Very discouraged

I have a CDL license and was sent to be checked for sleep apnea because of my license. I drive a school bus a couple hrs a day not a tractor trailer. I drive my car more. That was two years ago and was told that I had mild sleep apnea and got a machine and tried all different masks and found that using a machine that was set at 8 with nasel pillows worked for me. Then my Dr changed me to an auto machine set at 4 because he thought that's what I needed. I have been using this for over 1 year. I lost alo weight and just went to be checked again. I really thought I would be taken off the machine (I sleep so much better without it) but got a call that I still needed the machine (of course) but that my apnea was much better. They want to raise my pressure from 4 to 10? If it is better, why after 1 year do they want to raise the pressure? Iv'e been checked several times since this all started. I really feel like this whole process is a big rip off! I had to block the supply company on my phone because they call all the time and want to send supplies which I have tons of because they send so much so they can bill the insurance company. I am very discouraged. Does this make sense or am I being difficult? I think I need another opinion. Are there any tests that can be done on your own instead of going to the sleep centers? Help! Thank you!

Pressure needs have no bearing on severity of the sleep apnea.
A person can have a very mild OSA diagnosis with maybe AHI of 10 and they might need a pressure of 20 cm while a person with severe OSA diagnosis with AHI of 80 might only need 6 cm pressure.
It's all about the airway tissues themselves and how easily they collapse and what pressure is needed to hold the airway open and not about how often it collapses.
I know it seems like that doesn't make sense but it is the way things are. It's about the patency of the airway and how easy or not it is to keep the airway stented open.

Finally...we have heard of several people who have lost weight and end up needing more pressure...again it doesn't sound like it is logical but you aren't the first and won't be the last.
While your OSA might be improved in terms of the number of apnea events...the tissues in your airway are still floppy and sag and need to be held open with cpap pressure.

You can get a second opinion if it will make you feel better but what has happened to you isn't unusual at all. We have seen it often here on the forum. Weight loss doesn't guarantee anything in terms of OSA diagnosis or pressure needs.

As to why sometimes more pressure is needed even though the number of apnea events have declined...we don't know but I have sometimes wondered if the loss of some excess fat in the airway tissues has just created more flab to have to be held open...similar to what we see with the under arm skin thing when weight is lost and the skin under the arm really gets to sagging.

Leaving it at 4 for a year was very incompetent of them. The minimum should be set to something close to your pressure needs.

Learn what your machine can do and raise the pressure yourself.

There is software available to show you what is happening at night - use it. Look at the thread above called "Pusgy's tutorial..."

Only about 50% of people can get off cpap by losing weight - for the others it was the apnea which caused them to gain weight.

I have a CDL license and was sent to be checked for sleep apnea because of my license. I drive a school bus a couple hrs a day not a tractor trailer. I drive my car more.

I find it very disturbing that you think that sleep apnea is of little consequence when you carry 30 or 40 LIVES in your hands every school day--much more precious than widgets in a tractor trailer. After two years you are still showing denial about your apnea and the danger it presents to you and to the children you are charged with keeping safe. You say you "sleep better" without the CPAP--that implies you sleep without the CPAP that has been prescribed for you--how often???

Instead of wasting time and money on another sleep study that you can perhaps game without anybody looking, how about focusing on making this therapy work optimally for you? We can help you optimize the machine settings and the mask for the best possible comfort and highly effective therapy. It's imperative you use the machine every night, every time you sleep--your life and many others depend on it. And you can be sure I am NOT being overly-dramatic, apnea is dangerous--this is the absolute truth.

I saw her ask for HELP because she's very discouraged. Sometimes how you give someone advice is as important as what the advice is. Telling her when she's discouraged that she is in denial or think it's of little consequence is more likely to drive her away than help her .

She lost a lot of weight, great for her, she probably put a ton of effort into it, and was hoping and probably under the impression it would go away. That's not someone in denial or who thinks it's of little consequence, that someone working hard. Instead she's told she needs to up her pressure and is confused and frustrated. Perfectly understandable.

Lynnie wrote:I have a CDL license and was sent to be checked for sleep apnea because of my license. I drive a school bus a couple hrs a day not a tractor trailer. I drive my car more. That was two years ago and was told that I had mild sleep apnea and got a machine and tried all different masks and found that using a machine that was set at 8 with nasel pillows worked for me. Then my Dr changed me to an auto machine set at 4 because he thought that's what I needed. I have been using this for over 1 year. I lost alo weight and just went to be checked again. I really thought I would be taken off the machine (I sleep so much better without it) but got a call that I still needed the machine (of course) but that my apnea was much better. They want to raise my pressure from 4 to 10? If it is better, why after 1 year do they want to raise the pressure? Iv'e been checked several times since this all started. I really feel like this whole process is a big rip off! I had to block the supply company on my phone because they call all the time and want to send supplies which I have tons of because they send so much so they can bill the insurance company. I am very discouraged. Does this make sense or am I being difficult? I think I need another opinion. Are there any tests that can be done on your own instead of going to the sleep centers? Help! Thank you!

Lynnie,

1. Losing weight can sometimes "cure" apnea but unfortunately that's probably over-stated. Often it does not. Regardless the fact that you've made it better is incredible, no?

2. Don't worry about needing more pressure, that's in no way a negative and it might have been too low to begin with.

3. If you don't sleep well with CPAP there may be things you can do to improve that, but you'd need to say what specific things bother you, as it can be different for everyone. For one person it might be air blowing on them, for another it might be mask comfort etc. Often there are ways to overcome these things by changing masks or machine settings etc.

4. If you can please list your CPAP machine and mask in your profile, that will make it much easier to get help.

5. Do you have any idea what your test results were? How many "AHI events", what your lowest oxygen level was etc?

Again, I understand your discouragement, but from here it sounds like you've done great. This forum may be able to help you sleep much better with CPAP.

You mentioned that you have an "auto" machine ... I believe all autos are full data capable.
So download Sleepyhead software and see what is happening during the night.
That is not quite the same as a sleep test .. but it will tell you a lot.
I think you will find that your auto machine is set to a range of 4 to XX ... rather than just set to 4. So the auto machine can adjust to your needs

Lynnie,
I also was required to get a sleep study for a DOT physical when I felt like I was sleeping just fine. It was when I woke up that I was dizzy and it was a struggle just to get ready for the day, not while I was sleeping. I didn't know all the ways sleep apnea can affect you. It was a long process for testing, titration, and overcoming initial mask problems with basically no help. I was angry because everything was out of my control. Until I found this forum and answers to many of my questions. I downloaded Sleepyhead and actually felt in control again. I have experience with the medical field and their terminology but this was an area that I had never studied and found I had a lot to learn.
Now after over a year of therapy, I am so glad for that required Sleep Study. I saw my mother experience snoring and a lot of the complications of sleep apnea, but I didn't have enough knowledge to know at the time what was going on. Now that I know, it's too late for my mother, but I want to do what I can to avoid those complications. And feeling like I can accomplish things during the day is a great bonus!

1. Learn about your machine. Tell us what it is we can help.
2. If it is data capable, download Sleepyhead. This site will help you. https://sleep.tnet.com/resources/sleepyhead Also check out the other links he has a lot of info.
3. Ask questions, there will be someone to help.