What if...?

[Arlene1963]

It's true that week after week we read accounts of people who have used XPAP for a long time, getting great AHI numbers and yet simply aren't seeing results in energy levels or how rested they feel.

Maybe those of us who respond very well to XPAP have a type of OSA that is perfectly suited to XPAP i.e.. our issue is purely anatomical and once resolved, boom, we feel great.

As I said in my earlier post I hope that sleep medicine continues to dig deeper into OSA/SDB because if treating the condition does not improve the outcome for a good number of people, I suggest that there is a problem in deciding what is successful treatment. Is it just AHI?

Jnk, thanks for your thoughtful and in depth reply to my original post. I would love to see XPAP on the shelves in Walmart! I agree with so much you say on this forum and when I don't, enjoy reading the reasons why!

[chunkyfrog]

Walmart? I would prefer Costco or Aldi.
If I had no insurance, I would likely be using the pharmacy at Costco.

[ChicagoGranny]

Walmart? I would prefer Costco or Aldi.
If I had no insurance, I would likely be using the pharmacy at Costco.

Why not all three? Competition is good for us.

BTW, for people with no insurance, GoodRx coupons are great for prescriptions. And, Costco is not always the cheapest. We have a small, local pharmacy nearby that often beats the big boxes.

[ChicagoGranny]

They state...

"In adults, the most common cause of obstructive sleep apnea is excess weight and obesity, which is associated with soft tissue of the mouth and throat."

This would indicate that if you loose weight your sleep apnea is resolved.

Uh, no. You are a logic fail. The second does not logically follow the first.

[chunkyfrog]

After a draconian, but effective diet, I shed enough poundage to not even be overweight.
Guess what! No change in my apnea, only changes is agility, stamina, and my poor arthritic knees.
Losing excess weight is wonderful, but do not expect it to cure OSA.
It might, but it's a long shot--a very long one.

[jnk...]

What if the symptom of sleep apnea is a result of the body adapting to a stress.

Most health issues involve stress, such as that caused by a pathogen. But stress itself is a symptom, despite your speaking of it as if it weren't.

This stress can be physical, emotional, or chemical.

In the realm of the "what if" that you are operating in, you might as well add magical, extraterrestrial, imaginary, and psychosomatic, since there is no reason not to.

It is fundamentally true that no one completely and perfectly understands every disease, or any disease for that matter. So asking "what if we don't know everything about [fill in the blank]?" may be a fun thing to talk about on a board. But since it is basically a statement of the obvious (of course we don't know everything), no one should mistake it for being a productive or practical way to approach the treatment of any disease. It is a basis for research for the next big thing, yeah, but those guys already know we don't know everything.

We know that CPAP can keep the airway open, yet many report that after a few days, or weeks or months or years of use they still feel as tired as they did when they first started.

Exactly. CPAP only solves OSA. It does not solve every tiredness-related problem known to man.

The body adapts to the stresses imposed upon it and tries to heal itself. Why does this not happen in CPAP use.

It does, but only if you keep using CPAP. If you stop using CPAP, then you are creating problems (bad breathing and bad sleep) that keep the body from continuing to be able to heal itself.

Using a CPAP is not the same as taking a drug or having a surgery. It is merely a way to improve breathing and improve sleep in order to improve life. There are probably many, many thousands of things that can have a bad effect on breathing and sleep, not just one. We may not be able to list all of the things that can have a bad impact on breathing or sleep, but we CAN list the one thing that solves sleep-breathing issues for many people very, very well: effective use of CPAP. And that's no what-if. So I choose to embrace it thankfully without putting much emotional effort into wishing there were presently something better. I enjoy flights of fancy as well as the next guy. And I am glad research continues into understanding OSA in the search for the next breakthrough in treatment. But it is only if something comes along one day that actually proves to be better than CPAP, in the realm of reality, that I will then consider that something over CPAP--then, not now.

But don't let the disease model for all of this throw you. Simplify it further. For a person to keep alive and be healthy, that person needs air, water, food, and sleep. Sometimes a person has to use technological tools to get good healthy food and good healthy water. In much the same way, sometimes a person has to put a little work into being able to breathe well and sleep well. Consider CPAP to be the knife and fork that we need for taking in healthy air at night and getting healthy sleep. It is a tool well worth using until some better tool comes along. Maybe a better tool will come along, and maybe not. Until there is something better, use the best tool available to you to get what you need to live well. For me, it really is that simple. I find I enjoy my life more by choosing to continue to live as the simpleton that I am and always have been.

Hey, just me.

[HoseCrusher]

ChicagoGranny,

Now you have me confused...

If I eliminate "the cause" and still have the condition, was that really "the cause...?"

What if something else was "the cause?"

[HoseCrusher]

Jeff,

The body adapts to stress. Sleep apnea is a symptom manifested by the body under stress.

What if we were able to identify and eliminate the stress? Would the body go back to normal breathing during sleep?

I totally disagree with you. CPAP effectively treats the symptoms of OSA. It doesn't solve it.

Rather than focusing on the symptoms, why not focus on the bigger picture.

There are studies that suggest that in general we are over-breathing and mouth breathing. When mouth breathing is converted to nose breathing AHI is reduced by something in the 30% range. When over-breathing is reduced AHI is further reduced.

I can't totally get my head around over-breathing, but it seems to focus on the carbon dioxide levels in the body rather than the oxygen levels. If the carbon dioxide levels are kept within certain levels, the oxygen levels are maxed out.

If we agree that the body is adaptive and strives to heal itself, it would seem that simply treating the symptoms would not produce better results than getting to the root cause and treating that.

What if we don't know how to breath properly? Would it not be beneficial to practice breathing to polish those skills?

What if we don't know how to sleep properly? I think ChicagoGranny used to have a link to a list of things that can improve our sleep hygine. Perhaps we need to review that list and practice getting ready for sleep. The more we practice the better we get and before too long we wake up in the morning totally rested and ready to great the day.

About half of the people diagnosed with sleep apnea will not follow through with using CPAP to treat their symptoms. What if the root cause could be identified? They may find greater incentive to pursue treatment and the world would be a better place because more people would be well rested...

[Snoregone Conclusion]

As I see it, OSA is far more stress-inducing than it is stress-induced.

If your physiology is such that you have obstructions form, the body’s addiction to air causes it to fight for its life at a low instinctive level.

Here’s a thought for you to ponder, HoseCrusher: how many earth species are subject to OSA?

[jnk...]

The body adapts to stress. Sleep apnea is a symptom manifested by the body under stress.

Actually, the body adapts to OSA. Stress is a symptom manifested by the body when OSA is untreated.

What if we were able to identify and eliminate the stress? Would the body go back to normal breathing during sleep?

We can do exactly that by using CPAP, which eliminates the stress by allowing normal breathing during sleep.

I totally disagree with you. CPAP effectively treats the symptoms of OSA. It doesn't solve it.

And I totally disagree with you. CPAP solves OSA. When I use CPAP effectively, I no longer have OSA at all or any of its symptoms.

Rather than focusing on the symptoms, why not focus on the bigger picture.

Yes. I agree that is exactly what you need to start doing. Stop focusing on the symptom of stress. Focus on the big picture of using CPAP.

What if we don't know how to breath properly? Would it not be beneficial to practice breathing to polish those skills?

"Practice" and "skill" change nothing of consequence about how one breathes while asleep, since one is not conscious during sleep. You do know that, right?

When I use CPAP, I don't have OSA, much in the same way that I have 20/20 vision because I wear my glasses. It is a beautiful solution that eliminates all symptoms by eliminating the root problem itself by preventing my airway from narrowing. The unchangeable internal anatomy I was born with would make narrowing an issue during sleep, but that is no longer an issue for me at all, now that I have the solution to it: CPAP. There is no evidence that anything out there is better than that yet for me. Maybe one day there will be. But imagining that there is something like that available now using dreams and what-if statements will not make it so.

[ChicagoGranny]

What if something else was "the cause?"

You can imagine anything your brain is capable of imagining. This is different from reality.

[Snoregone Conclusion]

If something is found to legitimately replace xpap or the "one true cause" is found and a permanent solution exists, I'd expect your sleep doctors to go out of their ways to tell you the great news and get it solved for you asap for a small fee, both as part of their professional duty to treating your issues, as well as making sure someone doesn't beat them to it first.

Better check your email and voice mail inboxes!

[ChicagoGranny]

Here’s a thought for you to ponder, HoseCrusher: how many earth species are subject to OSA?

English bulldogs, Shih Tzu (and all other brachycephalic breeds of dogs), female Yucatan miniature pigs, obese Zucker rats, leptin-resistant New Zealand obese mice and many others.

https://en.wikipedia.org/wiki/Brachycep ... e_syndrome and https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821036/

BTW, did you know there is a very small, but growing, activist movement to stop breeding of brachycephalic dogs? Also, many veterinarians are against breeding brachycephalic dogs, but are afraid to speak out for fear of losing business.

Anatomical Disaster

[ChicagoGranny]

If something is found to legitimately replace xpap or the "one true cause" is found and a permanent solution exists, I'd expect your sleep doctors to go out of their ways to tell you the great news

And, don't forget, many sleep doctors and family members of sleep doctors have sleep apnea. This is an additional motivation to find a magic bullet.

[jnk...]

ChicagoGranny,

Now you have me confused...

If I eliminate "the cause" and still have the condition, was that really "the cause...?"

What if something else was "the cause?"

The cause of a problem is not always the key to fixing a problem.

Think about it this way. If I drive too fast and have an accident because of doing so, will driving slower afterward magically remove the dents in my car? No. The solution to fix that is elsewhere.

Someone born with the tendency to sleep-breathing problems that no drug or surgery can remove is blessed to be able to use a simple, natural, healing approach like pressurized air. No side-effects or knives involved!