Is it posible to become dependent on CPAP?

[rkuntz]

Ideally my Doc would like to see me off all my Meds including CPAP, but I wonder if we can become artificially dependent on this therapy. The assumption around here is that CPAP is forever, but I wonder if we can, over time, we loss an ability we once had simply through lack of use.

[prion]

I doubt it. It would be like becoming physically dependent on eyeglasses. About getting rid of it I doubt that as well. I have done a tremendous amount of reading
about apnea. The only thing that looked promising were a regimen of specific exercises involving the face throat tounge and mouth. If you had a very mild case of apnea
I could see that possibly working, maybe. They looked like they might be good for people using the machine as well. I'm trying them out
now, however it's too short a time and I have apnea too bad to ever get off the CPAP device.

[Kennerly]

Each situation is unique to some extent. You mention that your doc would like to eventually see you get by without the PAP. That leads to a couple of key questions:

-What is your diagnosis (that created the need for PAP) ?
-Why did you have (or did you have) a sleep study?

[jencat824]

My take on this is that once you start therapy, the body is in some way dependent on therapy, the body will crave the normal sleep the therapy makes possible. In short, IMHO yes you become dependent. I'm glad my body depends on this life saving therapy.

That said, if you Dr. sees you getting off CPAP, he thinks you are one of the very few who is on it for a reason that can be 'removed' or 'healed'. I'd like to know what that is, but it may be possible for you.

[herefishy]

When I first started CPAP there was some talk of the lungs becoming weaker from not having to work as hard as normal, but I never heard anymore of that. Anybody else heard of this?

[robysue]

Ideally my Doc would like to see me off all my Meds including CPAP

Why???

, but I wonder if we can become artificially dependent on this therapy. The assumption around here is that CPAP is forever, but I wonder if we can, over time, we loss an ability we once had simply through lack of use.

Comments:

1) The assumption around here is that CPAP is forever is because CPAP manages the OSA, but it does nothing to cure the underlying problem. To cure OSA would require one to find a way to fix the underlying problem that leads to our upper airways' tendency to collapse while sleeping. And at this point, there's no reliable way to do that: The surgeries touted as "curing OSA" often fail and even when they succeed, the "fix" seldom lasts for more than 5-10 years, and once the OSA returns, the surgery can make PAP more difficult.

2) In a small number of patients, the OSA is caused by weight gain. And losing weight and keeping it off can cure these patients. But most of these patients are dealing with mild or mild-to-moderate OSA and keeping the weight off is critical. And in the US, there's not a high percentage of people who manage to keep the weight off after losing a significant amount. Moreover, in most people with both OSA and weight problems, the causation relationship between OSA and being overweight is not very clear: While weight gain can lead to OSA, it's also become clear that untreated OSA can lead to weight gain. For many people with both OSA and weight problems, there's a nasty positive feed back loop at work:

• ... leads to worsening OSA leads to more weight leads to worsening OSA leads to more weight ...

And in the long run, it really doesn't matter whether the feedback loop started with OSA or started with too much weight.

3) The longer you use PAP successfully, the less likely you are to want to sleep without it. It's miserable to exchange a decent, apnea-free night's worth of sleep for going back to a night filled with dozens to hundreds of mini-suffocation events. It's not so much that we lose our ability to "arouse" or "wake up" to restart the breathing when we sleep without a PAP; rather it's that we've lost our ability to regard such a night's sleep as "normal" because our bodies now know what a normal night's sleep actually is. And hence sleeping PAP-free may be even more miserable than we remember it being pre-CPAP simply because it's no longer the norm our bodies expect.

4) The analogy to wearing eyeglasses is not as far-fetched as it sounds: Someone who is moderately to severely near sighted, becomes reluctant to not wear their glasses simply because life is so much easier when you just put them on. It's possible to get around your own house without your glasses on your nose because you know where everything is, but trying to drive a car or even walk down the street in a strange neighborhood is darn near impossible if you can see where you are going. So in order to function, you get to where you want to have your glasses on so that you can see where you are going more clearly. And yet even if you are someone who puts your glasses on your nose before you get out of bed and takes them off only after you're back in bed, no one tells you that you've become "too dependent" on the glasses. Same thing with CPAP: You get to where you really don't want to sleep without it because it's so much easier to go through life waking up feeling rested and having enough alertness and energy to get through your daily activities without struggling to stay awake or feeling fatigued all the time.

5) Unlike chemical drugs, all a CPAP uses is a bit of very slightly compressed room air. It's true that some of us have real difficulties in figuring it all out (including aerophagia, which can be painful), but plain old air is not likely to cause serious adverse side affects of the sort that many (most?) drugs can cause.

6) Many of us would love to see a real alternative to CPAP that works as well as CPAP. The docs who study OSA and potential treatments for it have not yet managed to find something that works as well as PAP therapy does yet. Oral appliances do provide a real alternative for a select number of patients with mild-to-moderate apnea, but they have their own set of problems and compliance with them is not as high as many people think it should be. And there are some off the wall sounding treatments in relatively early stages of development that may eventually become standard ways to treat OSA. But at this point, outside of the oral appliances, they're all far more invasive than a CPAP machine is.

[robysue]

When I first started CPAP there was some talk of the lungs becoming weaker from not having to work as hard as normal, but I never heard anymore of that. Anybody else heard of this?

Our diaphragms (and chest wall muscles) actually have to work harder to exhale (fully) against the positive pressure. Some newbies notice this extra work when they're first starting out by noticing muscle pain in and around the rib cage ....

[letsride]

I guess I'm dependent, I like to have a good nights sleep.

[nanwilson]

When I first started CPAP there was some talk of the lungs becoming weaker from not having to work as hard as normal, but I never heard anymore of that. Anybody else heard of this?

Funny... you sleep and use your machine for 6 to 8 hours and breathe on your own for the next 16 to 18....... you are therefore breathing on your own for up to triple the hours that you use the machine. .

[BlackSpinner]

Unless you are on an ASV you are working harder to breathe. The regular cpap machine just stints open your throat.

Dependent? Yes most humans are dependent on a certain level of O2 and a certain amount of good quality sleep in order to function well. Personally I am also dependent on clean air and clean water and on having a heated house when it is -30c and shoes and clothes at any temperature. I am also dependent on my glasses to see this as I am typing. We could probably survive without all these things for a while but I prefer not to even think about being naked outside even at the current temperature of -7c.

[chunkyfrog]

The doctor may have been trying to motivate the OP to just get started--
with the possibility it would not be forever; --and who knows?
No, I'm sure no doctor has ever told a little white lie to give the patient hope and commence treatment.
Most of us have hear the fib (or rumor), "If you just lose weight . . ."
(Maybe it sometimes works, but it's not statistically relevant.)

[Wulfman...]

Ideally my Doc would like to see me off all my Meds including CPAP, but I wonder if we can become artificially dependent on this therapy. The assumption around here is that CPAP is forever, but I wonder if we can, over time, we loss an ability we once had simply through lack of use.

Yeah, put me in the group that wants to know WHY your doctor would want you off of CPAP therapy.
Maybe you need to get a different doctor or at least another opinion.

It didn't take me long to NOT be able to sleep without my machine. If that's being "dependent", so be it. Yes, I've often thought it would be nice if I didn't have to, but it quickly became a part of my life and I can't imagine sleeping without it now. It makes breathing and sleeping so much nicer. I used to be able to do a nap in my recliner without it, but now, I don't even do that......my naps are always in bed now.......with my "breathing buddy".
I personally know at least one person who died because he opted not to use it one night, and I'm sure a number of people I've known and seen in the obituaries died because they needed it and didn't use it or were never clinically diagnosed with OSA.


Den

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[RobertS975]

As a physician and OSA patient, let me give you my take on this question: Someday, both the OSA sufferers and their physicians may look back on this era where patients have to sleep with contraptions out of the movie Alien attached to their faces. They are hard at work attempting to develop and perfect a technology in which a small pacemaker to stimulate the hypoglossal nerve is implanted, preventing the neuromuscular actions which are the cause of the great majority of cases of OSA.

https://www.sciencenews.org/article/pac ... leep-apnea

[Wulfman...]

As a physician and OSA patient, let me give you my take on this question: Someday, both the OSA sufferers and their physicians may look back on this era where patients have to sleep with contraptions out of the movie Alien attached to their faces. They are hard at work attempting to develop and perfect a technology in which a small pacemaker to stimulate the hypoglossal nerve is implanted, preventing the neuromuscular actions which are the cause of the great majority of cases of OSA.

First of all, that article is only available to those who "subscribe" to Science News.
But, the subheading states:

"Experimental device works for many patients who can’t use breathing machines

So, it won't help those whose problem is NOT in their throat.......like in their nasal passages.


Den

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[deerslayer]

Let's see..... with cpap Obstructive Apnea length is no more than 18sec at most......don't think i want to find out results without machine
tim