Untreatable OSA?

[ChicagoGranny]

joeljjk11

Here is something that I always harp on to anyone who has sleep apnea and is having any kind of difficulty with CPAP or sleeping:

- Practice good sleep hygiene (Google it and read several sources)
- Eat a good diet
- Have a regular, moderate exercise program
- Practice total abstinence of caffeine including sources like chocolate
- Review all medicines, vitamins and supplements you are taking to make sure none are interfering with sleep
- Optimize emotional stress in your life
- Use CPAP software to make sure your therapy is optimized

Except for the last one, all of these items are good practices for anyone who has been diagnosed with Bipolar I Disorder. In fact, they are good practices for every human.

I am wondering what symptoms you had that resulted in a prescription for Saphris? We have seen many CPAP patients who were initially diagnosed with emotional illnesses or brain disorders (primarily depression, anxiety, ADHD) who were actually suffering from untreated sleep apnea. In other words, the symptoms of sleep apnea have often been misdiagnosed as emotional illness or brain disorder. Many doctors have a big "blind spot" to sleep apnea.

[joeljjk11]

I have had the mental illness well before the sleep apnea. It's a long story but I was diagnosed when I was about 16.

The Saphris causes the OSA and here I am.

[joeljjk11]

Also I don't think I could give up caffeine haha. I am WAY too addicted to it. I do try to not drink any past noon or so though. I have noticed that this helps tremendously with the quality of my sleep.

[Julie]

Saphris (or any other drug) does not cause apnea. It may well aggravate a case, but that's all, so you need to rethink that. What I believe you need to do is work with whoever is most qualified, whether your GP, a psychiatrist, addiction counsellor, etc. and get off the Saphris and if necessary replace it with something else as I do believe it's really impacting your sleep and Cpap therapy - if not making them worse, certainly keeping them from improving. There are very many meds out there if you need to be on something, and often other types of answers besides meds for people with problems.

[ChicagoGranny]

Saphris (or any other drug) does not cause apnea.

You don't know that Julie. You are again speaking from a personal bias without any experience or outside source to back up what you are saying.

[ChicagoGranny]

I have had the mental illness well before the sleep apnea. It's a long story but I was diagnosed when I was about 16.

How do you know that you did not have sleep apnea years before you were 16? There are plenty of young people with sleep apnea and we have numerous adult forum members who suspect they had sleep apnea since adolescence and it was just not diagnosed until decades later.

[ChicagoGranny]

Also I don't think I could give up caffeine haha. I am WAY too addicted to it. I do try to not drink any past noon or so though. I have noticed that this helps tremendously with the quality of my sleep.

You may want to revisit that if you can get your AHI problem resolved. Just remember you need to taper off caffeine to avoid withdrawal headaches.

[Julie]

CG - You show me a peer reviewed medical research paper that proves Saphris causes sleep apnea.

[ChicagoGranny]

CG - You show me a peer reviewed medical research paper that proves Saphris causes sleep apnea.

I never said it did. You, on the other hand, made the statement, "Saphris (or any other drug) does not cause apnea."

If you want to demand "a peer reviewed medical research paper", the burden is entirely on you.

[joeljjk11]

A good many people find that more pressure is needed with a full face mask than with a nasal pillow mask so I would suggest using the nasal pillow mask if at all possible.

I haven't seen enough reports with the highest minimum to get a feel for what might be needed but if 14 isn't getting the job done then we go higher...

The aerophagia issues do make it difficult...are you using EPR? If so at what setting?
If you only need higher pressures part of the night I wouldn't go to cpap mode because you will need to use higher pressures all night instead of part of the night and that will likely make the aerophagia issues worse.

My EPR is on 1. Could this affect anything? Should I turn this off?

[OSAHell]

I have had the mental illness well before the sleep apnea. It's a long story but I was diagnosed when I was about 16.

The Saphris causes the OSA and here I am.

OSA is not the only sleep apnea type, it's just the most common... And there's even more SDB. And depending on the type of sleep study you had, your sleep doc might not have been able to see the "others" type and simply diagnose you with OSA. Although I personally doubt a med can cause OSA, I'm not so sure about others apnea types like CSA. Either way, CPAP/APAP might just be the wrong machine for you. Also, it's not impossible you had your SDB before 16, unless you had a sleep study at that time of course.

CPAP/APAP can basically only treat OSA. For many the others types of SDB you need an other type of machine.

What is your sleep doc saying about your problem with your therapy (higher than normal AHI)?

[HoseCrusher]

OK, sometimes people miss the obvious so I thought it might be good to start there.

Another suggestion is to check with your doctor and see if your drug can be taken via suppository. That would eliminate throat issues but you may have to wear a diaper to bed.

I'm guessing that you haven't been able to find another drug that has less side effects, but how about discussing with your doctor the idea of cutting back a little on the dose and perhaps adding something else to take up any slack?

Another idea is to explore with your doctor the world of sleep aids.

It sounds like your issue is a little beyond a simple machine adjustment, but make sure your therapy is adjusted for optimum results and then you may have to move on to explore something else.

[SewTired]

What was your AHI during the diagnostic sleep study without cpap?
I assume your AHI is still primarily obstructive in nature (OAs and hyponeas)?
When commenting on elevated AHI it is really helpful if we know the event category breakdown.

I am honestly not sure what my AHI was during my sleep study. I know it was within the 'moderate' OSA range. I believe it was around 15-20. I never received any paperwork or anything, the doctor left a voicemail on my phone last year regarding it but I no longer have this voicemail.

My AHI is mostly obstructive with a very small amount of Central.

Joel, to start with, try contacting your sleep doctor's office and getting a copy of your sleep study (and titration if that was separate). This is for your records, but it also helps in resolving problems that your doctor isn't solving.. i.e. your sleep. For instance, looking at my titration, they cannot get my oxygen level up to 100% - at best it is 91% because of a health problem. It could be your medication is causing the very same depressive result OR perhaps a different machine is in order. I'm very much a newbie at this, but my AHI was low in the first place - I'm trying to figure out how to get RERAs down so I get that it's complicated!

[chunkyfrog]

It disturbs me that this doctor seems to be actively PUSHING surgery.
IMHO, the OP needs to change doctors! ASAP!

[tiredandscared]

what's the drug called? It's possible to look up if it has any muscle relaxing effects. In which case it can aggravate sleep apnea, or push over a borderline case into sleep apnea. If you already have compromised soft palate muscles, adding a muscle relexant will make it worse. Add sleeping supine, and you definitely have the conditions to aggravate it.