear bifocals. Their needs have changed as they aged. But with good updates in the prescriptions, they can still continue to have the same success with good vision *while wearing their glasses*. We can't stop aging, but we can keep up with many of the changes.

[robysue]

Understood Palerider, cpap won't cure it. But are you agreeing that even with treatment SA will get worse over time. If so what does the future hold, higher and higher pressures or will treatment become less effective over time?

and

if your apnea needs are going to get worse, then you'll need more pressure, if they get better, you'll need less, and all using cpap will do is keep the rest of your body from falling apart faster than it will if you use the cpap.

The severity of a person's apnea is not directly related to the level of pressure needed to splint the airways open. There are people with moderate and severe OSA who only need relatively low pressures to properly treat their OSA and there are people with mild-to-moderate OSA who happen to need relatively high pressures to treat their OSA.

That said, the amount of pressure needed to treat the OSA can change over time. But that's as much due to changes in the muscle tone and throat structures caused by aging as anything else. Of course those aging-related changes in muscle tone and throat structure can also be related to a worsening of the underlying, untreated OSA. (And this is also why OSA tends to become more common as we get into our 40s, 50s, and 60s.)

[archangle]

This is the first time I have heard that even with treatment you will get worse over time. I hope that isn't the case, I thought that treatment stabilizes Sleep Apnea. I realize that with NO treatment it will get worse.

The "orthodox" answer seems to be that if you took two groups of apnea victims, treated one group with CPAP and let the other group go untreated, after a few years, and gave them both sleep tests without CPAP, their apnea levels would be the same.

I wonder if there are studies on this. I see a lot of problems, including ethical ones, with doing such a test. Obviously, it won't be a double blind study.

[SteveGold]

This is the first time I have heard that even with treatment you will get worse over time. I hope that isn't the case, I thought that treatment stabilizes Sleep Apnea. I realize that with NO treatment it will get worse.

The "orthodox" answer seems to be that if you took two groups of apnea victims, treated one group with CPAP and let the other group go untreated, after a few years, and gave them both sleep tests without CPAP, their apnea levels would be the same.

I wonder if there are studies on this. I see a lot of problems, including ethical ones, with doing such a test. Obviously, it won't be a double blind study.

I'ts an interesting question, and as you say almost impossible to answer. They just released a study looking at identical twins (one who exercises, one who doesn't - the exercising twin was dramatically healthier). Another very tricky research problem. And not blinded.

My guess is that the CPAP users would fare better. My "off therapy" sleep is better than it was before CPAP, I think because consistent treatment has opened up my airway. So those benefits would hold at least temporarily for CPAP users. And the CPAP users would likely have lower blood pressure and better health overall than their untreated counterparts, mental and physical. It would be interesting to look at whether the quality sleep provided by CPAP enables users to exercise more or maintain a lower weight, thereby lowering their untreated AHIs compared to non-users.

[robysue]

This is the first time I have heard that even with treatment you will get worse over time. I hope that isn't the case, I thought that treatment stabilizes Sleep Apnea. I realize that with NO treatment it will get worse.

The "orthodox" answer seems to be that if you took two groups of apnea victims, treated one group with CPAP and let the other group go untreated, after a few years, and gave them both sleep tests without CPAP, their apnea levels would be the same.

I wonder if there are studies on this. I see a lot of problems, including ethical ones, with doing such a test. Obviously, it won't be a double blind study.

I'ts an interesting question, and as you say almost impossible to answer. They just released a study looking at identical twins (one who exercises, one who doesn't - the exercising twin was dramatically healthier). Another very tricky research problem. And not blinded.

My guess is that the CPAP users would fare better. My "off therapy" sleep is better than it was before CPAP, I think because consistent treatment has opened up my airway. So those benefits would hold at least temporarily for CPAP users. And the CPAP users would likely have lower blood pressure and better health overall than their untreated counterparts, mental and physical. It would be interesting to look at whether the quality sleep provided by CPAP enables users to exercise more or maintain a lower weight, thereby lowering their untreated AHIs compared to non-users.

The question is not whether the long term CPAP users would be better off or not: Of course they would be simply because treating the OSA would mean that all those OSA-related co-morbidities would be less of a problem (or potentially not a problem) in the CPAP users, but would be a continuing (and probably worsening over time) problem for the non-CPAP users.

The question is whether the *untreated* OSA in the two groups would be the same. In other words, if you took the CPAPs away from the long term CPAP users for a week or two (to let their "natural, CPAP-less sleep re-emerge), would the long term CPAP users' *untreated AHIs* be comparable to the non-CPAP users' untreated AHIs?

As archangle points out, the conventional, orthodox answer to this question is: Yes, the *untreated* AHI for the long term CPAP users would probably be about the same as the *untreated* AHI for the non-CPAP users. But archangle also points out that he's not aware of any studies that have actually been done to compare a group of long-term CPAP users' *untreated AHI's* to a group of non-CPAP users' *untreated AHI's*. I'm also not aware of such a study. And it is clear that there's no way to double-blind such a study.

My "off therapy" sleep is better than it was before CPAP, I think because consistent treatment has opened up my airway.

My subjective experience is far different than yours.

I only have "moderate OSA" and at the time of my diagnosis I was NOT experiencing a lot of excessive daytime sleepiness or physical exhaustion. I was tired during the day, and I had a lot of low-grade pain in my hands and feet that was significantly worse in the morning. I also had an extremely difficult adjustment period to PAP therapy.

But in the last 4 years, I've only slept (all night) without the PAP a grand total of 3 or 4 times. And each time I woke up feeling far, far worse than I remember feeling on a daily basis prior to starting CPAP: On those rare occasions when I've not used the machine, the morning pain has been far worse than it was pre-CPAP; the sense of tossing and turning all night long and not getting much sleep has been far, far worse; and the level of exhaustion during the daytime has been worse. (Notably, excessive daytime sleepiness was NOT a huge issue for me on the days following those nights.) In short, going without my BiPAP for even one night is problematic in terms of how I feel the next day.

And falling asleep without the machine? I now do experience all the "jerk away because I'm not breathing" symptoms a lot of people report with untreated apnea. I never had that sensation before I was diagnosed with moderate OSA.

[Lukie]

Life is a death sentence.

CPAP makes it more bearable and the descent slower.

[Logies101]

Life is a death sentence.

CPAP makes it more bearable and the descent slower.

Well that's a lighthearted way to look at it

[Darth Lady]

Well, yeah, there were a lot of parts of me that descended lower as I started to age....including, apparently, my pharyngeal tissues

I probably had this condition for many years, perhaps even since college, but I think it got worse in the last few years before diagnosis. I gained weight (perhaps because of it; a great vicious circle), but losing it doesn't seem to be helping it much, at least so far.

[SteveGold]

The question is not whether the long term CPAP users would be better off or not:

I was just riffing on what kind of measurable long-term health effects would show up, similar to the twin study I mentioned.

Regarding untreated apnea between the two groups, it might be plausible for the CPAP group to have lower AHI due their airways being expanded and held open by air stents over years. My best guess is that I do better (but not well) off CPAP now because my airway had narrowed over years of untreated apnea, but your experience runs counter to that.

Other factors - like weight lost as an indirect side effect of treatment, from having the energy for more exercise or the focus for a healthier diet - could also affect untreated AHI in the CPAP group. CPAP is a treatment, not a cure, but over years and decades it could have all sorts of knock-on effects that would be interesting to tease out if we could possibly design the study. As you say, there's no such study right now that we know of.