Effectiveness of CPAP?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
SimSportPlyr
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Effectiveness of CPAP?

Post by SimSportPlyr » Sat Aug 18, 2012 6:26 pm

Hi Folks -

I'm looking for data on the success rate of CPAP.

This web site http://www.ihatecpap.com/cpap.html gives some success rate numbers, although I'm not sure I understand the difference between the '23-45%' and 'nearly 100%!' data.

BTW, I just got a CPAP machine a few days ago and I'm trying to get used to it (little success so far).

Thanks for any pointers!

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BlackSpinner
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Re: Effectiveness of CPAP?

Post by BlackSpinner » Sat Aug 18, 2012 6:33 pm

Add you equipment to your profile and we could help. Especially if you explain your problem.

If you actually use your cpap machine every time you sleep, your mask doesn't leak and your pressure is appropriate for your needs, and it actually provides the therapy you need then it is probably 99% effective in relieving your OSA.

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SimSportPlyr
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Re: Effectiveness of CPAP?

Post by SimSportPlyr » Sat Aug 18, 2012 6:48 pm

BlackSpinner, I updated my profile just now, although I'm having difficulty matching up the menu choices in the profile with my equipment.

Here's what the label on my equipment says:

Philips Respironics REMstar Auto A-Flex System One, REMstar Auto, DOM

Humidifier: System One HT Humid, DOM

The mask I've tried to use is ResMed Mirage FX. I also have a Swift FX that I tried for a short while. Both masks are loaners.

Another question: Is it appropriate to discuss the tradeoffs between CPAP and oral appliances on this forum?

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Pugsy
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Re: Effectiveness of CPAP?

Post by Pugsy » Sat Aug 18, 2012 7:10 pm

You have chosen the wrong machine and humidifier in your equipment list. Don't worry happens all the time.

Look on the bottom of your blower unit for a sticker that has the model number on it...usually preceded by DS or Ref...look to see if it is 550 or 560.

from the equipment list in the profile area.. look for a grouping of equipment that begins with PR System One xxxxx
If it is 550 choose PR System One Remstar Auto CPAP with AFlex.

If it is 560 from the equipment list...choose PR System One 60 series Auto CPAP and if you know you have the heated hose you can choose that one...there is a 560 that may not have the heated hose.

The 60 series is the newest model with the heated hose humidifier.

In the humidifier section look for the grouping that begins with PR System One...and make your selection base on your machine...

If you have the 560....send me a private message and I will point you to some software that you can use so you can see your data.
If you have a 550...look in my signature line at lower left of my post here and you will see information about SleepyHead and you can use it with the 550 model.

Please choose the text option in the equipment section...the images are tiny and we can't see model names on the images. Look at my profile here to see how mine is shown. It helps us help you better and faster if you have a problem. Otherwise we have to click on the link and it is a little bit more work for us and we tend to like less work.

Welcome to the forum. This stuff isn't easy but it isn't impossible either. Any problems you may have I bet you that someone here has had the same problem and worked through it. Just tell us what bugs you and we can come up with all sorts of ideas to help you work through it.

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SimSportPlyr
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Re: Effectiveness of CPAP?

Post by SimSportPlyr » Sat Aug 18, 2012 7:23 pm

Pugsy, I updated my profile based on your advice, although I'm still not sure it's correct.

My blower unit says "560P' on the sticker.

The problem that I'm having with this equipment is that it feels comfortable enough for about 5 mins, but after another 5 mins I feel like I'm not getting enough oxygen. I see that others have reported the same thing.

I've tried using this unit for two nights, and after tossing and turning for about an hour I take it off and fall directly to sleep.

BTW, I'm still interested in getting some success rates, if any exist in the public domain.

Thanks.

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Pugsy
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Re: Effectiveness of CPAP?

Post by Pugsy » Sat Aug 18, 2012 7:34 pm

You almost have the right machine...
This is the one you need to choose
PR System One 60 Series Auto CPAP + heated humidifer core

The 60 series Plus you have currently chosen is model 260 and doesn't offer data and if you don't change it then people will bug you telling you that your machine doesn't offer data and you need to get rid of it.

I will send you a private message in a few minutes about the software you can use. Right now SleepyHead won't work with it but EncoreBasic will.

Regarding success rates...I haven't seen any particular recent data and you have found your way to a cpap forum and we wouldn't be here if we failed and put the machine in the closet. So pretty much everyone here is using their machine. Now some have seen better results than others and some have an easier time of it than others. Some have seen immediate remarkable improvement and some people it takes some time and some work to see the improvement that they want to see.
So by "success" are you referring to just using the machine all the time...or are you referring to the quality of life after beginning and using cpap therapy?

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Pugsy
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Re: Effectiveness of CPAP?

Post by Pugsy » Sat Aug 18, 2012 7:38 pm

SimSportPlyr wrote:The problem that I'm having with this equipment is that it feels comfortable enough for about 5 mins, but after another 5 mins I feel like I'm not getting enough oxygen. I see that others have reported the same thing.
What are your pressure settings?
Are you using the ramp feature to work up to your prescribed pressure? If so...where is it starting and how long before you get to your pressure?

If you are starting out the night at 4 to 6 cm...for many people they feel like there simply is not enough air moving and they start feeling stifled or suffocated...while we won't suffocate at those pressures it sure can feel like we are.

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BlackSpinner
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Re: Effectiveness of CPAP?

Post by BlackSpinner » Sat Aug 18, 2012 7:39 pm

It depends on what you refer to as success. If you mean people using it? Then it seems to be just over 50% in general. Truckers and pilots have a much higher success rate - their careers depend on it so they are more motivated to get answers.
Simply by coming to this forum you have upped your chances to making it work. One of the main reasons for failure is the total lack of support out there to help people figure out the problems they are having.
Take masks for example. Would you plan to take a long hike with shoes you haven't walked in? Which don't fit you? And yet masks are not tried on laying down under full pressure. When was the last time you bought a pair of $300 shoes without trying them on and walking around the store?

Personally, I put the mask on and woke up the next morning feeling good.

_________________
Machine: PR System One REMStar 60 Series Auto CPAP Machine
Mask: Hybrid Full Face CPAP Mask with Nasal Pillows and Headgear
Additional Comments: Quatro mask for colds & flus S8 elite for back up
71. The lame can ride on horseback, the one-handed drive cattle. The deaf, fight and be useful. To be blind is better than to be burnt on the pyre. No one gets good from a corpse. The Havamal

SimSportPlyr
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Re: Effectiveness of CPAP?

Post by SimSportPlyr » Sat Aug 18, 2012 8:40 pm

A couple of you asked what I mean by 'success'.

In my mind, success does not translate to 'is using the machine (as prescribed)'.

In my mind mind, success is, "use of the CPAP machine significantly increases sleep quality'".
Last edited by SimSportPlyr on Sat Aug 18, 2012 8:47 pm, edited 2 times in total.

SimSportPlyr
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Re: Effectiveness of CPAP?

Post by SimSportPlyr » Sat Aug 18, 2012 8:45 pm

Pugsy, my pressure setting is 5 CM H20, which I understand is a low setting. I don't believe that I am using the ramp feature, but I'm not positive. The unit is pre-programmed; I have not changed any settings.
Pugsy wrote:
SimSportPlyr wrote:The problem that I'm having with this equipment is that it feels comfortable enough for about 5 mins, but after another 5 mins I feel like I'm not getting enough oxygen. I see that others have reported the same thing.
What are your pressure settings?
Are you using the ramp feature to work up to your prescribed pressure? If so...where is it starting and how long before you get to your pressure?

If you are starting out the night at 4 to 6 cm...for many people they feel like there simply is not enough air moving and they start feeling stifled or suffocated...while we won't suffocate at those pressures it sure can feel like we are.

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Pugsy
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Re: Effectiveness of CPAP?

Post by Pugsy » Sat Aug 18, 2012 9:00 pm

If one of your discomfort issues is feeling suffocated then that 5 cm starting point is a very likely culprit.
I did a screening of my own sister with my APAP machine and I wanted to use 4 cm because all I wanted was to see if some events popped up and she couldn't tolerate either 4 or 5 cm...she said I was trying to kill her by suffocating her.
It wasn't until I tried 6 cm that she could breathe comfortably.

If you aren't comfortable making a small change in pressure yourself then get with your machine supplier Monday and tell them that you are having problems breathing...feeling suffocated.

Also if your mask is too tight...it actually defeats the purpose because they need to inflate to work properly.
So besides it hurting like the devil if the mask can't inflate properly then the air doesn't move well and compound it with a low setting and it is uncomfortable.

So if you can describe each problem you have so that we have a real good idea what you are going through then we can come up with ideas to help.

Success to me is also an improvement in quality of my sleep and how I feel each day.
The cpap part of my therapy is a success. I no longer wake up with killer headaches from oxygen level drops to the low 70s. I no longer have to get up to pee every hour on the hour. I no longer nod off to nap at 9 AM when I just got up at 7 AM. Do I feel like running a marathon? No, I don't but I am 60 years old and I have other health issues and arthritis and I wouldn't feel like running a marathon even if I didn't have sleep apnea but you know what....at least I don't wake up every day feeling like I have just run a marathon.
The machine fixes one thing...sleep apnea...it doesn't fix stuff that is unrelated to sleep apnea. If we have poor sleepy hygiene or have insomnia or we only get 4 hours of sleep or the meds we take make us groggy during the day or whatever....it doesn't fix "bad sleep" and bad sleep can come from a whole lot of other things. There are a lot of sleep disorders besides sleep apnea.

I think a lot of "failures" come from people expecting the machine to fix something that is unrelated to sleep apnea.

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retrodave15
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Re: Effectiveness of CPAP?

Post by retrodave15 » Sat Aug 18, 2012 9:14 pm

SimSportPlyr wrote:Hi Folks -

This web site http://www.ihatecpap.com/cpap.html gives some success rate numbers, although I'm not sure I understand the difference between the '23-45%' and 'nearly 100%!' data.
I first look at the source of the data - my college statistics classes taught me that it is in how you ask the questions, you can make the data support your position. In this case they are selling a dental appliance.

With anything it takes time to go through the phases of adjustment, acceptance and recovery. I will take time to erase the sleep debt and reverse the damage that might have been caused by untreated sleep apnea. For me it was finding the right mask, the right pressure setting, but now I feel great, with the exception of my neck, but that is another story. In 10 months I have halved the dose of my blood pressure medication, I am getting my depression and ADHD under control, and for the first time in a very long time - I have a good outlook on life. One other added benefit - I have not had to fill my script for the little blue pill from Pfizer for quite some time - now that's motivation for me.

This forum I have found is an invaluable resource for questions and support.

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SimSportPlyr
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Re: Effectiveness of CPAP?

Post by SimSportPlyr » Sat Aug 18, 2012 9:36 pm

Pugsy -

There isn't much physical discomfort due to the mask itself. It is not overly tight-fitting. The discomfort seems to be entire the feeling of not getting enough oxygen.

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Pugsy
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Re: Effectiveness of CPAP?

Post by Pugsy » Sat Aug 18, 2012 10:02 pm

SimSportPlyr wrote:The discomfort seems to be entire the feeling of not getting enough oxygen.
Yep, common complaint when people use the lower pressures. Not enough air movement...stifling...suffocating...
Some people are quite happy at the lower pressures but a good many of us would feel like we are trying to breathe through a tiny straw covered with cheesecloth if we were to try 4 or 5 cm....

I sent you the link for the provider manual....try this..just for daytime experiment...not changing anything regarding actual therapy....go in to the clinical setup menu and change the minimum pressure to 6 cm...and try it for 5 minutes while awake with no intention of going to sleep..then try 6.5..then 7.0 ....see if the lack of oxygen feeling lessens.
I am not asking you to change your actual therapy pressure...just to test what it would feel like if you started out with a little more air moving.

Then contact your DME with your thoughts and get official approval to change things. It won't be the first time they have heard that the pressure was suffocating feeling.

Some people are comfortable making this change themselves....I don't get that feeling from you just yet. You aren't comfortable with your therapy yet...too many questions that are unanswered. Get some answers and you will get more comfortable with all this. There is a huge learning curve here...it's big but it isn't rocket science and certainly not impossible to surmount.

You have a whole forum of members here that will offer support, pat on the back, swift kick in the behind ...whatever you need...just ask.

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robysue
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Re: Effectiveness of CPAP?

Post by robysue » Sun Aug 19, 2012 10:02 am

SimSportPlyr wrote:A couple of you asked what I mean by 'success'.

In my mind, success does not translate to 'is using the machine (as prescribed)'.

In my mind mind, success is, "use of the CPAP machine significantly increases sleep quality'".
These are two very different questions with very different answers.

The http://www.ihatecpap.com/cpap.html site is primarily interested in measuring "success" as using the machine (as prescribed)". The common figures in published research indicates that the long term compliance rate for CPAP is somewhere around 50%. And "compliance" means "using the CPAP at least 4 hours each night for at least 70 to 75% of the nights." And that is a weaker definition than "using the machine (as prescribed)" since "using the machine (as prescribed)" means using the macine all night long, ebery single night. So the http://www.ihatecpap.com/cpap.html numbers may well be in the right ballpark since in their view "success" = "using the machine (as prescribed)"

Using your definition of "success" as meaning "use of the CPAP machine significantly increases sleep quality'" the success rate becomes very close to 100%--as documented by titration studies done in the lab. For almost all people with OSA who undergo a full night titration study, the PSG shows that CPAP at an appropriate pressure reduces the AHI to the normal range (AHI < 5) and very, very often in the lab setting, the AHI is reduced to 0.0 or very close to 0.0.

In practice, however, "success" needs both parts: A demonstrated ability for CPAP to reduce your AHI to 0.0 in the lab means nothing if you are unwilling (or unable) to tolerate wearing the mask night after night in your own bed. And far too many folks give up prematurely because of lack of patient support and education programs

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