Why I May Be OK Without CPAP

[Liam1965]

As many of you know, I had a really rough time with CPAP (and APAP) about a year and a half ago, and ended up not using it.

(Well, not entirely true, the APAP makes a really good argument starter with my lovely wife, who wants to know why it's still sitting in the middle of our bedroom floor if I'm not using it at all. But I digress...)

She has reported that except when I have really bad allergies or a cold (and thus my nose is completely stuffed up), I don't really snore as badly as I used to, and when she wakes and watches me sleep for a while, she almost never sees me breathe irregularly or stop for any appreciable time.

Now, I always thought I was a borderline case and that perhaps I didn't really NEED CPAP, and certainly I've discussed elsewhere why using CPAP made everything worse (for me, I'm certainly not advising anyone else not to use it, I really wished I could have made it work!), but I had some thoughts.

About 3 months before I had my sleep studies and started my CPAP trial (a very apt name for my time on CPAP), I also returned to singing for the first time in about eight years. Since that time, I've been singing regularly with both the local barbershop chorus and with a quartet I've formed. I know I ended up having to re-learn all of the muscular control that goes into proper singing. And I'm definitely back to singing like I did years ago (when I was a professional musician for a while).

So I'm thinking that part of why I no longer seem to have many apneic events MIGHT BE the better muscle tone in my throat.

Obviously, this is a single case, which means both that it might not work for anyone else, and in fact it might not even be what helped me at all. Since being diagnosed, I also try very hard to sleep on my side and never on my back, for instance.

And, of course, if it were my lovely wife Janet with the apnea problem, singing might cause more problems than it solves. No offense to my dear wife, who is in most other ways a wondeful wife, mother and human being, but she couldn't carry a tune if it had handles.

Nevertheless, I wonder if toning up the muscles of my throat helped my body to keep my throat open during sleep.

One last note, however, is that I don't think just random singing in the car will do it, if that's what helped, because I always did that. No, it was the serious singing that I think has helped. Joining a Barbershop group and learning to project again, learning proper mouth shapes and proper resonance and the like. I didn't take voice lessons this time, but I did review everything I learned in 4 years of them when I was younger.

Anyway, just my thoughts for this morning, put out there for comment and/or for anyone who might otherwise be interested in seeing if adding quality singing to their treatment regimen might help them as well.

Liam, making music during the day may have cut down on his "music" in the night.

[Sleepless in St. Louis]

Your hypothesis sounds plausible to me. I'd be interested in hearing from another member of the forum, KurtChan, who I believe is an opera singer. Good for you if you've managed to find a way to avoid sucking wind every night. One question though. Will you always be able to keep up your commitment to singing? Use your cpap for a doorstop I suppose just in case you will not always have the time etc to keep this up.

[DreamStalker]

The synergystic effect of 1) mild/borderline OSA to begin with, 2) serious toning of throat muscles, and 3) side sleeping is quite possible.

Unfortunately, I have only the possiblity of achieving the side sleeping

Congratulations on your freedom from the hose.

- roberto

[Liam1965]

One question though. Will you always be able to keep up your commitment to singing? Use your cpap for a doorstop I suppose just in case you will not always have the time etc to keep this up.

I hope so. I missed singing desperately for the 8 years I lived without it. One of the down sides of NH is that the outlets for singing aren't nearly as numerous nor varied as they were in the Washington DC area, and I had stubbornly refused for 8 years to sing in a group that wasn't *exactly* what I was looking for.

Finally, the lack of organized harmonies in my life really got to me, so I decided that a diet of only barbershop, while not my favorite option, beats starving.

So unless something happens that makes it physically impossible to continue doing (various different lung diseases, perhaps, or a botched tracheotomy (spelling approximate) ), I don't see any reason why I'll ever let my hobby go by the wayside again.

Liam, la la la.

[Liam1965]

Unfortunately, I have only the possiblity of achieving the side sleeping

Yeah, I went back and forth over the last 24 hours over whether to post this post or not, because for anyone that it MIGHT help (assuming the postulate is actually true), there will be plenty for whom it may just come across as "nyah nyah, I found a way to be hose free and you didn't..." rubbing their nose in it.

For reference, I didn't mean it that way. I honestly don't have any real reason to be at all certain that the singing had any effect, I just think it MIGHT have, and so might be of interest to other CPAPers (and if the consensus is that it's unrelated, that would be interesting for me to know as well).

Liam, married to a woman who can't sing because it makes his own voice sound that much better.

[inacpapfog]

Good for you , Liam!
Glad to hear that you are feeling well!
Sounds like you really enjoy singing!

So glad to catch a post from you. Your wit is heart lifting!
Please, keep coming back to spread a little cheer!

[sleepyinsunnyvale]

Why not take another sleep study rather than relying on anecdotal evidence that your OSA has gotten better (you didn't say cured so you must feel you still suffer from OSA).
Seems this would put this to bed (so to speak). If your AHI has improved to a range that your doctor feels a XPAP is not required then congratulations. On the other hand if your AHI has indeed improved put you still have some degree of OSA you still may choose not to use XPAP but at least you do so understanding the risks rather than rationalizing yourself into a false sense of security.

Just my $.02 worth..

[Liam1965]

For anyone who is successfully compliant, I absolutely agree, sleepless.

However, as I have detailed elsewhere, I have not been successfully able to use CPAP/APAP ever. I tried for 2-3 months back in Feb-May of 2005 and have not used it since. Suffice it to say, when I don't use the CPAP, I (sometimes) don't sleep well and don't wake feeling rested. When I use it, I sleep almost not at all.

So my point here wasn't to say "Look! I don't need to use my CPAP any more!", it was to say "Look! Even though I've been unable to use my CPAP, my symptoms seem to have gotten better, and here's why I think it might be!".

So having another sleep study would help (in my case) not a whit, because regardless of what it says, unless there's been some radical leap forward in the treatment of apnea, it's not going to put me back on the CPAP machine no matter what the reading says.

But for anyone who read my post and thought "Oh! I'll start singing and then I can stop using my CPAP", you do want to make sure it's really helped (or cured) you before stopping a therapy that is working for you.

Liam, let's make beautiful music together.

[Bookbear]

Liam:

Glad you posted....ANYthing that helps is worth discussing. When I read your post, I immediately thought of the digeredoo postings. If you have a "lean" throat to begin with, better muscle tone could well fend off OSA. If the problem is caused more by excess tissue in the throat, it probably wouldn't help that much. But your way of achieving it is certaintly more fun and enjoyable for others, too!

Sadly, I can't carry a tune in a dump truck, so unless we want household pets to flee and houseplants to wither, singing is out for me

Glad you found something what works. Sing well!

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): Liam

[kteague]

Liam,
If sharing your experience translates to someone who was marginal in their cpap need being able to push themselves back across that borderline, that's wonderful. Those whose apnea is severe are generally more resigned to cpap necessity. I always feel worse for those who barely meet the criteria for a diagnosis of mild sleep apnea having to go thru the adjustments of a cpap life. Whether practicing formal voice/breathing techniques (or playing the didgeradoo), singing and music are therapeutic on so many levels, so what's to lose? Thanks for sharing. I'm interested in hearing some follow-up effectiveness reports.
Kathy

[GoofyUT]

I too, wanted to add my congrats about your apparent triumph in rehabilitating your sleep-disordered respiration through singing. Certainly the world needs more music and there is NOTHING more important than GOOD MUSIC in your home, in my opinion.

Now having said that, here's what I'm fretting over. You classify yourself as "borderline". Is that based on the very few number of SDB events that you typically expeirence, or experienced during your sleep study? Because as I'm sure you know, LOTSA folks here, when diagnosed during a PSG, are shocked to learn that they have OSA, claiming that they thought that they slept OK. Most also proclaim, during those first few HORRIBLE months, that they sure as hell slept better BEFORE they had to go on this crazy hose thing. Most of us are aroused but not awakened by our SDB events events, and therefore, are not aware of them. And though partners/bed-mates often are better informants than we (as sleepers) are, their reports are by no means definitive or reliable. I had one patient who's wife assured him and me that her husband and bed-mate (one and the same, fortunately) slept fine and didn't snore, though his PSG revealed a night strewn with 40 second apneas.

So here's the rub: If you're "borderline" in your mind only with regard to your OSA or your need for xPAP, then you risk the continued occurence of SDB events, which result in the continued occurence of adrenergic events that result in the continued arousals that you might not event notice as you convince yourself that you are only a "borderline" apneic. In the meantime, your body as a whole will suffer from the depravation of oxygen that you are subjecting it to, and your heart and brain will suffer from the repeated boluses of adrenaline that your body is releasing to arouse you to get you to breathe better whilst asleep. THESE are the reasons that SDB is an INDEPENDENT risk factor for STROKE and CARDIO-VASCULAR DISEASE. Do EVERYTHING else right in your life, and if you don't treat OSA you still have a greatly increased risk for stroke or heart-attack.

Now, I admire your singing. And, I do believe that there is NOTHING more important than the presence of good music in your home. And I know that you believe that your lovely wife and BEAUTIFUL kids deserve no less than the good music that only you can provide them. So please, make sure that your beliefs about your borderline status are correct medically, not self-servingly, before you, one morning, wake up dead and deprive your family of that beautiful music forever.

Not being able to adjust to CPAP is NO reason not to be treated. It took me nearly six months to get it all to work, and I HATED the first four months. HATED THEM! But, its turned the corner and I've never felt better, in SO MANY ways.

Do you want to imagine someone saying at your interment....

"Liam....He gave up to soon, and stopped the music forever"........?.

Just a well intended thought bro (from one New Englander to another).

Chuck