How do I know if I am cured

[LarryPer1]

Howdy
Been on the machine for 2 years but I have lost 70 pounds since and heard maybe I won't need it any more
I don't want to try and sleep with out it and I don't want to get another sleep study at the hospital

Many Thanks Larry

[nanwilson]

Larry
You will need another test to tell if you still have it or not....and please do not get mad at me for telling you this.....there is no 'cure' for apnea. This is not a "lose weight and you will be cured" type of problem. There are folks here on the forum that have lost alot more than you and they are still on the hose.

[chunkyfrog]

When unicorns cavort on your lawn and poop jalapeño poppers.

[archangle]

Larry
You will need another test to tell if you still have it or not....and please do not get mad at me for telling you this.....there is no 'cure' for apnea. This is not a "lose weight and you will be cured" type of problem. There are folks here on the forum that have lost alot more than you and they are still on the hose.

You may very well be "cured" by weight loss. Weight loss isn't a surefire cure, but it works for some. Unfortunately, some people lose weight and don't cure their apnea.

Fill in your equipment on your profile. There's a link in my signature line on how to do this.

[Janknitz]

Some people (not all) no longer need treatment after losing weight (I wouldn't say "cured" because if you regain the weight as 95% of dieters do . . . ).

But the ONLY way to know if its safe to stop using CPAP is a new test. Ask your doctor or research online about home sleep tests if you don't want to do a sleep lab test.

[SleepyToo2]

Howdy
Been on the machine for 2 years but I have lost 70 pounds since and heard maybe I won't need it any more
I don't want to try and sleep with out it and I don't want to get another sleep study at the hospital

Many Thanks Larry

Sorry Larry, the only way you are going to know for sure if you are "cured" is to have that sleep study in the hospital. You may feel like your apneas have reduced and you may be able to reduce your pressure, but sleeping without your CPAP is a bit like driving at night with your lights off. You have no idea what is happening on the road. My suggestion would be to continue using your CPAP until you can afford to get a sleep study. If the study says you don't need to use the machine again that will be wonderful. Meantime you have been using good insurance.

[Todzo]

Howdy
Been on the machine for 2 years but I have lost 70 pounds since and heard maybe I won't need it any more
I don't want to try and sleep with out it and I don't want to get another sleep study at the hospital

Many Thanks Larry

Hi Larry!

I was recently forced to self titrate finding that I was unable to connect with the medical system in my new town after a move. I had also lost weight. I do watch my data carefully and was seeing signs of unstable breathing which are likely to occur if you loose weight. After reading up on unstable breathing I am more afraid of it than Obstructive Sleep Apnea (OSA).

First I tried running my machine in the Auto-PAP mode set at my original titration for the low (13 cm/H2O) but with the current setting as a high (15 cm/H2O). The trouble is that unstable breathing causes you to use a lot more air - which irritates the airway - and - brought about snoring in my case - which - caused the machine to crank up the pressure being in Auto-PAP mode. Auto-PAP is not a solution for me.

Then I reduced the pressure to the 13 cm/H2O in straight CPAP. Reading the resultant data I saw less unstable breathing. My Apnea Hypopnea Index (AHI) was always reasonable. This setting I evaluated for 16 days and decided to try a lower pressure.

At 12 things improved as at 11..10..9..8...-at 7 cm/H2O signs of OSA - AHI occurred and so I now use a setting of 8 cm/H2O. At each setting I evaluated the results for at least a week except the 7 cm/H2O which I tested only 4 days.

Actually I think this is a much better way of doing things:

1. It was done with me in my usual sleep setting. With frayed nerves from a trauma I experienced I am particularly tending toward "white coat effect".
2. The data was evaluated for many days and so not as subject to the variation that occurs in our natural day to day situations.
3. Each change in pressure was small so my breathing reflexes had time to adjust (over sixty days) before the evaluation of the data and new decision was made.

After doing this I would recommend it. You should have considerable experience looking at your own data night to night before you try it, however, so you know what to look for in terms of unstable breathing or AHI.

Have a great week!

Todzo

[chunkyfrog]

Someone else who has noticed white coats worn with little pointy hats.

[Guest]

Howdy
Been on the machine for 2 years but I have lost 70 pounds since and heard maybe I won't need it any more
I don't want to try and sleep with out it and I don't want to get another sleep study at the hospital

Many Thanks Larry

It's actually been reported by some users who lost lots of weight that they not only still needed their XPAP machines, but they actually needed MORE pressure.
It's also a probability that the Sleep Apnea caused the weight gain to begin with. So, losing weight isn't going to "cure" it.

Do you have a fully-data-capable machine and the software to evaluate your sleep during the night? That would also help, but wouldn't show how you would do without the machine.

.

[Todzo]

Someone else who has noticed white coats worn with little pointy hats.

Hi chunkyfrog!

The people in the sleep lab are usually pretty nice. However, putting your breathing in the hands of someone else - well - a recent murder movie took advantage of that. I do not think they helped sleep medicine at all!!!

The "many days" aspect of the data gathering helps to overcome what guess you could call the "one night effect". One single night of data, to me, after seeing many hundreds of nights of data for this one single person over that long time - well - one night I think is unlikely to be representative of what is actually the case.

This is especially true if there is a large pressure change involved. The body needs time to get used to using a different pressure setting. That is my experience.

The recent numbers I am reading indicate that only 50% of those who start PAP are still using it a year later. I think that the disrespect that our current medical community has for the "effects" and variability of the human person are some of the main reasons why.

I do hope we find a good way!

Todzo

and – try not to get poked by the pointy hats!!

[The Sheikh]

I have an idea on how Larry can do a quick check on his own before the sleep study - but want to see what others think of it first....

Every so often I wonder how bad my sleep apnea problem is WITHOUT using the VPAP machine. I figgered that maybe the pacing practice from the ASV machine has helped.

For one night, I adjusted the ResMed Adapt settings down to absolute minimum pressures. This is about 4 cm/H20 CPAP. 4 cm appears to have little effect on stopping OSA and with the ASV off, does nothing for centrals. Bottom line is this data capable machine gives me close to "real" data for simulated sleeping without a machine.

I realize if someone has a life-threatening problem without the machine it may not be a good idea. But I can sleep without a machine if need be, and it worked for me. The data showed me I have seen some breathing improvements but very much still need the machine, especially for transitional centrals.

Any ideas on this technique?

Tom

[Pugsy]

Any ideas on this technique?

4 cm pressure is still technically providing some therapy. It would be a way to maybe get an idea as to the need for continued therapy....
If someone uses 4 cm and still has enough events show up to meet diagnostic criteria or if they have a truckload of events...that answer is pretty clear. The machine is still needed.
Now if no real events popped up on the reports at 4 cm it could very well mean that enough weight has been lost so that the machine is no longer needed but since 4 cm still some therapy value it is possible for 4 cm to adequately prevent the events and thus might give someone a false sense of "I am okay...don't need the machine".
Now granted most people need more than 4 cm pressure but some people get by with that minimum.
It would be a tough call if I was doing the testing...part of me would be thinking "I don't need the machine" and the other part of me that hopefully would be the rational part of me would be saying "I think I may not need the machine any more but I need concrete proof which means some sort of sleep study..maybe a home study".

So 4 cm pressure could sure confirm the continued need for the machine but it can't truly confirm the absence of need.

The hard part for me would be sleeping at 4 cm pressure. I would feel like I was breathing through a coffee stirrer stick. Not enough air for comfort for me. Heck, even my titration sleep study started things out at 5 cm.

[Goofproof]

When you wake up at night check to see if you are in a box, then knock on the top, if it sounds like dirt is on it, you are cured of everything. Jim

[SleepyToo2]

the rational part of me would be saying "I think I may not need the machine any more but I need concrete proof which means some sort of sleep study..maybe a home study".

I know the home study can be used to set the pressure, but can it determine whether you have apnea or not? Or is that different equipment. An oximeter might provide guidance, but not if the person is not desaturating. What channels does an in-home study without a machine record?

[Pugsy]

What channels does an in-home study without a machine record?

I don't know. Never researched them because no need. Different home studies use different stuff. There are some very accurate home studies though that do indeed flag apnea events and not based solely on O2 drops either. Some home studies are fairly comprehensive even measuring sleep. Centrals might be the most limited data point but if someone didn't have a history of centrals while on the machine there shouldn't be any reason to suspect that they would materialize off the machine. Some use chest belts, some use EEG electrodes and I figure if a home study is considered good enough by Medicare to diagnose then good enough to rule out too.

If I felt great and 4 cm showed no events and I slept well with zero complaints then I would be satisfied with a home study for final ruling out. Now if I didn't feel so great then I would be wondering about other stuff and a different story.
Ruling out sleep apnea in the absence of any typical symptoms by means of a home study would be sufficient I would think.
Just my opinion and of course if someone feels better doing a sleep lab study...then of course that is their opinion.

The absence of any symptoms would be critical for me though. If I had zero events at 4 cm and still felt like crap then that would be a whole different ball game.

Using a pulse ox overnight would not be sufficient for me though because people can have apneas that don't cause significant desats. I don't hold with the opinion that apneas have to cause a desat to be a problem. I think that just the arousal part of an apnea disturbing the sleep cycle can impact things significantly.