looking for a link for CPAP side effects

[pje]

Is there a good resource for information about the side effects and contraindications for using a CPAP?

[Julie]

Not that I know of, and there's a good reason - there ARE no side effects. All that happens is air is 'pumped' into you (just like breathing) at a more regular rate... there are no chemicals involved, no surgery, nothing to elicit side effects. Of course we all have to fiddle with our mask fitting, and pressure setting, but the worst that I think can happen is that if your initial setting is a little too high, you may experience a bit of aerophagia (gassy pain), which usually responds to a slightly lower setting. Cpap is GOOD for you!

[roster]

-aerophagia
-induced centrals
-sore noses
-mask marks
-dry eyes
-more?

[SeaPappy]

frustration
a good night's sleep
tedium
feeling like a human
a well rested, well adjusted human
relaxation
playing well with others
having dreams
not getting up 5 times a night
oh, did I say, a good night's sleep...
Need I say more?............Just Do It!!

James....Doin' It for 7 years now and still keepin' on

[CollegeGirl]

There actually *are* contraindications to CPAP usage, but, if I recall correctly, they're all very rare medical conditions. I believe one of them is Cheyne-Stokes respiration (this is only a contraindication to straight CPAP or APAP - I believe this requires an ASV machine? But, I'm rusty on this. Wait for someone more knowledgeable to chime in.)

Edit: Actually, I just did a search, and came across an old post of mine that lists the usual contraindications. The last thing I'm referring to, where I ask if anyone knows what it's called, is the Cheyne-Stokes respiration I just mentioned. Yes, I'm quoting myself. My apologies.

I just wanted to clarify in case someone else who doesn't snore comes across this thread. I barely snore at all, but I've had a lot of success with the auto. That study is definitely outdated.

HOWEVER, I do want to put some info out there. This is from the Respironics User Guide for the Auto:

"Studies have shown that the following pre-existing conditions may
contraindicate the use of positive airway pressure therapy for some patients:
• Bullous Lung Disease
• Bypassed Upper Airway
• Pneumothorax
• Pathologically Low Blood Pressure
• Pneumocephalus has been reported in a patient using nasal
Continuous Positive Airway Pressure. Caution should be used when
prescribing CPAP for susceptible patients such as those with: cerebral
spinal fluid (CSF) leaks, abnormalities of the cribriform plate, prior
history of head trauma, and/or pneumocephalus.
(Chest 1989; 96:1425-1426)
The use of positive airway pressure therapy may be temporarily contraindicated
if you exhibit signs of a sinus or middle ear infection. Contact your
health care professional if you have any questions concerning your therapy."

These seem to be contraindications for using CPAP therapy in general, not just the Auto. However, I have also learned from this board that autos should not be used for people who have Central Sleep Apnea or Mixed Apnea, and that they should not be used for people who have a certain kind of heart condition/disease - though I can't remember what it is off the top of my head.

Can someone who knows what that condition is please post? I think it'd be great to have a list of things people can read before they consider buying an auto.

Don't get me wrong - I love autos. I just would hate for someone to get one based on this forum's recommendation and then not be able to use it.

That post is from this thread: viewtopic.php?f=1&t=13672

[hobbs]

[Wulfman]

Is there a good resource for information about the side effects and contraindications for using a CPAP?

WHY?

What is the nature of or reasoning behind your question?


Den

[Julie]

All the things Rooster listed are not 'side effects', but minor issues to be worked out on an individual basis for each patient to get proper fitting for masks, etc., and the conditions that are incompatible with Cpap are rare, and anyone who has them would be followed closely by many MD's who would know enough not to prescribe Cpap for those patients. Side effects are physical reactions to medications (Cpap is not medication) and not 'mechanical' problems adjusting to equipment.

[roster]

Is there a good resource for information about the side effects and contraindications for using a CPAP?

WHY?

What is the nature of or reasoning behind your question?


Den

Den,

You are correct as usual. Without knowing the context of the questions a good answer can not be given.

Regards,

[pje]

Thank you for your observations. I am an eye doctor and patients using CPAP complain of dry eyes and change in eyeglass prescription. I need to find a study of side effects that would prove or disprove these or others.

[Wulfman]

Thank you for your observations. I am an eye doctor and patients using CPAP complain of dry eyes and change in eyeglass prescription. I need to find a study of side effects that would prove or disprove these or others.

If you go to the Search line above, and put in the word "eye" or "eye and problem", you will have a large number of posts to look through........many of them won't pertain to what you're looking for, but some will. Yes, there have been quite a few people mentioning the problems you stated......and more. Poorly fitted or adjusted masks may play a part of it......also the air venting from the masks along with higher prescribed pressures probably lead to those problems, too.

However, I'm not aware of any "studies" that have looked into this........but, from what I've read, the problem is "real" and for a variety of reasons.

Den

[DreamStalker]

Thank you for your observations. I am an eye doctor and patients using CPAP complain of dry eyes and change in eyeglass prescription. I need to find a study of side effects that would prove or disprove these or others.

Some CPAP patients have complained of eye issues related to treatment. For some, a leaky mask can blow air into their eyes all night long (they just need to mitigate the leak problem). Others on more rare occassion leak air from their sinus cavity out of their tear ducts (I recall that there are plugs that can be used to mitigate this type of issue).

I'm sure others will chime in to give thier thoughts.

[roster]

Thank you for your observations. I am an eye doctor and patients using CPAP complain of dry eyes and change in eyeglass prescription. I need to find a study of side effects that would prove or disprove these or others.

pje,

Sorry to deviate a little bit from the cpap discussion but are eye doctors becoming aware of the eye problems that can be caused by sleep apnea? Here is a recent article from Mayo Clinic Proceedings:

Eye Conditions Linked with Obstructive Sleep Apnea
Monday, November 10, 2008

ROCHESTER, Minn. — If a good night's sleep helps the brain and body perform better, it's a good guess that sleep problems can cause more than just fatigue. Numerous studies have shown a connection between sleep disorders and medical conditions such as cardiovascular disease, cerebrovascular disease, and metabolic disorders, including the risk of obesity and diabetes mellitus. In the November issue of Mayo Clinic Proceedings, Mayo Clinic researchers outline several interesting associations between sleep disorders and eye disease.


Obstructive sleep apnea and eye disorders

More than 12 million people in the United States have obstructive sleep apnea — a potentially serious sleep disorder in which breathing repeatedly stops and starts during sleep. Sleep apnea has several types. The most common is obstructive sleep apnea (OSA), which occurs when throat muscles relax and block the airway.

Multiple studies have identified OSA as an independent risk factor for the development of several medical conditions, including high blood pressure, which are related to impairments or alterations in a person's vascular (circulatory) system. With their own complex and sensitive vascular system, the eyes can sometimes signal and be affected by systemic vascular problems.

"Given the vascular consequences of OSA, it is not surprising that ophthalmologic manifestations exist," explains the article's lead author, E. Andrew Waller, M.D., a Mayo Clinic pulmonologist and sleep specialist.

The researchers conducted a literature search focused on sleep disorders and eye disease. In the article, they discuss a variety of ophthalmologic conditions associated with obstructive sleep apnea. Highlighted below are a few findings.


* Floppy eyelid syndrome: This disorder causes eyelids to evert (turn inside-out) spontaneously during sleep, resulting in excessive watering, stickiness, discomfort and blurred vision. While not a serious medical problem, this syndrome can signal that a person also has OSA, which can lead to more significant health problems.
* Glaucoma: This condition is the second most common cause of blindness and the most common cause of irreversible blindness. OSA is linked to two forms of this disease — primary open-angle glaucoma (POAG) and normal-tension glaucoma (NTG). The severity of glaucoma appears to correlate with the number and duration of apnea episodes in patients with OSA.
* Nonarteritic anterior ischemic optic neuropathy (NAION): Research shows an increased incidence of OSA in people diagnosed with NAION. This condition is characterized by the sudden painless onset of vision loss in one eye, often noticed upon awakening. Up to 6,000 patients annually in the United States are diagnosed with this condition, which can cause irreversible vision loss.
* Papilledema: People with OSA may have a higher incidence of papilledema, swelling of the optic nerve in both eyes. Papilledema typically occurs due to increased pressure within the skull and can lead to progressively worsening vision and, in some cases, blindness.


According to Dr. Waller, knowing the links between these eye conditions and OSA may hasten early diagnosis and appropriate treatment.

"Our understanding of the mechanisms that link these disorders is minimal," says Dr. Waller. "However, the recognition of these associations is important for primary care physicians, ophthalmologists, and sleep physicians. For patients with OSA, a routine eye examination to evaluate for early signs of glaucoma, particularly in the setting of visual loss or change, should be recommended. Patients with ophthalmologic diseases known to be associated with sleep apnea should be screened clinically for sleep apnea and referred to a sleep center if signs or symptoms are present."

The authors from Mayo Clinic are Rick Bendel, M.D., ophthalmologist and Joseph Kaplan, M.D., pulmonologist and sleep specialist.

A peer-review journal, Mayo Clinic Proceedings publishes original articles and reviews dealing with clinical and laboratory medicine, clinical research, basic science research and clinical epidemiology. Mayo Clinic Proceedings is published monthly by Mayo Foundation for Medical Education and Research as part of its commitment to the medical education of physicians. The journal has been published for more than 80 years and has a circulation of 130,000 nationally and internationally. Articles are available online at http://www.mayoclinicproceedings.com.

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To obtain the latest news releases from Mayo Clinic, go to http://www.mayoclinic.org/news. MayoClinic.com is available as a resource for your health stories.

Link to source: http://www.mayoclinic.org/news2008-rst/5075.html

Regards,