Dumb Question or Merely Mystified

[blownaway]

But based on my experience.

Does CPAP "cure" apnea or does it merely respond to apnea events. The reason I ask is that my AHI for the last 4-5 months has been under 1.5 or less, down from an average of around 5+ when I first started. Normally, I only sleep around 4 hrs/night but last night I slept for 8.5 hours, a real rarity. But there was only one event, a clear airway indicator for an AHI of 0.15. HOWEVER, when I quit using the machine, I start getting very sleepy at times during the day. So while the numbers are one thing, reality is quite another.

[palerider]

But based on my experience.

Does CPAP "cure" apnea or does it merely respond to apnea events. The reason I ask is that my AHI for the last 4-5 months has been under 1.5 or less, down from an average of around 5+ when I first started. Normally, I only sleep around 4 hrs/night but last night I slept for 8.5 hours, a real rarity. But there was only one event, a clear airway indicator for an AHI of 0.15. HOWEVER, when I quit using the machine, I start getting very sleepy at times during the day. So while the numbers are one thing, reality is quite another.

cpap doesn't "cure" apnea (not sure what the quotes are for) any more than glasses "cure" bad vision. in fact, glasses and cpap have about the same effect on the underlying condition.

if you should wear glasses and decide to go around without them one day, your vision isn't going to have improved due to the previous use of your glasses.

[LSAT]

But based on my experience.

Does CPAP "cure" apnea or does it merely respond to apnea events. The reason I ask is that my AHI for the last 4-5 months has been under 1.5 or less, down from an average of around 5+ when I first started. Normally, I only sleep around 4 hrs/night but last night I slept for 8.5 hours, a real rarity. But there was only one event, a clear airway indicator for an AHI of 0.15. HOWEVER, when I quit using the machine, I start getting very sleepy at times during the day. So while the numbers are one thing, reality is quite another.

cpap doesn't "cure" apnea (not sure what the quotes are for) any more than glasses "cure" bad vision. in fact, glasses and cpap have about the same effect on the underlying condition.

if you should wear glasses and decide to go around without them one day, your vision isn't going to have improved due to the previous use of your glasses.

+1

[BlackSpinner]

Brace don't cure a leg, glasses don't cure eyesight, a bra doesn't cure saggy breasts, a jock strap doesn't cure droopy penis, clothes don't cure a tendency to frost bite at -20c

[chunkyfrog]

I wear glasses and a hearing aid; and I need help breathing while I'm asleep.
With my various "crutches", I can enjoy life as if I were born luckier.
It works for me.

[blownaway]

Y'all answered the first part of my question (rather sarcastically it seems) but not the second which is: why has my AHI declined so drastically over the last few months? I'm sure that were I to retake the sleep study again, at this time, it would produce a radically different result, there being very few recordable sleep events. Yet I can't deny that using CPAP produces a noticeable benefit, more alertness during the day. Do I just chalk this up to inexplicable mystery?

[yippeekia]

CPAP can prevent events from happening, thus allowing you to sleep better. There could be many other factors that could improve your numbers as well. Perhaps you have been sleeping on your side more, rather than your back. Perhaps you haven't been eating right before bed. Perhaps your allergies are better. Perhaps you have changed your medications, etc. Not saying that it is any of these things, but they all can impact sleep quality.

Best Wishes!

[Julie]

Have you lost a lot of weight? It can make a difference, though won't mean you can go off Cpap. And it's possible some other condition you had when you started Cpap has cleared up, even if it wasn't something you were particularly aware of or that had been diagnosed.

[rohdej]

Your low AHI is what was left after getting "Good" treatment. You look to be well treated when using your XPAP.

Most of us do start the first few days on CPAP with a higher AHI but As you got control leaks, getting a good fit on your mask and letting the machine do its job the AHI scores tend to drop. These low scores are not curing you. They only indicate that the treatment is working, you are breathing the way the machine expects you to because the machine is splinting your airway open.

Just like glasses correct vision closer to 20/20 only when you ware them. If you sleep without your Xpap you will revert to your old untreated AHI score and feel the effects.

[blownaway]

CPAP can prevent events from happening, thus allowing you to sleep better. There could be many other factors that could improve your numbers as well. Perhaps you have been sleeping on your side more, rather than your back. Perhaps you haven't been eating right before bed. Perhaps your allergies are better. Perhaps you have changed your medications, etc. Not saying that it is any of these things, but they all can impact sleep quality.

Best Wishes!

Yeah, many of those points were in the back of my mind when I first posted, including the preventative aspects of CPAP. If CPAP forces airway open, does that not also keep the airway open for a period of time, thereby preventing closure and by extension any additional events from occurring as long as the present level of pressure continues. This is why I put the word "cure" in quotation marks, to take it with a grain of salt. Once the pressure drops off significantly, a collapsing airway is again likely to occur. So at the very least its safe to say that prolonged use of CPAP is likely to cause a significant reduction of events for people like myself who don't have severe apnea.

[BlackSpinner]

CPAP can prevent events from happening, thus allowing you to sleep better. There could be many other factors that could improve your numbers as well. Perhaps you have been sleeping on your side more, rather than your back. Perhaps you haven't been eating right before bed. Perhaps your allergies are better. Perhaps you have changed your medications, etc. Not saying that it is any of these things, but they all can impact sleep quality.

Best Wishes!

Yeah, many of those points were in the back of my mind when I first posted, including the preventative aspects of CPAP. If CPAP forces airway open, does that not also keep the airway open for a period of time, thereby preventing closure and by extension any additional events from occurring as long as the present level of pressure continues. This is why I put the word "cure" in quotation marks, to take it with a grain of salt. Once the pressure drops off significantly, a collapsing airway is again likely to occur. So at the very least its safe to say that prolonged use of CPAP is likely to cause a significant reduction of events for people like myself who don't have severe apnea.

Not always. REM sleep for many people requires more pressure to keep the airways open. That is why titration can be so wrong if you don't get into REM sleep. It can take you mind up to a month to accept the fact that it is safe to sleep deeply now with that thing on your face. So for some people they get MORE events as they get used to the therapy. The pressure required can change during the night which is why there are usually some events left.

There is some indication that the use of cpap can hang over for a few days for people who are not severe which is why they tell you not to use it for about a week before another sleep study.

[Janknitz]

Y'all answered the first part of my question (rather sarcastically it seems) but not the second which is: why has my AHI declined so drastically over the last few months? I'm sure that were I to retake the sleep study again, at this time, it would produce a radically different result, there being very few recordable sleep events. Yet I can't deny that using CPAP produces a noticeable benefit, more alertness during the day. Do I just chalk this up to inexplicable mystery?

You're assuming your UNTREATED apnea will be better because your AHI on the machine is going down. But let me ask you this--what's the setting on your machine for reporting AHI?? it can be set for an average of 1 month, 1 week, 1 day. So what you may be seeing is simply acclimating to the machine. The first few weeks AHI is typically higher as the settings are getting dialed in and you are getting used to sleeping with the machine, conquering leaks, etc. So what you may be seeing is the average coming down over a month as you get settled in with your machine. Even if your machine setting is for one day only, it just tells me that you have acclimated well to the machine and are getting good, effective treatment now.

I'm quite sure that if you were to retake the sleep study again, you are likely to get similar results to your original study because the machine has done nothing to "cure" your apnea. Nice wishful thinking, though.

[D.H.]

Frequent Apnea events irritate the airways, perhaps making your AHI even worse. However, you are not "cured," so don't expect that the improvement would continue (or even maintain) if you were to discontinue treatment. Also, as somebody already pointed out, you are more accustomed to CPAP now, so you just have a "routine" that works for you.

[Tino2You]

Y'all answered the first part of my question (rather sarcastically it seems) but not the second which is: why has my AHI declined so drastically over the last few months?<snip>

Hi Blownaway,

Have you looked at the data that your machine is recording? It should tell you how many events and what type you are experiencing. Also tells you what pressure you are being administered throughout the night. It is possible that your hitting the sweet spot where the therapy is being very productive. In my case I need higher pressure when I am on my back than when I am on my side. Recently I had shoulder surgery and had to sleep on my back. My pressure was almost flat lined at the high pressure setting (well ok at the 95% level) but my AHIs were still <1.

Other things that can cause a drop in AHI is getting used to the mask/machine and sleeping better (sometime when you toss and turn the machine reads it as an event. Maybe you have finally got the mask/seal where it should be (newbies tend to over tighten).

All of the stuff listed above should be viewable in the data.

-tino ... with no sarcasm

-tino

[palerider]

Y'all answered the first part of my question (rather sarcastically it seems)]/quote]
no sarcasm was intended on my part, simply a very apt analogy likening this medical condition to another common one that people use a mechanism to overcome.

but not the second which is: why has my AHI declined so drastically over the last few months? I'm sure that were I to retake the sleep study again, at this time, it would produce a radically different result, there being very few recordable sleep events. Yet I can't deny that using CPAP produces a noticeable benefit, more alertness during the day. Do I just chalk this up to inexplicable mystery?

you tell us, there are many variables in the human condition that play into how your body responds to things, list everything that's changed, even if it seems insignificant, and perhaps someone can guess as to what the difference is. also post detailed charts of what your sleep was like a few months ago, and what it's like now.

otherwise, you're just asking people to gaze into their crystal balls, or tea leaves, and divine an answer for you.