CPAP & Aortic Aneurysm

[Midwest_non_sleeper]

I have a coworker that has been diagnosed with OSA through two sleep studies with an AHI of around 40. Her doctor recommended CPAP therapy, but insurance declined it. She also has an aortic aneurysm, so I don't know if that plays any part.

There is very little documentation on aortic aneurysm and OSA, but I did find a little bit. A study showing that CPAP may actually help prevent the aneurysm from rupturing (due to lowering blood pressure), though that study is in question. This person can receive a free machine from a relative, which I told her to do. I do not know what brand or model it is, but it may be better than nothing.

Is there any reason why this person should NOT be on therapy due to the aneurysm? I wouldn't think that an aortic aneurysm would have much to do with someone's respiratory system and OSA, but I wanted to see of there was some other information or opinion.

[Julie]

We are NOT doctors, and while we may know about Cpaps in general, and OSA to a larger extent than others with no experience of years on the forum, we could not possibly comment on your question - not validly, though some will probably have lots to say. Your co-worker (not even a close relative) needs to talk to his/her own doctor and/or be referred to a cardiopulmonary specialist and should not be taking advice from you (nothing personal, but hope you understand). Cpap just blows a little air into your throat to help keep it open so it can reach your airway so you do not keep choking overnight. That's what it does, and all it does. Side benefits of lower BP and/or fewer bathroom visits are great but again not related to an existing aneurysm. And as someone who's worked in teaching hospitals all my life, I would not think Cpap or OSA has anything to do with something as serious as an aortic aneurysm, but would not dream of even discussing it with the 'patient'. Google is not a doctor either, by the way and obviously knows nothing at all about this individual's med. specifics.

[Midwest_non_sleeper]

I am in agreement with you Julie, I told her that she needs to get in touch with her doctor asap, I just didn't know if there was a medical reason to NOT use PAP therapy with her condition, or if anyone had a similar condition and could shed a little light.

Let me rephrase that first line, I STRONGLY suggested that she get back in touch with her doctor, as in, today.

[Julie]

Good for you... I sometimes get too harsh with people over stuff like this - wasn't aimed at you, but sometimes others can be positively scary.

[GTOJim]

I have an ascending aortic aneurysm, discovered about the time I went on CPAP, around 2002 or 2003. I've very close to needing surgery and have been closely monitored. The good news is my aneurysm is considered stable, meaning it hasn't gotten any larger. My heart doctor feels the aneurysm was caused by high blood pressure and has me taking three blood pressure medications.

Answering your question, Yes I have OSA and an aortic aneurysm. The difference is my aneurysm isn't located in my abdomen it's in my chest close to my heart which very often goes undetected. I'm very lucky it was discovered, otherwise it is doubtful I would be here today. It should be safe to use CPAP with an aneurysm. Personally I would highly recommend it, it is very important to get high blood pressure under control.

Over the years I've met many people who have OSA and don't use their CPAP. My sister-in law for example threw her CPAP away.

In your friends case OSA isn't something to be taken lightly.

[Midwest_non_sleeper]

Good for you... I sometimes get too harsh with people over stuff like this - wasn't aimed at you, but sometimes others can be positively scary.

No worries, I knew what you were saying. I'm not a doctor and I would never pretend to give someone advice on something I know nothing about.

[Midwest_non_sleeper]

I have an ascending aortic aneurysm, discovered about the time I went on CPAP, around 2002 or 2003. I've very close to needing surgery and have been closely monitored. The good news is my aneurysm is considered stable, meaning it hasn't gotten any larger. My heart doctor feels the aneurysm was caused by high blood pressure and has me taking three blood pressure medications.

Answering your question, Yes I have OSA and an aortic aneurysm. The difference is my aneurysm isn't located in my abdomen it's in my chest close to my heart which very often goes undetected. I'm very lucky it was discovered, otherwise it is doubtful I would be here today. It should be safe to use CPAP with an aneurysm. Personally I would highly recommend it, it is very important to get high blood pressure under control.

Over the years I've met many people who have OSA and don't use their CPAP. My sister-in law for example threw her CPAP away.

In your friends case OSA isn't something to be taken lightly.

Thanks for the info, I didn't think it was risky for whatever reason to use XPAP with an aneurysm. Hers is also near her heart, and I believe it is stable as well. Anyway, she's going to go back to her doctor, because an untreated AHI of 40 is pretty bad. Her blood pressure is consistently high, and untreated OSA may play a part in that - but she needs to discuss that with her doctor.

[jnk...]

My understanding (as someone with zero medical training) is that the exact location, nature, and condition of an aortic aneurysm can determine the advisability of lung function testing, for example, which can, of course, involve sudden fluctuations of pressures well beyond what CPAP involves.

Airway closures caused by untreated OSA can result in violent sudden fluctuations of pressures (both air and blood) and damaging unpredictable hormonal responses. As a general rule, preventing such closures with something as harmless as the slightly pressurized air of CPAP is much more likely to reduce complications and risks for the cardiovascular system than to cause them. For that reason, very few conditions are firm contraindications of PAP, I believe.

But in harmony with earlier posts: we pay docs to help us make those calls for ourselves, since our personal histories and family histories can sometimes involve exceptions to most any rule of thumb.

But if I read you correctly, the doc recommended PAP and she just needs to pay for it out of pocket for some reason. Her medical coverage is about money; what the doc recommended is about what she needs for her health. Unfortunately, the two don't always line up well.

[Midwest_non_sleeper]

I just spoke with her, her doctor recommended XPAP therapy after she had the sleep tests, but never submitted a prescription for her - which is likely why insurance denied it.

She is going back to the doc tomorrow to get either a prescription or a referral to a sleep doc. Someone messed up, and she should be raising hell.

[jnk...]

Not that I have anything against heck-raising, but the details of the mix up may lie well hidden, deep behind the medical 'red/white wall of silence.' I probably wouldn't pursue it forensically unless my coworker was willing to submit to a polygraph about HER recollection of all events and discussions that may have occurred with medical personnel subsequent to the polysomnography.