Medical complications of untreated sleep apnea

[Jay Aitchsee]

I don't know that anyone is trying to "beat up" the OP, Pugsy. I don't think it is/was clear from his postings that his OSA has been successfully treated. Personally, I don't consider an AHI "under 5", as the OP stated above, as necessarily satisfactorily treated. So far, in my opinion, suggestions have been made to help the OP not suffer further damage from untreated OSA.

Further, I don't think anyone really cares if successful treatment results from CPAP or a MAD device. The goal is successful treatment, whatever the device. As far as using a MAD device with CPAP, that seems reasonable to me, or at least reasonable to trial. I can see where, in some instances, dual treatment could be beneficial, though I am personally not aware of results where this has been tried.

Hopefully, the OP will find a treatment that works. Of course, most of us are partial to CPAP because we know it does.

[Pugsy]

Why beat me up every time I post anything?

You talking to me or someone else? I sure wish you would figure out how to address your responses when not talking to the OP.
If you can't master the quote button maybe say something like "to so and so"

Just in case you were talking to me....I wasn't talking about you or to you. I was just making a general comment.
Contrary to what you might think....not all my responses after yours have anything to do with you at all.
I was going to post what I said early this morning when I first saw the post..... long before you said anything but something came up and I didn't have time to get it done until now.

[ravenous28]

Good grief...

Wish I wouldn’t of even brought up the topic of me using an oral device with my airsense 10. I’m not newb using cpap and I’ve been using it just fine to be honest. I know how to analyze my data on sleepyhead, I know how to adjust my device as needed. I work with my doctors and I’m not in any immediate threat of dying Julie... and my mouth feels good so thanks for the warning about tmj, my doctors and dentist I go to check me for that...I have mild to moderate sleep apnea. I’m alive and well and 37 yrs old. I’m not dead yet..I’m not even fat Julie.. I’m just big boned. Spare me the drama on the internet. I was just posting information about stuff going on with me and you don’t know the half of it or anything about my life.

[ravenous28]

I don't know that anyone is trying to "beat up" the OP, Pugsy. I don't think it is/was clear from his postings that his OSA has been successfully treated. Personally, I don't consider an AHI "under 5", as the OP stated above, as necessarily satisfactorily treated. So far, in my opinion, suggestions have been made to help the OP not suffer further damage from untreated OSA.

Further, I don't think anyone really cares if successful treatment results from CPAP or a MAD device. The goal is successful treatment, whatever the device. As far as using a MAD device with CPAP, that seems reasonable to me, or at least reasonable to trial. I can see where, in some instances, dual treatment could be beneficial, though I am personally not aware of results where this has been tried.

Hopefully, the OP will find a treatment that works. Of course, most of us are partial to CPAP because we know it does.

It’s .5 ahi consecutively on the resmed airsense 10 auto thanks yes it’s treated on the cpap I can assure you that much unless both myAir app and sleepyhead are telling me wrong. The issue was wasn’t about the cpap not working for me now to treat the osa it was about the mouthpiece which apparently is something forbidden to talk about around here because it’s a pos and doesn’t work for anyone I guess. The liver issues I mention are talking about the past 7 years prior. Before cpap auto even came out and wasn’t working for me. So come over to my house then if you want and monitor me sleeping. I can assure you I’m treated with resmed airsense 10 auto.... maybe not the dental device but again I have no way of knowing that unless I go by feelings or multiple sleep study’s for proof. Even if I came back on these forums with proof that the oral device was working from my sleep study, I have a feeling it would still get laughed at because the ahi came back with a number of .7 with normal sp02 levels..yes it’s nice cpap gives you statistics every night and you are lucky it does because the oral devices don’t. I understand that. I’m not bashing cpap guys so please chill out

[grayghost4]

I use a MAD device every night with my Cpap. I have one made by a dentist (it is sitting in the cabinet, unused ) the one I have used for the past three years is a boil and bite from ebay (cost less than $2)
it is set with my lower jaw a little forward for the upper.
This keeps my mouth sealed and gives better result with the cpap.

As you can tell from my AVATAR I have a difficult mouth problem

You will find the Population here is kinda sensitive to anything not CPAP!

[ravenous28]

I use a MAD device every night with my Cpap. I have one made by a dentist (it is sitting in the cabinet, unused ) the one I have used for the past three years is a boil and bite from ebay (cost less than $2)
it is set with my lower jaw a little forward for the upper.
This keeps my mouth sealed and gives better result with the cpap.

As you can tell from my AVATAR I have a difficult mouth problem

You will find the Population here is kinda sensitive to anything not CPAP!

Yea, I noticed. The mad im using is not the boil and bit ones you can buy on eBay. It’s the tap 3 tl and is one that is approved for use of osa by both my insurance company and doctors. It wasn’t made by my regular dentist either but by certified sleep board medicine doctor dentist in my area that works directly with sleep medical doctors. So hopefully I get support on it and not made fun of because I’m going against the current of strictly cpap. I wasn't told to knock myself out and have fun with my tmj like Julie said..if my dr treated me like that I’d look for another one

[Jay Aitchsee]

I don't know that anyone is trying to "beat up" the OP, Pugsy. I don't think it is/was clear from his postings that his OSA has been successfully treated. Personally, I don't consider an AHI "under 5", as the OP stated above, as necessarily satisfactorily treated. So far, in my opinion, suggestions have been made to help the OP not suffer further damage from untreated OSA.

Further, I don't think anyone really cares if successful treatment results from CPAP or a MAD device. The goal is successful treatment, whatever the device. As far as using a MAD device with CPAP, that seems reasonable to me, or at least reasonable to trial. I can see where, in some instances, dual treatment could be beneficial, though I am personally not aware of results where this has been tried.

Hopefully, the OP will find a treatment that works. Of course, most of us are partial to CPAP because we know it does.

It’s .5 ahi consecutively on the resmed airsense 10 auto thanks yes it’s treated on the cpap I can assure you that much unless both myAir app and sleepyhead are telling me wrong. The issue was wasn’t about the cpap not working for me now to treat the osa it was about the mouthpiece which apparently is something forbidden to talk about around here because it’s a pos and doesn’t work for anyone I guess. The liver issues I mention are talking about the past 7 years prior. Before cpap auto even came out and wasn’t working for me. So come over to my house then if you want and monitor me sleeping. I can assure you I’m treated with resmed airsense 10 auto.... maybe not the dental device but again I have no way of knowing that unless I go by feelings or multiple sleep study’s for proof. Even if I came back on these forums with proof that the oral device was working from my sleep study, I have a feeling it would still get laughed at because the ahi came back with a number of .7 with normal sp02 levels..yes it’s nice cpap gives you statistics every night and you are lucky it does because the oral devices don’t. I understand that. I’m not bashing cpap guys so please chill out

Sheesh, .5 is considerably less than 5 and, yes, I would consider that treated...No need to come to your house. I am sorry I misunderstood what you were asking. As I said, I don't care what device you use. Like most here, I don't have any experience with a MAD device, but I certainly don't consider it "forbidden". If it works, great. But knowing if it does seems to be the rub.
Good luck to you.

[palerider]

Why beat me up every time I post anything?

Because you so often don't seem to pay attention to what's going on in the thread, and you never use quotes so anybody knows what the hell you're talking about.

[ravenous28]

I’m sorry also if I didn’t explain my whole entire story good enough. It would be a long story to go into details and I really can’t do all that typing on my iPhone...maybe someday when I get a chance I can. But for now have a good night everyone.

[TropicalDiver]

Has anyone ever had any experience of linking abnormal liver function blood test results to untreated osa? Over the last 6-7 years (and around the time I was diagnosed with osa) my doctors noticed I had unexplained elevated liver ast/ast. It would go up and then back to normal with months and months of testing over the years. After seeing a liver specialist doctor having multiple blood tests, a liver biopsy and fibroscan and there’s nothing wrong with my liver, maybe some fatty liver and something that the doctor can’t explain to maybe very tiny external damage that is benign in all the scans. My doctors have no idea what’s going on but there’s nothing major/scarring etc.

I have done a fair bit of research on liver issues. There are many links between liver disease and various other things. For example, psoraisis and liver disease. And, yes, apnea and liver disease. And various autoimmune diseases and...hyperlipidemia and... BTW, if you have a diagnosis of NAFL, it would be incorrect to say that there is nothing wrong with your liver.

That said, you are correct that it is the scarring that you want to especially avoid (and that usually begins with inflammation/NASH). The gold standard (in most ways) is still the biopsy. The problems there are it is both invasive and samples a tiny amount of the liver volume -- making it possible to miss major things via the biopsy. A fibroscan is a decent (and fairly new to the US) tool -- but is best at detecting fairly significant scarring. It also has issues if your BMI is> 30.

The MRE is a better tool than the FS...it can the fat % in the liver and is more sensitive in terms of scaring. I assume you have been screened for the various hepatitis strains as well as for things like the various inflammation markers.

[sleepy-programmer]

I’m sorry also if I didn’t explain my whole entire story good enough. It would be a long story to go into details and I really can’t do all that typing on my iPhone...maybe someday when I get a chance I can. But for now have a good night everyone.

How long have you been on CPAP now? If you've been on the dental device this long, I'd think you could compare how you feel generally on CPAP. Have you noticed a difference in sleep, energy levels, function, etc? It's a bummer, I don't want to be on CPAP either, but I want to give it a few months to understand what it might do for me. Some folks here have said it took months before they really noticed anything. If you've already been on it for months that's a different story I suppose.

[ravenous28]

Has anyone ever had any experience of linking abnormal liver function blood test results to untreated osa? Over the last 6-7 years (and around the time I was diagnosed with osa) my doctors noticed I had unexplained elevated liver ast/ast. It would go up and then back to normal with months and months of testing over the years. After seeing a liver specialist doctor having multiple blood tests, a liver biopsy and fibroscan and there’s nothing wrong with my liver, maybe some fatty liver and something that the doctor can’t explain to maybe very tiny external damage that is benign in all the scans. My doctors have no idea what’s going on but there’s nothing major/scarring etc.

I have done a fair bit of research on liver issues. There are many links between liver disease and various other things. For example, psoraisis and liver disease. And, yes, apnea and liver disease. And various autoimmune diseases and...hyperlipidemia and... BTW, if you have a diagnosis of NAFL, it would be incorrect to say that there is nothing wrong with your liver.

That said, you are correct that it is the scarring that you want to especially avoid (and that usually begins with inflammation/NASH). The gold standard (in most ways) is still the biopsy. The problems there are it is both invasive and samples a tiny amount of the liver volume -- making it possible to miss major things via the biopsy. A fibroscan is a decent (and fairly new to the US) tool -- but is best at detecting fairly significant scarring. It also has issues if your BMI is> 30.

The MRE is a better tool than the FS...it can the fat % in the liver and is more sensitive in terms of scaring. I assume you have been screened for the various hepatitis strains as well as for things like the various inflammation markers.

Yes I see a liver specialist doctor in Pittsburgh currently. I had just about every blood lab you can think of out there and scan and liver biopsy done with the end result showing my liver functioning normal. The doctors can’t explain why the blood labs are up and then back to normal over the years. From what I understand explained is there is perhaps something as to what he said you would see in external inflammation but it’s very minor and not something he can label as nafld or Nash. I did mention that I had sleep apnea and he doesn’t think that’s a factor. Although I didn’t tell him perhaps it’s long term untreated apnea? Right now I don’t have Nash but he wants to test it as if it was Nash by diet and taking vitamin e and pulling more function blood labs this year to see if it improves etc.

I’ve been dealing with this for like 7 years and it dawned upon me seeing this listed the way it did in the Mayo Clinic website about sleep apnea. I’m curious exactly what that means... does it mean perhaps these numbers are just skewed because I want treating my osa properly over the course of the years and my body was not healing itself during sleep the way it should or is it something else. I’d like to know what is meant by sleep apnea causing abnormal results on liver function tests because it sure seems like this may be something to look into. I don’t know how long I’ve been suffering from apnea but I wasn’t formal diagnosed with it until 2012.. tried the cpap for a month and failed it, then went on the mouthpiece for 6 years without a proper sleep study. I guess I felt ok over the years but I’m not really good with that analysis because I’m so used to being drained and tired with family life and responsibilities that it seems like normal. I went back on cpap the last 2 months and it’s treating the osa, according to sleepyhead and myAir app so far but you can see why I’m curious to know if I was and am treated for the osa with the mouthpiece.. personally I’d prefer the mouthpiece option if it works in treating correctly but I can’t say for sure until I have a follow up on soon.

I just wonder if this is all correct I might if just wasted 7 years not properly treating my osa and never really knowing and possibly explaining the reason for the elevated liver mystery. It sort of makes sense that if you keep going on sleeping like crap for years and not fixing it or checking to make sure it works it’s gotta have an effect on your body and organs one would have to assume. It’s not like people on cpap who can easily get their results on an sd card daily. The mouthpiece you can only go by feelings and paying for sleep studies over and over again. Like I said I’m getting another sleep study done in about a month and that will be the final verdict for me. The reason I’m doing on these so called tests with the mouthpiece is because I get 3 nights only and I need to make sure I’m at a good adjust on it where I can feel like it’s working the best I can do. I had a sleep study done with the mouthpiece last December but it was a failed test because the mouthpiece was falling out of my mouth while I was sleeping and I was subconsciously bitting it back into place random times throughout the night. I know this because I recorded myself sleeping on my iPhone during the tests.

I recently went back to my sleep dentist and to it adjusted and re lined to stay in and it’s working now on that front. So time will tell I guess with the study if I pass or fail.. I’m sorta mad honestly because the first 3 night study with the mouthpiece I did in December the sleep lab people destroyed my data by using the wrong software and I had to do yet another 3 more nights a week later... then like I said I found out the mouthpiece wasn’t even staying in my mouth.. it was a disaster al during Christmas break. So as of right now, I still don’t know for a fact that it is working for me or not. But I know thanks to remed myair and sleepyhead that cpap is. It’s just a mess really. But I don’t want to give up either on it without knowing. Once I get this apnea completely under control no matter what device I end up ultimately using for a few months etc I can then start seeing if indeed it had anything whatsoever to do with the elevated liver with those blood labs scheduled.

Again it’s all hypothetical right now and I won’t know anything yet. All I know is yes I’m treated with the apap and it’s working great honestly and in a real way I will be sort of mad if I find out i fail with the oral device sleep study because that means I just wasted 7 yrs potential sleeping like shit. And I’m sure long term low sp02 levels for many years associated with osa can’t be good for my body either. Again this is all just an educated guess but not treating it can’t be good. So Atleast I’m trying to take this issue more serious now.. that’s the story of with my osa journey it hasn’t been good and yes I know it’s my fault for not following up like I should’ve back in the beginning when I was using the mouthpiece. Unfortunately, insurance and the doctors don’t require it to continue in or monitor compliance the way they do with cpap. I was supposed to get a follow up sleep in 2013 with mouthpiece and I didn’t so yes it’s all on me. I sort of slipped through the cracks on it and no one cared to schedule the sleep study or find out. It was me who actually went back to the sleep dentist and told him the story and he then said yeah.. we gotta get you tested for a sleep study.... so anyway wish me luck on it all i guess.

[sleepy-programmer]

You say the CPAP has been working for you, glad to hear that! Can you physically feel the benefits? Good luck with everything and getting the oral device to work. Mine didn't work for me.

Also can you please break this post up into paragraphs? It's very hard to read as it is.

[ravenous28]

You say the CPAP has been working for you, glad to hear that! Can you physically feel the benefits? Good luck with everything and getting the oral device to work. Mine didn't work for me.

Also can you please break this post up into paragraphs? It's very hard to read as it is.

Yeah I feel it but it’s hard too at times because my sleep has been all over the place with being messed up lately due to lack of sleep with 2 young kids etc etc. Back in 2012 I can say yes I felt good, the snoring was eliminated or so my wife said but again I don’t know because I’m rated mild to moderate I might’ve just been living with it most of my life feeling so used to it. Even with the cpap it’s saying treated on sleepyhead and I feel ok but it’s still very hard to go by my feeling alone because I don’t get a full 8 hrs maybe 5-6 per night recently with the kids. Personally, I think the mouthpiece was working over the years but not perfectly and there’s no way of me knowing unless I keep paying for ongoing sleep studies or try to go by feelings alone. I wish I could just purchase the resmed apneas airlink home sleep study myself that the doctors prescribe and use the software. Last I looked it was like 5000 dollars online and you had to be approved medical to be allowed to buy it. Remed has that market place locked down from the general public getting their hands on it. I’m fact there’s big warnings when you get the equipment that says if they don’t get the home sleep kit back from you in 5 days your account will be billed 2500 dollars. So yeah they don’t want the public having it or using it to analyze their own sleep study.. you have to pay if you want it. Cpap users have it easier since they can use sleepyhead and third party software whatever to easier see how the treatment is going. Here’s the device that the doctors use. It’s forbidden for the general public to use because it will actually tell you your own data better then sleepyhead even. It’s a shame because
there is no way this device is complicated to figure out how to use. I’m sure the software does all the analysis anyway. But this is the device they are sending out for people getting home ones done. If anyone here has one for sell or knows where to legally get one let me know.

https://www.resmed.com/us/en/healthcare ... k-air.html

[ravenous28]

I don’t expect most people here to understand exactly what a MAD is or does being on a cpap talk forum.

You might be surprised. Many people here that are successfully using cpap have a MAD taking up space in a drawer somewhere.

I’d be curious to hear their stories if they got a real custom made MAD like tap 3 or just one on eBay boil and bit that’s not approved for treatment of osa. The way it is with my insurance where I live is you can’t even get a MAD covered by insurance unless you first try cpap you failed the therapy. Only then will insurance help you pay the cost of a 2000 dollar mouthpiece. Unless you go to a local dentist in your area who wants to make one up for you, you might be able to get it cheaper and outside insurance. Most people probably won’t want to fork over the money to test out something that can’t be trailed and returned like cpap can...the place I’m going to the dentist is a certified board member sleep specialist. Not just a random dentist making oral devices for people coming in.