Long term effects of its use

[Truth behind talking points]

Is there any long term study of the use of the CPAP machine? I was diagnosed a slight apnea problem. According to my Doctor I do not need the machine, but since I barely qualify for it she recommended that I use it for the apnea and snoring problems. I have been researching it and it looks like there is tons of good marketing for it, but there are very short in facts with regards to the downside of it. I am fairly young, and the idea of being slave to a machine for the next 60 years of my life is a scary one.

1) Are there any unbiased, peer-reviewed studies of the long term use of the CPAP machine?
2) Are there any studies of persons that stop using it? For example, if I start and then stop after a year, will I return to slight apnea, or will I then have full apnea?
3) What happens to a person’s that has bee habituated to the machine and try to take a nap without it? Will he/she be able to nap?

Will the documented side effect of nasal congestion make me even more dependent on the machine?
After seeing how cigarette companies advertise something that was easy to start using and hard to stop, I am very careful starting something that I will not be able to stop. The adds, web page, and forum have language that is very similar to the ones used to defend the cigarettes. After all the definition of a trap is something easy to start, but impossible to stop.

Is the CPAP Machine a trap designed to treat the symptom while increasing the underlying root cause (congestion)?

[Julie]

Hi, if you're having nasal congestion, try turning down the humidifier- it's often the cause. As to whether people have used Cpap for a long time (and lived to tell about it ) yes, though relatively fewer than now because it's use is barely a generation old, if that. I've never heard of any negative stuff regarding long term use. If you nap without Cpap, you'll "sleep", but feel just as lousy when you awaken as you would sleeping a night without it - why wouldn't you? If you stop using it, you'll probably feel not terrible the next day, but gradually feel worse and worse as time goes on. Apnea is not cured by a certain length of Cpap use, so it will come back.

[Wulfman]

Is there any long term study of the use of the CPAP machine? I was diagnosed a slight apnea problem. According to my Doctor I do not need the machine, but since I barely qualify for it she recommended that I use it for the apnea and snoring problems. I have been researching it and it looks like there is tons of good marketing for it, but there are very short in facts with regards to the downside of it. I am fairly young, and the idea of being slave to a machine for the next 60 years of my life is a scary one.

1) Are there any unbiased, peer-reviewed studies of the long term use of the CPAP machine?
2) Are there any studies of persons that stop using it? For example, if I start and then stop after a year, will I return to slight apnea, or will I then have full apnea?
3) What happens to a person’s that has bee habituated to the machine and try to take a nap without it? Will he/she be able to nap?

Will the documented side effect of nasal congestion make me even more dependent on the machine?
After seeing how cigarette companies advertise something that was easy to start using and hard to stop, I am very careful starting something that I will not be able to stop. The adds, web page, and forum have language that is very similar to the ones used to defend the cigarettes. After all the definition of a trap is something easy to start, but impossible to stop.

Is the CPAP Machine a trap designed to treat the symptom while increasing the underlying root cause (congestion)?

Welcome to the forum.
Although a great deal of your post makes me angry at the way you've approached this therapy, I'll try to keep my response neutral.

First of all, you say you're "fairly young". None of the rest of us developed full-blown Obstructive Sleep Apnea overnight. It developed over quite a few years. They may have caught yours at the beginning stages and over time it will most assuredly get worse. The more years you suffer from sleep apnea, the more harmful effects it has on the body. Sleep Apnea deprives the body of needed oxygen while you sleep. It's not a sleep disorder, it's a breathing disorder. Many physical factors can enter into it......nasal limitations (enlarged turbinates and deviated septum)......collapse of the airway while sleeping......jaw shape and placement.......and many others. Then, there's also Central Sleep Apnea which is neurological in nature......the brain forgets to tell the body to breathe.

If you're not overweight yet, you may very well become that way......the oxygen deprivation throws your body metabolism out of whack. Contrary to what's being spewed in the media, sleep apnea is more likely to cause weight gain than the weight gain causing sleep apnea.

I can think of many other things I would rather NOT be dependent on for the rest of my life. Having a CPAP assist my breathing during the night is not one of those and it also makes for better sleeping.

I NEVER take a nap in bed without mine, but I CAN manage an hour or so in my recliner without it. General advice is to "never nap without your PAP".

Don't be in denial. Face this situation like an adult......get and use the machine. NOT using the machine can lead you to an early grave.


Den

[Beyond talking points]

Thank you for the replies; I defiantly did not try to make anybody angry only to find facts. There are tons and tons of web sites and research telling me the benefits, but I have not found any with regards to long term studies. I am only looking for the balance view of it.

I know marketing and one of the typical approaches to sell a new technology is to dismiss concerns by selling the advantages. This is what most web sites are doing. I am simply trying to go beyond the marketing into the facts. It is the responsible thing to do as I only have one life to live. I am still looking for answers for the three questions above.

For clarification:
1) The same way that I never started smoking, I have not started using the CPAP machine yet.
2) All that have taken a nap under a palm tree on a beautiful beach with the love of your life knows that there are times you want to be as God brought you to this world without being tatter to cell phones, power lines, or CPAP machines.

[Wulfman]

Thank you for the replies; I defiantly did not try to make anybody angry only to find facts. There are tons and tons of web sites and research telling me the benefits, but I have not found any with regards to long term studies. I am only looking for the balance view of it.

I know marketing and one of the typical approaches to sell a new technology is to dismiss concerns by selling the advantages. This is what most web sites are doing. I am simply trying to go beyond the marketing into the facts. It is the responsible thing to do as I only have one life to live. I am still looking for answers for the three questions above.

For clarification:
1) The same way that I never started smoking, I have not started using the CPAP machine yet.
2) All that have taken a nap under a palm tree on a beautiful beach with the love of your life knows that there are times you want to be as God brought you to this world without being tatter to cell phones, power lines, or CPAP machines.

Define "long term".
For one thing, this is a relatively "new" therapy......about 30 yrs. old. It's only been in the last 5 - 20 yrs. that the prevalence of this condition has become more knowledgeable.

None of us are "marketing" this therapy to make a buck off of it.......but, we can damn sure tell you that it works and we don't want our lives shortened by sleeping without it or go back to the way we were before we started therapy.


Den

[roster]

2) All that have taken a nap under a palm tree on a beautiful beach with the love of your life knows that there are times you want to be as God brought you to this world without being tatter to cell phones, power lines, or CPAP machines.

I once loved to nap on the beach. Once my condition was diagnosed, I realized the napping on the beach was a symptom of my sleep apnea. Now I prefer to body surf all day.

God brought me into this world bloody; covered with body fluids; messing in my pants; and screaming selfishly anytime I was the least bit hungry, cold or hot. A week without my CPAP and I would be back to the way God brought me into this world.

[Truth behind talking points]

Thank you for your information and candor. I appreciate all the comments specially the one that say that I have a rare gift that it was diagnosed early. I understand that this is the best and most likely the only option to somebody with significant apnea and I would never, ever, challenge their decision to live tatter versus dying of lack of oxygen. All I want to know how to I use this gift of early warning? Will going to CPAP right away give me a boost of energy (well rested) but take away my ability to find other options? Or will it give me the temporary rest needed to address the root cause.

[roster]

All I want to know how to I use this gift of early warning? Will going to CPAP right away give me a boost of energy (well rested) but take away my ability to find other options? Or will it give me the temporary rest needed to address the root cause.

You have apparently undergone a diagnostic PSG. What about a titration study?

Have you been evaluated for Positional Sleep Apnea?

Do you have obstructive, central or complex sleep apnea?

What was your AHI and what is the nature of any oxygen desaturations?

What is your BMI?

Do you have any comorbidities?

How is your general physical and emotional health?

Exactly how old are you?

[packitin]

deleted

[Truth behind talking points]

Rooter……Thank you, thank you, thank you!!!! This is what I meant by truth behind talking points. I have read all the talking points about either CPAP or lack of oxygen, but the information that you just share is what I have been looking for.

Q: You have apparently undergone a diagnostic PSG. What about a titration study?
A: No, I have not. All that the Dr did was a sleep study follow for a ‘Congratulations, it was barely but you qualify for a CPAP. You can start using it today.” Then proceded to share talking points about the benefits of the machine. After my research it looks like she was reading from the web site of one of the manufacturers.

Q: Have you been evaluated for Positional Sleep Apnea?
A: No, I have not

Q: Do you have obstructive, central or complex sleep apnea?
A: I have no idea. I asked and the doctor said that the study was designed to know if I qualify for the CPAP.

Q: What was your AHI and what is the nature of any oxygen desaturations?
Q: Do you have any comorbidities?
A: No idea.

Q: What is your BMI?
No idea. I took it from around 40 to the 20s five years ago. I should be back to around 30 now because I needed to stop excersizing due to surgery. I started excersizing again and should be back to the 20s in two months.

Q: How is your general physical and emotional health?
A: I have a 3 year old girl that barely started sleeping through the night 1 year ago. I am highly paid because I get results under very challenging and stressful conditions where others have failed before. It is not unusual for me to only have 20 total hours of sleep from Monday to Friday and on some a couple of times a year to have a 6 to 10 total hours available of sleep in a week. I change time zones frequently. I underwent surgery last year and returned to work only to find out that there is a long list of persons that took advantage of my two month medical leave to lobby for my work. I do balance stress by happy family life and meditation. Typical stuff…….

Q: Exactly how old are you?
A: 41.

As you see, CPAP for life may be premature decision as there are may be other options. I am greatful as you have given me areas to focus my research for before my next meeting with my doctor.

By the way; I like and appreciate your humor and even though I surf my wife does not. She rather nap.

[kteague]

The answers to the above posted questions may clarify things. If your results were indeed mild, and your study of good time and quality, you may want to investigate if your situation has decent odds of help with a dental device. But below is a "little light reading" on cpap treatment adherence.

Poor adherence (30-60%)... leaving many OSA patients at heightened risk for co-morbid conditions, impaired function and quality of life.
http://www.ncbi.nlm.nih.gov/pubmed/20308750
CONCLUSIONS: Good adherence to long-term CPAP treatment can significantly reduce HbA(1C) levels, but has no effect on markers of insulin resistance.
http://www.ncbi.nlm.nih.gov/pubmed/19231280
CONCLUSIONS: Good compliance to CPAP treatment lowers the serum levels of cardiovascular risk factors...
http://www.ncbi.nlm.nih.gov/pubmed/17573492
CONCLUSIONS: In patients with moderate-to-severe obstructive sleep apnea, compliant CPAP usage may improve insulin secretion capacity, reduce leptin, total cholesterol, and low-density lipoprotein levels.
http://www.ncbi.nlm.nih.gov/pubmed/19127383
These results indicate that CPAP decreases blood pressure among those with OSA...i]
http://www.ncbi.nlm.nih.gov/pubmed/17548722
CONCLUSION: ...patients with higher BP at entry and good CPAP compliance achieved significant reductions in BP.
http://www.ncbi.nlm.nih.gov/pubmed/17925415

P.S. Do get your report to see the details for yourself. Qualifying for CPAP is just a starting point. Not qualifying can be a matter of a suboptimal study. You sound like the kind of person who is going to want the details, and that will get you to making an informed decision.

[SleepingUgly]

I don't think the questions you are asking are unreasonable ones. With every treatment, one should ask what the benefits are, what the costs are, what would happen if one didn't choose the treatment or stopped treatment, etc. It is responsible to ask these questions.

Get a copy of your sleep study report immediately. The forum members here can help you understand the details if you're too busy in your life as a secret agent/spy to learn it all right now (I'm jealous!). It is possible, for example, as Rooster/Roster alluded to, that your AHI is exclusively on your back and you could use positional therapy (e.g., no sleeping on back--there are ways to do this). Your oxygen saturations are an important variable in deciding how critical therapy is. Also, by any chance were you sleep deprived at the time of your sleep study? Was your surgery related to your airway?

From my research, it seems apnea gets worse over time. This is due to aging tissues, as well as damage sustained, both to the brain, and locally, that makes it worse. I've never seen a thing that would lead me to believe that one would be worse off after stopping CPAP treatment than if they had never initiated it. I can't think why that would be so.

There are other options besides CPAP(i.e., dental devices and surgery). CPAP IS the gold standard, but if you have mild apnea and you travel through space and time killing terrorists with nothing but your Matt Damon-like skills, you may be happy with some of the other options.

[Truth behind talking points]

Thank you, I actually read some of them last night! I will go ahead and read the others shortly. They were informative and interesting. There is definitely evidence that compliance improve quality of life. What I found interesting is how easy it was to find them and several other ones that were focused on compliance, versus how hard is to find answers to my first questions.

[roster]

Have a look at these basic questions which everyone should eventually be able to answer before they begin treatment: Questions to ask about your PSG and Titration Study, wiki/index.php/Sleep_study.

What type of doc are you using? What is her level of experience with sleep studies and CPAP?

What symptoms brought you to have a sleep study? Was it in-lab overnight or portable home study?

Is she planning to write you a prescription for CPAP without a titration study?

Please calculate your current BMI.

What type of surgery did you undergo last year?

What position(s) do you sleep in?

What does your jaw structure look like? Well-advanced chin with wide upper and lower jaw - "boxy-looking" face? Or somewhat recessed chin with jaws narrow side-to-side?

Are your teeth straight or crowded and crooked? Did you have braces as a child? Have you had any permanent teeth (including wisdom teeth) extracted? For photographic examples of poorly developed jaws see http://li14-183.members.linode.com/heal ... pment.html The photograph of the last lady in the article is an excellent example of a well-developed jaw.

Get some answers to all these questions and we can discuss best next steps. I do believe in getting a diagnosis and a plan of treatment from a doctor. Members here should not be making diagnoses and setting up treatment plans. However they can help guide you from the beginning of the process through to optimization of the therapy.

Rooter

[Beyond talking points]

Sleep Ugly,

There is no way that you can be ugly with such a good heart. Thank you for understanding my concerns.

I was sleep deprived at the time of my study, and I am not a super agent. I am only a corporate “get well” guy that fixes bad departments. I am usually their last chance. If I succed they keep their jobs and I get a bonus. If I fail we are all unemployed.


Rooster,
Sorry for the typo on your name. It is no excuse, but I was typing with my 3 year old on my lap. It also explains my bad grammar. Please keep singing at the Sun as no offence was intended.

My surgery was on my foot. It is not directly related to my air passages, but your questions let me realized that the surgery forced me to sleep on my back for 3 months. I used to sleep on my side. I have no idea if I am sleeping on my back or side now! My wife usually falls sleep before me and wakes up after me.

I do have a strong jaw, and had braces as a child. There has been some permanent teeth removed.

All,
You are asking significantly better questions than my doctor. This is definitely helping me prepare for my next course of action. For example, I had allergies at the time of my test. If it is obstructed and it can be simply fixed by allergy medicine then a CPAP will be counterproductive as it increases congestion.

Keep the advice coming.