Questions

guest57 · Post by **guest57** » Sat Apr 15, 2006 4:57 am

I have been sleeping bad for a long time. Very bad.

Anyway I want to try CPAP.

I'm not going to the doc. I went recently and had bad experiences. I ended up missing some appointments and being dismissed as a patient. Also there is no way I could sleep at these sleep centers, I am very picky where I sleep. I'm also insured but pay deductible and 20%. I'm not paying the cost either.

So I have the ability to buy a used machine from a friend for $300. Thinking of doing this since I will have no percription.

All I wanna know is, it's not a auto CPAP, I understand they have to be set. What I plan is starting at the lowest setting and going up until it helps. I've slept bad for years now a few nights testing wont hurt.

Only other thing I wanna know is, they say weight loss helps. I am definitly overweight, but not hugely obese or anything. I want to know if losing weight ALWAYS helps sleep apnea or just sometimes?

Another thing is I weigh 260 normally. Recently I had lost thirty pounds in short time, down to 230. (which I have since gained back). The point was I slept as terribly as ever when I was at 230 as far as I can remember. Also I remember not sleeping well even as a much skinnier kid. This makes me doubt losing weight will help. . Any thoughts?

guest57 · Post by **guest57** » Sat Apr 15, 2006 5:01 am

Oh yeah the other concern I had was on another board someone said using Cpap can cause central apnea if the pressure is too high I guess? I am worried about that. I certainly dont want to do anything dangerous.

Jim Eads · Post by **Jim Eads** » Sat Apr 15, 2006 5:58 am

I have to say that I think you have a bad plan.

You need to get over whatever it is that is preventing you from obtaining competent medical advice.

LDuyer · Post by **LDuyer** » Sat Apr 15, 2006 6:13 am

guest 57,

I have to agree with Jim on both counts -- you have a bad plan, and you need to get over whatever it is that is preventing you from obtaining competent medical advice. Pretty smart words there, Jim.

There seems to be alot of things you won't do -- cooperate with doctors, find a good doctor, try to take a sleep study, consider alternatives to a sleep clinic sleep study, pay for some of the insurance costs, or even read up alot on sleep apnea, it appears.

But you will pay some money to self-medicate. You intend to self-medicate yet you don't even know if you have sleep apnea. What if you have something else? What if you have some underlying cause to your condition that should be identified? What if you have some symptoms which need to be treated whether or not you are treated for sleep apnea? And you're worried about centrals and about doing "anything dangerous"? Yet you still want to self-medicate.
Excuse me for being blunt, but self-medicating yourself for a condition you only guess you have is irresponsible.

Linda

Wulfman · Post by **Wulfman** » Sat Apr 15, 2006 9:02 am

guest57,

In principle, I agree with the previous posters. However, I understand (to some degree) where you're coming from. So, here are some of my thoughts and suggestions:

Either have somebody watch you sleep or video or audio tape yourself sleeping. If you are choking and gasping for air while you're sleeping, you suffer from sleep apnea. Loud snoring is another potential indicator.

I don't think purchasing your friend's CPAP machine and trying to sleep with it for awhile (to see if it improves your sleep) is all that bad of an idea. I'm beginning to believe a little more air while sleeping would do a lot of people some good.

I disagree with your plan to start at a very low setting and work up. I would suggest a setting of 10 or 12 (midrange) and see what that does for you.

OSA can also be the cause for your weight gain. It also (potentially) has other devistating effects on the body.
This is one other area where I disagree with you since a doctor would be able to tell if you have other contributing or resulting health issues. Having an overnight pulse-oximetry test done would also be able to tell if your blood oxygen is falling too low at night. This can be another result of OSA.

I wish you luck in whatever you decide to do.

Den

Snoozin' Bluezzz · Post by **Snoozin' Bluezzz** » Sat Apr 15, 2006 11:51 am

There are two significant issues here:

A positive diagnosis for OSA - I don't think this can trustworthily eyeballed, you won't know if you do or don't and if it ain't positive you could be creating other problems for yourself.

Establishing a correct pressure. Even if you have a reasonably supported belief that you have OSA there is no way for you to determine a correct pressure setting for yourself using a straight CPAP without monitoring capabilities. This would require an xPAP with full monitoring capability, smartcard, card reader, software, and computer.

It would appear that you have read enough these posts to think that you can do this yourself with some success but you will also have read enough to know that even the smartest, with the best medical help (rare but there) can sitll have problems getting it right.

To be successful with CPAP you first need to know that you have OSA or UARS, then you need to know what pressure will alleviate it. You will need to try different masks/interfaces to see what will work because that aspect in increcibly idiosyncratic. You will very possibly needed heated humidification.

All in all I think this is a bad plan. You need some sort of medical assistance. And this is from someone who is a tremendous cynic about the medical/health care industry!!!

To paraphrase the old saw about the man who has himself for a lawyer...

SB

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~AP · Post by **~AP** » Sat Apr 15, 2006 12:02 pm

It's not very easy to be dismissed as a patient by a doctor - that's usually the last straw from the medical point of view.

I urge you to find a doctor you will trust and work with to help you solve your health problems. It's great that you are willing to try CPAP but you also need to have a physician. I guarantee you will feel better once you start sleeping better.

The people on this forum are very helpful and whatever you decide to do - I wish you good health.

NightHawkeye · Post by **NightHawkeye** » Sat Apr 15, 2006 12:33 pm

Guest57 wrote:Anyway I want to try CPAP.

OK, since you're asking for opinions, I'd encourage you to try it.

I'll even offer you the same advice my sleep doc gave me when I decided to try it. Start out with the lowest pressure and work your way up gradually. Things can go wrong at higher pressures that don't go wrong at lower pressures, such as central apnea and painful aerophagia. Even mask leaks are much more of a problem at higher pressures. About the only thing that seems to go wrong at low pressures seems to be breathing a little excess CO2.

You will run into problems. No ifs, ands, or buts on that. Working with a physician will probably help you past some of the therapy problems, but on the other hand will create a whole different set of problems for you (as evidenced by the numerous posts on the subject here). I say, if you're ready to tackle this yourself, and blame no one but yourself when things go wrong, then go for it.

I did it myself, after "failing" a couple of sleep studies, so it's not impossible by any means. I've made my share of mistakes in the process too, but all through the process felt much better on CPAP than off.

Hope this helps.

Regards,
Bill