Weekly update + Q: Non-CPAP spouses & Impact of Obamacare

[no1texan]

Here's a brief update for the last week since my last post. First night on my BiPAP 6/22, AHI 14.87. In the following days, my AHI has dropped 5< 3 times, 2 times just over 5. Still have high leaks. The rep came by and agrees the leaks must be coming from my mouth and is sending a chin strap to try. Otherwise I am enjoying my BiPAP immensely. There is no question about my increase in energy but not a huge rush but I can clearly notice different times each day that I have more energy and drive to get things done that before would have been a struggle. I believe the benefits from my BiPAP are being hidden by my obesity and diabetes 2. I am working very hard on both of these particulary my weight. I expect to reach my first short term weight goal Aug 22. As I lose my weight and especially when I reach my target weight I expect the diabetes to quieten down and eventually go dormant.

Questions - completely different topics:
1. For you with spouses who do not use CPAP, do they say if your machine is noisey and if yes, is it enough to impact their sleeping? Before going on CPAP there was noise from snoring, etc. But now my wife says the machine does make a noise she can hear and sometimes it is louder which i don't know what would make it louder at different times.

2. If Obamacare is allowed to continue, i.e. not repealed in 2013, I am curious if anyone knows yet the impact of Obamacare on coverage for sleep apnea tests and therapy machines/equipment especially for those on Medicare.

Texan

[avi123]

Here's a brief update for the last week since my last post. First night on my BiPAP 6/22, AHI 14.87. In the following days, my AHI has dropped 5< 3 times, 2 times just over 5. Still have high leaks. The rep came by and agrees the leaks must be coming from my mouth and is sending a chin strap to try. Otherwise I am enjoying my BiPAP immensely. There is no question about my increase in energy but not a huge rush but I can clearly notice different times each day that I have more energy and drive to get things done that before would have been a struggle. I believe the benefits from my BiPAP are being hidden by my obesity and diabetes 2. I am working very hard on both of these particulary my weight. I expect to reach my first short term weight goal Aug 22. As I lose my weight and especially when I reach my target weight I expect the diabetes to quieten down and eventually go dormant.

Texan

Comments,


Please forget that your Diabetes will go dorment even if you stop binging on Girls Scout Cookies!

About loosing weight to improve your BiPAP performance you better loose more than 20% of your present weight, and especially the fat tissue in your throat.

Sorry about the slim chances.

[Janknitz]

No1Texan, I don't know what bee got up Avi's butt, but most of us aren't A***holes here. That was uncalled for.

You may find it much easier to lose weight on PAP. Apnea and disruptive sleep patterns interfere with the hormones (insulin, grehlin, and leptin) which regulate appetite and body fat--and cause diabetes!

The machine is not perfectly silent, but perhaps the sound your wife is hearing is due to mouth leaks? My DH is very grateful for my CPAP as it's MUCH quieter than my snoring. He often slept on the couch BC (before CPAP) and he has been able to sleep beside me every night since.

[jweeks]

First night on my BiPAP 6/22, AHI 14.87. In the following days, my AHI has dropped 5< 3 times, 2 times just over 5. Still have high leaks.

Texan,

Welcome to the BiPAP club. It is nice to see your AHI going down.

The leaks are something that you have to get under control. Leaks can trick the machines into running wild and prevent them from adjusting enough to treat events. There really are only a few choices, and those are (1) full face mask, (2) chin strap, or (3) sealing up your lips (either taping or with one of the other similar tricks). I cannot handle a full face mask (I have a high cheek bone, so none of them will fit), so I run with a nasal pillow mask (Swift LT). I cannot get just a chin strap to work--my lips still open up and let the air out. Just tape doesn't work since moisture gets blown through my lips and dissolves the glue on the tape enough to cause leaks. As a result, I do both tape and a chin strap. It is a little bit of a pain in the butt, such as always having to be clean shaven, but it is worth it to be able to wear a nasal pillow mask.

As far as the weight goes--you will find it easier to lose as you get your treatment fully dialed in and into a groove. I wouldn't look at weight loss as the silver bullet. However, there are 1000 reasons to lose weight, and being diabetic, everything you can do will help. My brother had small weight issue and was diabetic, and he found that low carb worked best for maintaining good blood sugar levels, but that wasn't always the low fat alternative. If you haven't already found a support group for diabetics, search one out.

As far as the noise goes, try putting your machine along side your bed, maybe about 8 inches off of the floor. That way, the noise should be largely absorbed by the side of the mattress. There are other reasons to keep your machine below your bed. For example, if you get moisture in the hose, it will run down into the water tray rather than into your nose. Another trick is to use a fleece liner on your hose to help absorb some of the airflow noise. You might also want to try a few different masks to see if one makes less noise than the others. For example, my beloved Swift LT is pretty noisy, but the Swift FX is quieter.

One thing that might bother your wife is that the BiPAP changes noise levels as your breathe, and since your respiration rate varies over time, it isn't a constant noise. It is possible that you can find a way to mask that noise, such as running a fan in your bedroom. A fan would have a constant noise, which can quickly fade into the background.

I notice that once I get to sleep, I don't hear my machine any more. That raises the question of when your wife is hearing the noise, and why she isn't asleep. Any chance that she also is having problems sleeping? It could be that she is worried about your pre-CPAP breathing issues and is sleeping very lightly, or possibly she doesn't quite trust the machine yet.

Best of luck, and please keep posting updates.

-john-

[no1texan]

Comments,


Please forget that your Diabetes will go dorment even if you stop binging on Girls Scout Cookies!

About loosing weight to improve your BiPAP performance you better loose more than 20% of your present weight, and especially the fat tissue in your throat.

Sorry about the slim chances.

avi123, unless you have at least M.D. following your name (if you do you should update your profile) plus many diabetic studies over years of research to support your statements, you are completely wrong and your discouraging "unfounded" comments don't belong on this forum. There is not enough space to list the many medical reports that show the positive effect weight loss has on diabetes 2. Notice I said diabetes 2, not diabetes 1. You did not make this distinction which further says you don't know what you are talking about. When I have reached my weight goal, I will have lost 40% of my current weight which has the high probability of removing the need (by my doctor's concurrence) for taking diabetes 2 medication. "Fatty tissue in your throat," another unsupported ignorant statement you have made. Medical professionals all say it is the fat around the middle-belly fat that is most dangerous. To make direct and factual comments on this forum that are true and based on medical data is helpful to OP and other readers. But to make false, misleading statements as you have made don't belong on this forum. Anything you post in the future will now be in question because of your unfounded reply on this thread.

Importance of Weight Management in Type 2 Diabetes: Review with Meta-analysis of Clinical Studies
1. James W. Anderson, MD, FACN,
2. Cyril W.C. Kendall, PhD, FACN and
3. David J.A. Jenkins, MD, PhD, DSc, FACN
http://www.jacn.org/content/22/5/331.full
Obesity is a major risk factor for development of diabetes, and excessive energy intake is a major contributor to poor glycemic control in Type 2 diabetes. The impact of obesity on risk for diabetes as well as coronary heart disease (CHD) risk factors and the benefits of weight loss in decreasing risk for developing diabetes and improving glycemia and CHD risks were reviewed. A systematic review of the medical literature to assess the impact of obesity and weight gain on risk for diabetes and CHD was done. We performed a meta-analysis of the effects of weight loss for obese diabetic individuals. Controlled clinical trials assessing lifestyle changes on risk for developing diabetes and weight loss effects on glycemia and CHD risk factors were reviewed. Obesity and weight gain can increase risk for diabetes by greater than ninetyfold and CHD by about sixfold. Very-low-energy diets (VLED) decrease fasting plasma glucose values by ∼50% within two weeks and these changes are sustained with continued energy restriction. Twelve weeks of energy-restricted diets were associated with these significant decreases: body weight, 9.6%; fasting plasma glucose, 25.7%; serum cholesterol, 9.2%; serum triglycerides, 26.7%; systolic blood pressure, 8.1%; and diastolic blood pressure, 8.6%. Larger weight losses were associated with larger reductions in these values. The reviewed data suggest that US health care providers should endorse the American Heart Association’s and European diabetes associations’ recommendations that diabetic persons achieve and maintain a BMI of ≤25 kg/m2. Weight management may be the most important therapeutic task for most obese Type 2 diabetic individuals.

Very low energy diets in the treatment of obesity.
Mustajoki P, Pekkarinen T.
SourcePeijas Hospital, Department of Medicine, Sairaalakatu 1, 01400 Vantaa, Finland. pertti.mustajoki@pine.pp.fi
http://www.ncbi.nlm.nih.gov/pubmed/12119638
Very low energy diets (VLEDs) are defined as diets which contain energy levels of less than 3.4 MJ (800 kcal) per day and contain daily allowances of all essential nutritional requirements. These diets have been in clinical use for more than 20 years. They are used as the only source of nutrition for 8-16 weeks, which usually achieves a weight loss of 1.5-2.5 kg per week. Before using this type of diet a medical investigation is necessary to evaluate contraindications and to check medication use during the diet. To facilitate maintenance, cognitive behavioural counselling should always be included in a weight reduction programme using a very low energy diet. VLEDs have no serious harmful effects and can safely be used in patients with various chronic diseases. Programmes using VLEDs produce better short-term weight loss than programmes without the diet. However, in randomized controlled trials VLED-based programmes have not achieved significantly better long-term maintenance than conventional programmes. VLEDs are used when rapid weight loss is necessary because of an obesity-related disease. In other patients with obesity it is an alternative to other conservative approaches for treatment of obesity. In type 2 diabetes it may improve long-term glucose metabolism better than conventional weight reducing diets. Some studies suggest that after a VLED-based programme long-term maintenance is better among men than women. This possible gender difference is an important topic for further research

[nanwilson]

Avi..I don't know where you get your nutty info...but for your info my D-2 is well contolled by what I eat, as a matter of fact I am now below the criteria for D-2. I really don't know anyone that has diabetes that would be stupid enough to binge on girl scout cookies...wash your mouth out, you are way off base.

Texan....Keep up the diet, believe me it does work on your type 2. There are very few of those prescribed with cpap that have been able to go off the hose by loosing alot of weight...there are a lot of skinny folks here on the forum, so weight is not always the culprit. Loosing weight may not fix your osa, but it will certainly help diabetes, heart disease and general well being. Good luck. I am will to bet that your wife will soon get used to the white noise of your machine...white noise is a heck of alot better than listening to heavy snoring from a freight train all night.
Cheers
Nan

[no1texan]

Texan....Keep up the diet, believe me it does work on your type 2. There are very few of those prescribed with cpap that have been able to go off the hose by loosing alot of weight...there are a lot of skinny folks here on the forum, so weight is not always the culprit. Loosing weight may not fix your osa, but it will certainly help diabetes, heart disease and general well being. Good luck. I am will to bet that your wife will soon get used to the white noise of your machine...white noise is a heck of alot better than listening to heavy snoring from a freight train all night.
Cheers
Nan

Agree nanwilson. My goal for losing weight, for me it is 110 pounds is to put DB-2 as inactive as possible-not cured-but reduced and reduce all the other risks due to obesity. I knew my osa was not specifically related to my weight but treating osa would help to get more quality sleep and thereby feel better = help to reduce weight.

[DoriC]

Tex, is it possible for you and your wife to sleep in separate rooms during this adjustment phase? Mike and I had to do that because 2 sleepless people under the same roof created a real storm! Once I was able to sleep a little better,even though I was awakened several times during the night to make his adjustments for him, I could handle the cpap and every day stuff better. It's all about compromise...and keeping the wife happy!.

@Avi, Do you ever Preview your responses before you hit the Send button?? Try it, please!

[SleepDepraved2]

My RT told me that the machine will get louder if it has to compensate for leaks, so that is probably what your wife is hearing.

My husband loves my machine. The one I use is very quiet, and even if it weren't, it still would be quieter than my snoring.

You might consider getting a white noise machine. We have one in our room and it helps even out the different ambient noises that can disturb your sleep. My husband is a musician and sometimes has issues with tinnitus after a gig, so I bought him one for Christmas. I run it at night to help even out HIS snoring now. Though now that he is seeing the results of my BiPAP after only a week, he wants me to go with him to the doctor next week to talk about another sleep study to see if he can tolerate a different mask than he was offered at the clinic he went to, not the same as mine. I've told him how my joints are no longer hurting me and how my eyesight seems to have improved, both of which are problems he has. He also is a type 2 diabetic and would like to see if it would help with his weight loss.

The increase of energy helps you move more and more sleep helps your metabolism speed up, so you should absolutely see an impact.

Even with the weight loss, you may find you still need BiPAP. I know I have snored all my life, at every weight I have ever been at, including when I was at my ideal weight, so while I hope to lose weight, I expect I will be using my machine the rest of my life.

[no1texan]

Agree re: need for CPAP not tied to weight. Even when I reach my weight goal, I will have my BiPAP for many years or even forever even if only just because I enjoy it so much.

Thanks for all the constructive suggestions re: mouth breathing solutions. I am going to try the chin strap for a while when I receive it and I have some Blue painters tape handy if needed.

Good comments on reducing the NSN. At least the noise I make is no longer snoring. By the way, for you CPAP veterans, NSN is a new acronym I made for non-snoring noises.