Long term effects of its use

[SleepingUgly]

I have done significantly more difficult and expensive research on fairly less significant issues!

I should have guessed you were just trolling from your user name etc.

Mea culpa

What do you mean by this?

[SleepingUgly]

I just posted something but don't see it (the sleepiness this time of night and the two threads is confusing me...). I'll try again. What I said in the post is that although I don't have citations, my impression is that you can expect not be any worse for having used CPAP if you stop it. You may be somewhat better off if you use it for a longer period of time and then stop, if during that time you've prevented some of the damage that would have occurred during that time. Certain things, such as the effects of aging, are unstoppable whether or not you use CPAP. It's also possible that, when you stop, you will be no better than if you had never used it. In that case, it's like treating diabetes with insulin or medication. You prevented some of the secondary damage that would have occurred during that time, but now that you've stopped, your blood sugar will go up and you will start the downward decline. I am getting some of these inferences from an MP3 interview with Dr. Kasey Li about MMA surgery, which is obviously irrelevant to you at this point, but in the course of the interview, he speaks to some of these things.

Here is a link to the interview:

http://www.sleepapneasurgery.com/audio/ ... 49f272.mp3

[Beyond talking points]

Bill,

As I mentioned, I am a corporate problem solver. I do work a lot on adoption of new technologies, and it has given me certain skills that are helping me on my very personal research. The name Beyond Talking Point comes from the talking points that all new technologists give their marketing persons. If you want to check the theory, go to CNN, MSNBC, FOX News and research the iPad, they all have the same talking points. It is a hall of mirrors all reflecting to the same talking points. Never less than five, never more than 12. I have seen it myself go from e-mail to news on some technologies that I have worked on and it is pretty amusing. I am sure that somewhere Steve Jobs is smiling about all the reporters repeating his words.

Regarding this topic, I am not trolling, I am not an insider, and the closest that I have been to medical research myself was on adoption of X-Ray digital imaging over film. As I mentioned, I have done significantly more thorough research on significantly less relevant topics. The less relevant was a hint that I am not from the medical industry. I am actually disappointed that I do not have an insider in my rolodex.

I am very concerned with this decision and I started my research from zero knowledge just 3 days ago. I am not about to make a lifelong decision based on a 15 minute conversation with my doctor. God gave me intellect and skills, I will use them.

Regarding the oximeter, are you talking about the $400 PulseOx 7500 Wrist Oximeter by SPO Medical? At this price I want be sure that I order one that is recomended.

[Muse-Inc]

Might search here on the CMS oximeters -- they're popular. I had my doc's Respironics (Nonin mfg) on loan for a few nights -- very nice hand-held with a long cord. Used wraparound stickies to keep it on finger. It's very expensive & so is the software. I'm thinking about the CMS 60D myself.

[Beyond talking points]

Sleeping Ugly,

Thank you, that is what my gut was telling me, but my brain was asking for the facts
I will listen to the interview tomorrow morning. I will try to go to bed early tonight.

Regarding Bill comment..... he insinuated that I was an insider. The same way that I am sure that there are marketing persons from CPAM manufacturers trolling these forums, there are persons from competing technologies trolling too. I am not an insider, and I am concerned about my health.


Muse,
Thank you for the lead on the oximeter. I am researching them on my other computer.

[kteague]

Some things running thru my mind... Still trying to figure out how your doctor could say a qualifying diagnosis of mild sleep apnea doesn't merit treatment. My first PSG that picked up OSA was measured mild. Fast forward - mild to moderate. Forward again - moderate to severe. Not saying you have to overreact now, but keep in mind that revisiting this periodically is a good idea, regardless of the treatment you choose at this time. Still thinking your report will clarify things for you.

I too feel it's only reasonable to do due diligence to understand the risks and benefits of any recommended treatment comparative to the options. But don't be too hard on fear as a motivator. Not everyone has the same time and ability to measure their steps. Obviously, you aren't at the point where a hasty decision is necessary. You are fortunate. By the time I went on CPAP, I was too desperately ill and cognitively impaired to ask questions or do research, even with mild OSA. Did fear make me blindly accept that I needed CPAP treatment? Guess so. I had one foot in the grave and another on a banana peel. I had gone from being a shining star getting promoted for my abilities to being a liability to the company. Going out on disability, I was afraid to drive - had fallen asleep at the wheel. Afraid to cook for myself - could burn the house down. Afraid to go anywhere alone - would wake up in strange places with no concept of how many hours had passed. Afraid to sleep - nightmares of death - mine. Afraid of a future where I hadn't the strength to walk 15 feet from the bed to the bathroom without resting in a chair partway. I know you're not in this position, but hope you can understand why some of us are very passionate about this being taken very seriously. That's all I'm saying.

[ozij]

I am very concerned with this decision and I started my research from zero knowledge just 3 days ago. I am not about to make a lifelong decision based on a 15 minute conversation with my doctor. God gave me intellect and skills, I will use them.

If that is true, you should stop wasting your time with a bunch of people you don't know, who have no credentials to show you, whom may all be industry insiders, part of a huge scam trying to make you waste money on a machine you don't need. Start doing your research where scientific research is done.

I too feel it's only reasonable to do due diligence to understand the risks and benefits of any recommended treatment comparative to the options. But don't be too hard on fear as a motivator. Not everyone has the same time and ability to measure their steps. Obviously, you aren't at the point where a hasty decision is necessary.

Use the time you have to research the subject thoroughly:

• Learn how to evaluate research methodology
• Find out which sources (if any at all) and which studies (if any at all) you can trust
• Make sure you find the "insider" who will give you the goods on the industry, you can manage that easily through the network you created as a corporate trouble shooter. The Rolodex and 2 (!!!) computers will help you with that.
• Make sure you will then find the other "insider" who will give you the good on the first "insider"
• While you're doing that, keep track of your health -- but be very very careful, any solution suggested by any doctor to any presumable medical problem you might have may just be a front for a corporation attempting to make money out of you.

Life is tough -- I'm sure you know nobody and nothing but you and your own intelligence can be trusted.

Oh, And in case you're planning to come back here to save us with the results of your research -- forget about it. I will save you time: when you try to tell us the truths you discovered, you will find out that each of us trusts his or her own experience and intelligence far far more that we do yours. And that may make you very very angry and abusive -- a waste of your valued time.

Wishing you the best
O.

[Mac33]

http://www.newsmaxhealth.com/health_sto ... 13939.html
Here's a little something else to chew on..........watch me get flamed !!!

[ozij]

Why flame a person if we can read the source?
All added emphasis mine.

http://www3.interscience.wiley.com/jour ... 1&SRETRY=0

ABSTRACT
Sleep-disordered breathing is much more prevalent in elderly people than in middle-aged or young populations, but its clinical significance in this age group is unclear. This study investigated retrospectively the rates of all-cause mortality in elderly people (≥ 65 years) with a laboratory diagnosis of sleep apnoea, and compared their rates of mortality with that of age-, gender- and ethnicity-matched national mortality data. Survival of 611 elderly people was ascertained after a follow-up of 5.17 ± 1.13 years. Their age was 70.4 ± 4.8 years, body mass index 30.4 ± 5.9 kg m−2 and respiratory disturbance index (RDI) 28.9 ± 20.1 events h−1. Seventy-five (12.27%) patients died during the follow-up period. In comparison with the demographically matched cohort from the general population, the standardized mortality rate of the sleep laboratory cohort was 0.67 [95% confidence interval (CI): 0.53–0.88; χ2 = 11.69, P < 0.0006]. When calculated separately for patients with RDI < 20 (no/mild apnoea), RDI 20–40 (moderate apnoea) and RDI > 40 events h−1 (severe apnoea) there was a significant survival advantage for the moderate group with a standardized mortality rate of 0.42 (P < 0.0002), while elderly people with no/mild apnoea tended to have lower mortality and those with severe sleep apnoea had the same mortality as the matched population cohorts. Cox regression analysis revealed that sleep latency and comorbidities but not sleep apnoea severity were associated independently with mortality. The survival advantage of elderly people with moderate sleep apnoea, combined with recent findings on the potential cardioprotective effects of chronic intermittent hypoxia, raise the possibility that apnoeas during sleep may activate adaptive pathways in the elderly.

Note -- these are people who survived to be 65 or more.
Younger ones may have been killed by the co-morbidities sooner.
The assesment of co-morbidities is probably far more reliable that RDI measured in a lab.
RDI includes any Respiratory Disturbance -- some with very light hypoxia, some with bad hypoxia.
It is nothing less that amazing to see this study measuring "intermitent hypoxia" by using RDI instead of using oximetry.
I guess the results with using oximetery were nothing to write home about.

O.

[-SWS]

...he insinuated that I was an insider. The same way that I am sure that there are marketing persons from CPAM manufacturers trolling these forums, there are persons from competing technologies trolling too. I am not an insider, and I am concerned about my health.

Since your very premise is based on insinuating that so many of us are here on the seedy corporate principles of hidden agenda, he might have been just rewarding or exemplifying your insinuations with more of the same.

And the blatantly insinuating nature of your contentions in this thread finally got me to Googling to see just what the insinuating connotation behind the term "talking points" might be: http://en.wikipedia.org/wiki/Talking_point. I was curious because I don't often hear the term "talking points" either on this message board or in colloquial conversations.

Thank you, that is what my gut was telling me, but my brain was asking for the facts

I think most of us, at least on this message board, are independent opinion formulators. We like to debunk myths with facts . But we also expect our debunkers who claim to value the same to use the likes of truths and facts as they debunk. In that vein of mutual respect for the likes of facts, truths, and empiricism do you happen to have any reputable social-science empiricism to support one of your key assertions about third-tense verbal usage:

You can usually assume that it is a corporate marketing person when they post in third tense. The machine helps persons ….. the machine has been proven to …. I have worked with many corporate marketing teams and this is a typical (unethical) way of influencing the market. They are not legally required but they should disclose that they work for the industry.

Skeptical thinking is preferable in my own opinion. But when that skeptical thinking entails suspecting the worst of others around us who are not guilty, then that skeptical thinking enters the unjust mindset of "guilty until proven innocent". And that, in turn, reminds me of the time I returned to the first real estate property that I had purchased as a young adult. I had lived in that property for a few years, and then decided to rent it out rather than sell it when I moved along to my next dwelling. One day I returned to that condominium's storage bin to get supplies for maintenance. My tenant had called about a plumbing problem that I decided I could quickly and easily repair myself. One of my former neighbors, of whom I was only superficially acquainted, became both accusatory and confrontational with me when she saw me exiting the storage room. After all, she knew I had moved out and assumed I had no legitimate business whatsoever in that storage room. And that storage room had experienced theft a couple times in recent years.

However, the entirely legitimate scenario---that I still owned the condominium as rental property---had never even dawned on her. She simply saw me exiting the storage room where theft had occurred in the recent past, and assumed I had also been in the storage room for illegitimate reasons. After catching an earful from her, I calmly explained that I still owned the property and was there to do maintenance. However she didn't bother to apologize to me for her entirely unflattering mistake. Instead her irrational mindset transferred from being falsely angry with me for so obviously being there to steal or perform ill-deeds, to a brand new situational premise of my having implicitly revealed her all-too-human and incriminating foolishness. She didn't miss a beat transitioning from one anger premise to the next. And I was the passive and presumed-guilty recipient or adversary of both of her seamless anger stages...

"Guilty until proven innocent" is when skepticism goes too far in my honest opinion. And most sane nations that employ modern jurisprudence try hard to avoid that lady's compounded mistake. I think our truth-based debunkers on this message board would be both wise and just to do the same.

[solecava]

Hello, Beyond Talking points

I think i can join you in your concerns. I read the other day that antidepressants are useless unless for serious cases: I bet if I sent a message to depressive.org (I just made this up, but it may exist), questioning the usefulness of antidepressants I too would be flamed. Cpaptalk.com is a place of cpap users, most of whom benefited much from the use of cpap. It is just natural that they should be concerned/insulted by anyone questioning the real usefulness of the therapy they chose. I am not a CPAP user, but, just like you, I may have to become one in the near future, given my OSA and low SPO2 events during sleep. I found this thread because I share your concerns about addiction to CPAP. If you (or I) were suffering from severe sleeping problems, like many who have been immensely helped by CPAP, we would not be verifying the possible side-effects of it: it is all a matter of cost/benefit. Since we are border-liners, it is just natural that we should be concerned. We only want to make an informed decision, and it is amazing that many users of this site should be so emotional about CPAP. Some of the responses you got (and so elegantly dealt with) would be at home in religious sites!

OK, CPAP is great and is saving lives of people with serious problems. But, what about people with mild problems? would it be overshooting or, worse, would it make our mild situation worse? most of the cited studies were done on people with severe problems, but where are the studies on the side-effects of misuse (for example, by people who actually don't need it)? usually, anything that can be life-saving in some situations can be harmful in others (think of using isoprenalin in people without heart conditions). So, the question might be rephrased as "where does the threshold between useful/harmful lie?".

Frankly, my dear CPAP users, the questions asked were not so hard to answer, if you could only drop your guard a little:

for those of you using CPAP for over two years, we would really like to see your sincere and kind answers to the following questions:

a) if your CPAP machine breaks down, do you sleep worse than before you started using it?
b) what side-effects have you experienced? what do you have to put up with in order to enjoy the benefits of CPAP use?
c) do you use CPAP every night or can you sleep once in a while (like when travelling/camping) without it?

thank you all very much, and especially Beyond Talking points for raising the issue.

[-SWS]

Solecava, you seem to have converted Beyond Talking Points' two-fold message to only the innocuous half: your paraphrasing and even praise seems to miss the very clear insinuation that many of us are here on this message board to execute corporate hidden agenda. Beyond Talking Points could have very easily phrased his/her questions as innocuously as you have above---without those unflattering insinuations of seedy corporate hidden agenda.

Those innocuous questions about side-effects have been discussed here many times. However, if you and Beyond Talking Points want scientific facts even more than patient opinions about whether you should try CPAP, then here are some Google Scholar references to "mild OSA" instead of our biased "talking points":
http://scholar.google.com/scholar?hl=en ... a=N&tab=ws

Approximately 15% to 20% of CPAP users will initially present machine-induced side effects known as Complex Sleep Apnea. Severe OSA patients are actually less inclined to be among that 15% to 20% estimate. Some of those 15% to 20% will manage to satisfactorily adapt to CPAP. However, many will not. Beyond those statistics, around 40% to 60% of all CPAP users will never manage to make long-term CPAP compliance. That's a whopping statistic that has been repeatedly discussed here---along with treatment alternatives despite this message board supposedly being dedicated to CPAP treatment rather than focusing on CPAP alternatives. This message board is, after all, very clearly called cpaptalk. The message board's name and stated purpose should serve as a dead giveaway clue why there's so much focus on CPAP around here. There are other apnea message boards out there should this CPAP message board seem overly focused on CPAP to ANY newcomers. One such example is: http://www.sleepapnea.org/. Another example is: http://www.talkaboutsleep.com/message-boards/. I would encourage newcomers to read through their dental appliance and surgery posts.

Clearly the answer is that CPAP does not work well for everyone---regardless of severity. A suitable approach with ANY treatment is to at least try what independent researchers happen to term the "gold standard" for treatment---CPAP in this case. Then carefully compare objective medical and subjective benchmarks to determine if that "gold standard" treatment deserves continuation or displacement by trial with alternatives. Simple as that.

But let's quit with the utter nonsense that so many of us here are on this message board to execute hidden corporate agendas...

[Beyond talking points]

Good morning all,

Let me clear things up a little bit. Off the over 15 forums that I found with related topics, I chose to post on this one because it is the most honest one. It is clear that you have been honest in your personal opinions. It was a good decision to ignore the others and focus here.

I am not challenging your situation, or your decisions. That will be arrogant and insulting. I am only trying to work on mine. Based on what I have read our situations are different and different situations may lead to different treatments.

I appreciate your advice, support and challenge. You have given me many ideas for research and areas to find additional information. Now I know what key words to use, what topics to cover.

Finally, I have not dismissed any of the comments. Even the flamers have let me to realize the importance of this decision.

At this time I do request to help me go back to the original topic.
1) Are there any unbiased, peer-reviewed studies of the long term use of the CPAP machine?
2) Are there any studies of persons that stop using it? For example, if I start and then stop after a year, will I return to slight apnea, or will I then have full apnea?
3) What happens to a person’s that has bee habituated to the machine and try to take a nap without it? Will he/she be able to nap?

[-SWS]

Are there any unbiased, peer-reviewed studies of the long term use of the CPAP machine?

Unfortunately CPAP hasn't been in wide use long enough for "solid" longitudinal studies in epidemiology. The best longitudinal study under progress IMHO is this one: https://apples.stanford.edu/index.html

Are there any studies of persons that stop using it? For example, if I start and then stop after a year, will I return to slight apnea, or will I then have full apnea?

You will never find a reputable doctor or scientist portraying CPAP as if it were either a cure or path to remission. On that basis there will likely be no studies to prove that apnea either disappears or returns with discontinuation of CPAP. However, many of us have discontinued CPAP for a variety of reasons---painful trigeminal neuralgia in my own case. When we do, the the symptoms and/or pathophysiology of untreated apnea tend to instantly reappear. And that makes perfect sense since CPAP cannot cure apnea or bring about remission.

What happens to a person’s that has bee habituated to the machine and try to take a nap without it? Will he/she be able to nap?

Many of us can and do nap without CPAP. However, some of us cannot nap without CPAP because our apnea severity is sufficiently extreme to preclude sleeping without CPAP. There are no empirical studies that I am aware of assessing epedemiological risk or benefit of napping with or without CPAP. Common sense implies that if long sleep sessions benefit from CPAP by preventing apneas, then short sleep sessions benefit from CPAP by preventing potentially hypoxemic apneas as well.

[BlackSpinner]

2) Are there any studies of persons that stop using it? For example, if I start and then stop after a year, will I return to slight apnea, or will I then have full apnea?

This depends on your body and why you have OSA. If it is caused by obesity and you have gotten fatter yes it will increase. Is it because of age ? Well you are now older so yes maybe it will have increased.

3) What happens to a person’s that has bee habituated to the machine and try to take a nap without it? Will he/she be able to nap?

Yes you can sleep without the machine but you will have apneas. Plus your body habituates to apnaes and when you use a cpap machine it stops doing that, so though the apneas may be no worse when you stop using the machine your body will react much more negatively to the lack of oxygen, rather like someone who has spent a year at sea level suddenly moving to the Andes.

It doesn't take a peer reviewed study to tell that. This isn't about sleep, it is about oxygen starvation while you sleep and all the resulting damage to your major organs and your brain. Plus sleep deprivation due to constantly almost waking up in order to breath cause causes all sorts of strange mental results - including the inability to learn new things - which is what your job is all about isn't it? It can cause paranoia, depression and anxiety. It might even cause people to think all market execs are out to get them!