No longer need CPAP

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
resmed user
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Re: No longer need CPAP

Post by resmed user » Mon May 31, 2010 2:12 pm

CollegeGirl wrote:I can tell you right now that even though I am quite large, WLS would not cure my sleep apnea. Not a chance. Why? Because I've been snoring and choking in my sleep since I was an (underweight) infant. My sleep doctor in fact suspects that that is the majority of the reason I became this overweight to begin with - decades of untreated sleep apnea. Some people's apnea will *not* be cured with weight loss surgery, and yet these people (along with those for whom this IS true) are going to be told that a sleep study is "not necessary" because WLS cures sleep apnea in all instances? That seems very dangerous to me.
I agree, and I certainly would not suggest that WLS is an automatic cure for anyone or anything. You need to know your history. I know that weight created my sleep apnea and hypertension, and apnea created more weight and greater hypertension, as it does for many people--a viscous cycle. The degree to which weight exacerbates these problems is the degree to which losing the weight will help reduce, or possibly eliminate them.

resmed user
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Re: No longer need CPAP

Post by resmed user » Mon May 31, 2010 2:21 pm

donnafowler wrote:Good for you Resmed user! We are happy for your success. No one wanted to give you a hard time, but only wanted to be sure you were protecting your health! So often it is tempting to say, "I feel better," but fail to take the steps necessary to make sure treatment is no longer needed. This applies to all kinds of problems, not just OSA--I am thinking about people who stop taking antibiotics before the infection is truly gone and end up even sicker, just as one example.

Congratulations on your weightloss and your newfound health!
Thank you Donna. I understand and appreciate the concern. I wasn't clear enough. You are right of course, to be cautious and the example of antibiotics is a good one. My Doc did agree that I did not need the cpap any longer. And with all due respect to Wulfman, although I did show up still as "Mild," I'm going with my doctors assessment as not needing it. If it changes down the road to where I need it again, I will have to get it again. But just as I am not keeping the clothes I wore when I was 350 pounds, after 18 months, I am no longer keeping my cpap, "just in case" things change again to the point I need one. Time to let it go.

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Goofproof
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Re: No longer need CPAP

Post by Goofproof » Mon May 31, 2010 3:14 pm

If it changes down the road, where you think you need it again, I hope I'm not traveling on the same road. If I am I hope me lawyers can find this thread. Jim
Use data to optimize your xPAP treatment!

"The art of medicine consists in amusing the patient while nature cures the disease." Voltaire

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DoriC
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Re: No longer need CPAP

Post by DoriC » Mon May 31, 2010 9:28 pm

Can someone clear this up for me? What numbers on the sleep study correlate with mild,moderate,severe OSA? I was under the impression a diagnosis of even mild indicates apnea events and needs therapy. Besides the numbers what other factors determines if a patient might benefit from cpap or it's not really necessary? Hope you understand my roundabout way of posing these questions, I know what I'm trying to ask!

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Wulfman
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Re: No longer need CPAP

Post by Wulfman » Mon May 31, 2010 9:47 pm

DoriC wrote:Can someone clear this up for me? What numbers on the sleep study correlate with mild,moderate,severe OSA? I was under the impression a diagnosis of even mild indicates apnea events and needs therapy. Besides the numbers what other factors determines if a patient might benefit from cpap or it's not really necessary? Hope you understand my roundabout way of posing these questions, I know what I'm trying to ask!
AHI/RAI** Scale =
<5 events /hour = (none);
5-15 events/hour = (mild);
15-30 events/hour = (moderate);
>30 events/hour = (severe).


Den
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WearyOne
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Re: No longer need CPAP

Post by WearyOne » Mon May 31, 2010 10:20 pm

Anything under 5 is considered normal enough not to be on cpap. In fact, insurance companies will not pay for a cpap if a sleep study indicates less than 5. (At least that's what I've read and been told.)

I feel mine is weight-induced because I had a sleep study when I was not overweight (due to sleep issues that ended up being stress and anxiety related) and I was diagnosed as not having OSA. Ten years and 40 pounds later I had another sleep study and was diagnosed with moderate OSA (RDI 19). I don't know for sure that losing weight will reduce my AHI enough to eliminate OSA, but I believe that for me the possibility exists because I didn't have it when I wasn't overweight and did once I gained.

For so long all you heard was that being overweight was the only cause of OSA that I think a lot of people now are resistant to the fact that some people (not all) could cure their OSA by losing weight. I know thin people who have OSA and thin people who don't. I know overweight people who have OSA and overweight people who have had sleep studies thinking they had it and they don't.

Remed user, congratulations! I am so happy for you, losing the weight and not having OSA any longer. I wish you much continued success!

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Jay K
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Re: No longer need CPAP

Post by Jay K » Mon May 31, 2010 10:45 pm

Encore User's improvement from bariatric surgery piqued my interest and I therefore googled "bariatric surgery and sleep apnea." The link to the article below, which includes links to some of the relevant research studies, suggests that although the surgery may result in a lower AHI, it usually does not do so sufficiently to remove the need to continue using CPAP therapy. I don't want to be misunderstood as having suggested it never happens, or it didn't happen to Encore User. I'm just saying it doesn't look like the silver bullet many of us are looking for.

Here is the link http://junkfoodscience.blogspot.com/200 ... e-for.html.

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Re: No longer need CPAP

Post by kteague » Tue Jun 01, 2010 4:38 am

I've been over on PubMed trying to find studies before commenting on all this. You're right Julie, I have not perceived you as one to just accept anything willy-nilly, and honestly, I was a bit taken aback by your blanket statements in this and another thread proclaiming WLS as a cure for OSA. Can you provide us with any links to the studies you are basing your stance upon? I haven't been able to find them. It sounds like you are saying that it is not the weight loss itself but the act of the surgery that "cures" the OSA. So, are you saying weight loss without surgery would or would not accomplish the same results? Am I misreading your comments?

Resmed User, so your followup sleep study said your apnea is now mild, so did your doctor explicitly said mild OSA does not merit treatment? When mine was still termed mild it caused significant adverse affects on my well being. I was under the impression mild means a treatable condition. Am I missing something?

I don't think anyone would want to hold on to their OSA diagnosis just for the fun of it all. If weight loss is proven to cure my sleep apnea, I'll receive that blessing and promptly stop using my cpap. Since I was symptomatic even when trim and fit, I'm not holding my breath. I'd love to be proven wrong.

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Julie
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Re: No longer need CPAP

Post by Julie » Tue Jun 01, 2010 5:17 am

Let's say I was (obviously) misled by the very public presentations (TV and otherwise, on the news, not in ads) of some supposedly more than qualified research centres saying the surgery was a cure-all. And because of the way things were presented, that the researchers/surgeons, etc. themselves said they did not know for sure why it all worked (I did get the feeling weight loss was not necessarily the only component), but that it did, I just assumed it was true. Maybe the same way those who believed at first that PPPI's were 'the' answer, only to find out later that problems recurred. I hope I know better next time!

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DoriC
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Re: No longer need CPAP

Post by DoriC » Tue Jun 01, 2010 8:19 am

kteague wrote: Resmed User, so your followup sleep study said your apnea is now mild, so did your doctor explicitly said mild OSA does not merit treatment? When mine was still termed mild it caused significant adverse affects on my well being. I was under the impression mild means a treatable condition. Am I missing something?
K, thank you, that's the question I was fumbling with in my previous post.

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Mask: Mirage Quattro™ Full Face CPAP Mask with Headgear
Humidifier: HumidAire H4i™ Heated Humidifier
Additional Comments: 14/8.4,PS=4, UMFF, 02@2L,
"Do or Do Not-There Is No Try"-"Yoda"
"We are what we repeatedly do,so excellence
is not an act but a habit"-"Aristotle"
DEAR HUBBY BEGAN CPAP 9/2/08

Mac33
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Re: No longer need CPAP

Post by Mac33 » Tue Jun 01, 2010 9:28 am

I didn't use my CPAP last night and used my SPO oxygen/pulsemeter. I also had three vodkas earlier in the night and took an ambien to sleep. I had 17 desats 16 of those were 90% saturation or above. One went down to 86 for about 12 secs. I slept for 8h 37m. My AHI was 57 at my sleep study with almost all apneas/Hypopneas at 20 secs or less. Half were Hypopneas. I feel great and not sleepy at all. As a matter of fact I get better sleep without that mask on my face most of the time. Will this condition kill me if I forgo using all the time. I don't think so. I've done this many other times with similar results. I know people here are hardcore but sometimes you wonder about this cash cow doctors now have...............

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kteague
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Re: No longer need CPAP

Post by kteague » Tue Jun 01, 2010 9:42 am

Thanks, Julie, for clarifying. ResMed User, sorry I hadn't tuned in to you having been retested and this was your doctor's recommendation that your mild sleep apnea did not need treated, and that your ENT wants to follow up in 6 months. Unless I missed this too, I don't know where along the mild spectrum your results fell. In my mind a mild of 14 would merit more consideration than a mild of 6. Maybe this is all much ado about nearly nothing. Generally I'd be concerned if my doctor's advice contradicted current teaching unless it made perfect sense to me. Apparently this makes sense to you and you are comfortable with that advice and I wish you all the best as you live out that conviction. And here's wishing you an "all clear" followup in 6 months. Dori, we know you don't fumble, you are just a very gracious lady.

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ardneham
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Re: No longer need CPAP

Post by ardneham » Tue Jun 01, 2010 9:50 am

Looking for Surgery in OSA I came across this piece of information which may interest some in the Forum:-

"Surgery for Sleep Apnoea
Search for Sleep Clinics & Specialists

Medication is not generally thought to be of any help for sleep apnoea (also spelled 'sleep apnea') sufferers. However, there are several surgical options available. Although surgery would be an extreme option, it is available should other procedures and aids not be beneficial. Obviously, surgery will only be considered after other attempts have been made and your sleep disorder will most probably need assessing in a sleep clinic, and a doctors full approval for the surgery to take place.

Surgeries available are:

Uvulopalatopharyngoplasty (UPPP) for Sleep Apnoea
The first task with this surgery would be to learn how to pronounce it! Uvulopalatopharyngoplasty involves removing part of the soft palate, the uvula and the tonsils in order to enlarge the throat and ease airway access. The success rates with this surgery are very 50/50 and are often reduced after time as the surgery improvements begin to decrease. Evidently, it will only be necessary to operate this surgery if it is the soft palate, uvula and tonsils that are causing the blockage. People will blockages elsewhere (obese people normally have obstructions further into their airways) will respond less well to this surgery.

Laser-assisted uvulopalatoplasty (LAUP) for Sleep Apnoea
Laser Assisted uvulopalatoplasty is more commonly used for snoring problems and only mild forms of sleep apnoea. It invovles a surgery that is performed under local anaesthetic and the laser is used to remove the uvula and part of the palate in several small procedures (up to five in four to eight week intervals). This can cause an increased dryness of the throat after surgery and in some paitients it is a concern that sleep apnoea is left undetected as the snoring (the most noticable symptom at night) ceases and the sleep apnoea continues. Therefore, if you have a serious case of sleep apnoea you may be advised against this type of surgery.

Radiofrequency Ablation for Sleep Apnoea
Radiofrequency Ablation can be used for many different reasons including sleep apnoea and can also be used in a similar way to LAUP but instead of lasers it involves radiofrequency. The radiofequeny waves are used to shrink tissue at the back of the tongue. The benefits of this procedure are that it can be performed in a doctors surgery and has been seen to have reduced complications and uncomfortableness compared to LAUP.

Tracheostomy for Sleep Apnoea
Tracheostomy is the oldest method used to treat sleep apnoea. It is the most effective of surgeries, having a success rate of nearly 100%. However, it is an extreme surgery and is only recommended in severe cases of sleep apnoea and potentially life-threatening cases. The procedure involves placing a tube directly through the patients neck into the windpipe. It is only used in rare cases now as UPPP is favoured first.

For children who suffer from sleep apnoea surgery is available with a removal of tonsils and adenoids and this does have a success rate with a cure of 75% and above.

As with any sleep disorder, it is a matter of finding the right treatment for your sleep apnoea and evidently the less complicated methods will be employed first. If you do feel as though you could be suffering from sleep apnoea, then do not suffer in silence. Generally this disorder can be treated, and with simple methods in a lot cases. Try and complete a sleep diary to assess the extent your sleep disorder is having an effect on your life and do not hesitate to contact your doctor for professional diagnosis and advice."

resmed user
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Re: No longer need CPAP

Post by resmed user » Sat Jun 05, 2010 4:14 pm

WearyOne wrote:Anything under 5 is considered normal enough not to be on cpap. In fact, insurance companies will not pay for a cpap if a sleep study indicates less than 5. (At least that's what I've read and been told.)

I feel mine is weight-induced because I had a sleep study when I was not overweight (due to sleep issues that ended up being stress and anxiety related) and I was diagnosed as not having OSA. Ten years and 40 pounds later I had another sleep study and was diagnosed with moderate OSA (RDI 19). I don't know for sure that losing weight will reduce my AHI enough to eliminate OSA, but I believe that for me the possibility exists because I didn't have it when I wasn't overweight and did once I gained.

For so long all you heard was that being overweight was the only cause of OSA that I think a lot of people now are resistant to the fact that some people (not all) could cure their OSA by losing weight. I know thin people who have OSA and thin people who don't. I know overweight people who have OSA and overweight people who have had sleep studies thinking they had it and they don't.

Remed user, congratulations! I am so happy for you, losing the weight and not having OSA any longer. I wish you much continued success!
Thank you very much!

resmed user
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Re: No longer need CPAP

Post by resmed user » Sat Jun 05, 2010 4:23 pm

kteague wrote:I've been over on PubMed trying to find studies before commenting on all this. You're right Julie, I have not perceived you as one to just accept anything willy-nilly, and honestly, I was a bit taken aback by your blanket statements in this and another thread proclaiming WLS as a cure for OSA. Can you provide us with any links to the studies you are basing your stance upon? I haven't been able to find them. It sounds like you are saying that it is not the weight loss itself but the act of the surgery that "cures" the OSA. So, are you saying weight loss without surgery would or would not accomplish the same results? Am I misreading your comments?

Resmed User, so your followup sleep study said your apnea is now mild, so did your doctor explicitly said mild OSA does not merit treatment? When mine was still termed mild it caused significant adverse affects on my well being. I was under the impression mild means a treatable condition. Am I missing something?

I don't think anyone would want to hold on to their OSA diagnosis just for the fun of it all. If weight loss is proven to cure my sleep apnea, I'll receive that blessing and promptly stop using my cpap. Since I was symptomatic even when trim and fit, I'm not holding my breath. I'd love to be proven wrong.
There are no guarantees in life or in medicine. Your doctor would be the best one to tell you if it would "cure" you or not. I'd guess they would never use the "c" word anyway cause they cannot know how YOU will react. They may be able to tell you that you have other physiological conditions which will continue to give you problems.

As for "mild" perhaps it depends where on the scale one falls, in the low range or in the upper range. I have heard that gastric bypass (not lap-band surgery) does OFTEN and QUICKLY reverse type 2 diabetes. But again, OFTEN is not ALWAYS. I have not heard that about OSA. It is said in many places that this surgery (or significant weight loss by any means) can IMPROVE or REVERSE OSA. While one might not lose the CPAP, an improvement is still a very positive thing!