Dr. Dean Edel speaks about CPAP and chronic pain

[Janknitz]

http://vaca.bayradio.com/kgo_archives/k ... =2&hour=14 (this segment is about 45 minutes in)

A caller to this national doctor call in show asked if Dr. Edel could explain why the arthritis in her knees stopped hurtin when she started CPAP therapy.

He had a few theories, his main theory is that a person on CPAP tosses and turns less, and therefore joint pain is decreased. But he acknowledged that there may be other explanations as well

I know I don't move in my sleep any more or less than before, but the arthritic pain in my shoulder is MUCH improved since CPAP. I'm still not sure I'm ready to give CPAP all the credit, but I'm not ruling it out, either.

[MarylandCPAPer]

Is Dr. Edel a real doctor?? I hear him on the radio quite a bit and shudder at a lot of bad advice he gives. I am not a medical professional but I have competent doctors who I trust and whose treatments work. Dr.(??) Edel constantly gives out bad information on his radio show.

The other day, he said that not all DCIS (ductal carcinoma in situ) develops into breast cancer. Excuse me, but DCIS IS breast cancer. A close friend just had surgery for DCIS and a related condition that was State 3 breast cancer and is being treated with radiation. I couldn't believe hs said DCIS may not turn into breast cancer, when it IS breast cancer.

I have not listened to what he has said about sleep apnea, but I would ask a doctor with experience as a physician before asking Dean Edel anything and hoping for an accurate answer. I believe he has worked as an eye doctor and then became a radio personality. I listen to him sometimes for entertainment (more like watching train wrecks on the radio), but I would not follow his advice on anything without an opinion from a competent doctor.

Just my 2 cents worth.

[Slinky]

I used to listen to Dr Dean Edell when I was running my mail route - until he responded to a question about Crohn's disease. He was so far off base I never did listen to him after that.

[kteague]

I think it is generally accepted that poor sleep correlates with a low pain threshold. Stands to reason then that the better sleep that results from cpap treatment could improve pain levels.

[unadog]

As my Rheumatologist told me, they use sleep deprivation as a form of torture!

There have been many studies showing that sleep deprivation **causes pain** in otherwise healthy subjects.

My theory is that progressive brain change (shrinkage) is responsible for much of the generalized pain and fatigue of fibro. What Hans Seyle called the the "general adaptation syndrome" from stress (no sleep, allergies, etc. etc.)

That so-called "doctors" reasoning is so limited, mechanistic, and short sighted that you almost wonder whether he ever studied medicine and the immune system? Arthritis is an immune system disorder ....


This site goes a little too far I think, but makes the point:

http://thesleepsite.com/content/view/42/50/


Fibromyalgia sufferers tend to lack normal amounts of slow wave sleep (stages 3 and 4 of non-REM sleep, also called delta sleep). These stages are the deepest, soundest stages of sleep. They have been felt important for the restoration of the body during sleep.

It also was found that if one deprives normal people of slow wave sleep, they develop fibromyalgia symptoms! Thus, one can imagine a vicious circle being established. The more pain, the worse the sleep quality, with less stage 3 and 4 sleep--which then makes the pain even worse.

And a recent investigation found SLEEP APNEA in 80% of fibromyalgia victims. Sleep apnea fragments sleep, thereby reducing slow wave sleep. Sleep apnea is extremely common--potentially serious if severe, with such complications as heart attack, high blood pressure, stroke, heart failure and sleep-related highway crashes--and eminently treatable!



This is from Wiki (limited, but handy ....)

The term stress was first employed in a biological context by the endocrinologist Hans Selye in the 1930s

General adaptation syndrome

Stress is how the body reacts to a stressor, real or imagined, a stimulus that causes stress. Acute stressors affect an organism in the short term; chronic stressors over the longer term.

Selye researched the effects of stress Alarm is the first stage. When the threat or stressor is identified or realized, the body's stress response is a state of alarm. During this stage adrenaline will be produced in order to bring about the fight-or-flight response. There is also some activation of the HPA axis, producing cortisol.

Resistance is the second stage. If the stressor persists, it becomes necessary to attempt some means of coping with the stress. Although the body begins to try to adapt to the strains or demands of the environment, the body cannot keep this up indefinitely, so its resources are gradually depleted.

Exhaustion is the third and final stage in the GAS model. At this point, all of the body's resources are eventually depleted and the body is unable to maintain normal function. The initial autonomic nervous system symptoms may reappear (sweating, raised heart rate etc.). If stage three is extended, long term damage may result as the capacity of glands, especially the adrenal gland, and the immune system is exhausted and function is impaired resulting in decompensation.

The result can manifest itself in obvious illnesses such as ulcers, depression, diabetes, trouble with the digestive system or even cardiovascular problems .....

[Kiralynx]

I was diagnosed with sleep apnea because on on-going pain issues after my cancer surgery and because of the hip pain which didn't exist during the day, but which woke me at least twice a night since 2002.

The pain management doctor who sent me for my sleep test said that when anyone presents with chronic pain, she sends them for a sleep test first and rules out sleep apnea before considering any other treatments.

My hips don't hurt, for the most part, since CPAP.

[oscar98]

I was diagnosed with sleep apnea because on on-going pain issues after my cancer surgery and because of the hip pain which didn't exist during the day, but which woke me at least twice a night since 2002.

The pain management doctor who sent me for my sleep test said that when anyone presents with chronic pain, she sends them for a sleep test first and rules out sleep apnea before considering any other treatments.

My hips don't hurt, for the most part, since CPAP.

It's quite interesting that you mention this. I had not drawn a connection between the two, but I've been having terrible hip pain on the right side when I sleep for about a year now. I was getting regular trigger point injections at the orthopedist. I canceled the injection apt this week because my hip suddenly stopped hurting.

Now that you mention this I realize that around the time I committed myself to making cpap work is about the same time the hip pain stopped. My low back and right shoulder are also not hurting nearly as much as before.

Now if I could just get the migraines under control, 22 migraines in the past months is insane. I usually only have one or two a month.

[Jersey Girl]

I have moderate arthritus and very little cartaladge in my left knee. CPAP has not made one bit of difference in my pain level for that condition. It has, however, helped me to function better in life with the fog of fatigue having been lifted. I still had to see an orthopedic for my knee, however. Perhaps cpap is a placebo affect with arthritus for some?

Regards,

Jersey Girl

[cotech50]

Based on the physiological changes that I have seen in myself since starting cpap about 6 mos ago I am convinced that OSA which I had for who knows how many years must have been the cause of many of my problems. I have seen a steady slow improvement ever since starting cpap. The lack of good sleep must compromise the immune system which over time slowly manifests itself in a wide variety of physical changes none good for the body or soul. Too bad there is not a way of telling just how close a person was to a major life changing event when they start getting treatment. In reality one never knows how close the body is to a breaking point. Well I know for a fact that positive changes are still taking place and I do not know how much more improvement to expect but I will take what I can and enjoy it.

[Muse-Inc]

...I do not know how much more improvement to expect but I will take what I can and enjoy it.

Started CPAP therapy Aug '07 and still seeing improvements, have had some backsliding and had to make some adjustments & now dealing with persistent multiple nightime wakeups for which I am still seeking a possible cause and resolution...but overall, it's been nearly continuous mostly small improvements. Slowest to recover has been my short-term memory which I notice but few around me do so it's gotta be better than it was. Oh, and my weird word phenomena is just about gone: used to say box or envelope when I meant pot...right concept, wrong word.

[Kiralynx]

It's quite interesting that you mention this. I had not drawn a connection between the two, but I've been having terrible hip pain on the right side when I sleep for about a year now. I was getting regular trigger point injections at the orthopedist. I canceled the injection apt this week because my hip suddenly stopped hurting.

Now that you mention this I realize that around the time I committed myself to making cpap work is about the same time the hip pain stopped. My low back and right shoulder are also not hurting nearly as much as before.

Now if I could just get the migraines under control, 22 migraines in the past months is insane. I usually only have one or two a month.

Pretty amazing, isn't it? Within a short period of time after getting my pressures optimized, the pain issues were resolving. Sure makes me wish that I'd had a sleep test the first time I complained about it, back on 2002! I could have been spared a great deal of misery.

Can't say on the migraines, but perhaps that will ease, too. Sure hope so, for your sake.

[Kiralynx]

I have moderate arthritus and very little cartaladge in my left knee. CPAP has not made one bit of difference in my pain level for that condition. It has, however, helped me to function better in life with the fog of fatigue having been lifted. I still had to see an orthopedic for my knee, however. Perhaps cpap is a placebo affect with arthritus for some?

I am quite sure that CPAP is not a placebo effect on my arthritis.

OTOH, I have not yet reached a stage so degenerative that I have no cartilage, as you have. It was beginning to go. Might be interesting, in another year or so, to have a scan and see how that compares with the one done in 2007, the year before I was diagnosed and got my BiPap.

My mother, with congestive heart failure, which I am convinced was caused by undiagnosed apnea, also had no cartilage in her knees. Perhaps you may count yourself fortunate that you have not yet reached the point of any further damage to your body from the apnea.

[oscar98]

Perhaps cpap is a placebo affect with arthritus for some?

Regards,

Jersey Girl

I'm not sure if it could be considered a placebo effect because for it to be such I would have needed to have been told ahead of time the cpap might improve my pain. I had no expectation for it to improve anything other then daytime sleepiness and didn't draw the connection between cpap and the pain until about and hour ago. Perhaps the difference from one person to the next is the root cause of the pain.

I've seen a big decrease in hip, low back and shoulder pain but I don't have arthritis, my husband on the other has arthritis, bone spurs and bursitis and hasn't seen any change in how his joints feel. (or at least his level of complaining hasn't changed any)

[dwsupt]

I have been seeing the opposite effect. I now sleep through the night and many nights I do not move at all. By 5 -6 a.m. I hurt in the knee and hips and back from staying motionless all night. That being said, I would take it everynight compared to being up all night and unable to slepp soundly.

[brazospearl]

My experience has been that pain is much relieved now that I'm on CPAP therapy. I don't know if it's just because I'm sleeping better or what. I used to wake up many times during the night, and I thought it was because of the pain. Now I think I woke up because of the OAS and I just noticed the pain because I was awake. Either way, I feel lots better, orthopedically-speaking, than before.