Normal person breathing through CPAP

[LinkC]

archangle, has anyone ever told you, "You worry too much?"

lol Make that "You worry too much about too little."

[napstress]

I suspect there may be some long term negative effects from CPAP, but not from just one night. And I believe the long term bad effects of CPAP are a lot less than the long term negative effects of apnea.

What do you suspect are some long-term negative effects, archangle?

The big one would be becoming dependent on it to some extent.

Did anything atrophy because of the assistance of CPAP?

I also wonder if there are any long term bad effects on the lungs, nose, ears, throat, sinuses, stomach, or intestines? We say it's important to clean the equipment properly to prevent infection, so infection is a risk the medical professionals are concerned about. Is there some organism that finds a CPAP patient a more attractive target than an untreated apneac? If there's no such organism now, will some existing organism adapt to prey on CPAPers?

Does the dry (or moist) air have any long term effects on the airway? Does the extra pressure stretching out the alveoli and lung tissue do anything long term?

Ventilator patients often suffer long term side effects. CPAP is MUCH gentler, but are there some of the same risks?

There's almost no medical treatment that doesn't have SOME long term side effects.

We know about a number of potential side effects with CPAP.
Dry mouth
Stomach and intestinal gas problems
Irritation from the mask
Headaches
Cough, lung irritation
Eye irritation
Sleep disturbance
Increased central apneas
lifestyle changes from being tethered to the machine
psychological (embarrassment, shyness, claustrophobia, fear of bedtime, depression)
Difficulty of taking naps
Pain or other problems from changing your sleep position
CPAP dependence
Problems with relationships
Irritation, rage, insanity from dealing with DME's, insurance, sleep doctors, sleep labs, etc.
Shrinkage of the wallet

All in all, it's worth it to me so far. I'm really sick if I don't get my CPAP.

Thanks, Archangle. I've had exactly these same concerns. So much so that at the start of CPAP therapy I googled for the side-effects of CPAP therapy. All that came up was items like your second list (immediate side-effects). I was looking for items like those from your first list (long-term side-effects) but never found them. God forbid the Medical Establishment look further than the tip of its nose in terms of long-term consequences of the treatments it offers! These are serious considerations for me as I hop back in the CPAP saddle again. It is true that I am a worrywart. I find it very supportive to know that you have the same misgivings—yet believe that CPAP therapy is worthwhile in spite of them. Thank you so much.

[ameriken]

Think of two identical apnea sufferers. Put one on CPAP, leave the other treated. 10 years down the road, stop the CPAP. Is CPAP guy's apnea now worse than the guy who was never treated? Is his sleep now more miserable than the untreated patient? Did anything atrophy because of the assistance of CPAP?

Could be that in 10 years down the road you couldn't complete the study because the guy who was never treated died from his apnea.

[chunkyfrog]

I can think of one more significant downside to CPAP use:
It might help trolls live longer, too.

[robysue]

I will admit that CPAP seems to be a necessary part of my life now---due more to the dang diagnostic test, the obvious improvement in my AHI numbers on therapy, and the potential for reducing my risk for some of the scary comorbidities of untreated OSA rather than a genuine increase in daytime functioning (yet) or because existing identifiable comorbid conditions. And maybe because it has taken me so long to just get back to functioning as well as I did before starting CPAP, I think the side effects archangle has posted are not something to just casually toss aside as "worrying too much about too little."

Dry mouth in particular can lead to real---not imaginary---problems in other rather critical parts of our body's functioning. Not for everybody, probably not even for most CPAPers, but for some people these this very common side effect of xPAP can lead to either a worsening of dental problems or the start of dental problems. Dry mouth is nothing to sneeze at: In addition to the obvious discomfort, chronic dry mouth can easily lead to more tooth decay; periodontal disease; inflammation of the soft tissues of the mouth; problems with chewing, swallowing, and talking; and more. Dry mouth is a rather common side effect of many medicines, and it is also one of the most common reasons for patients to discontinue a particular maintenance medicine when there's another alternative to try. But alas, with OSA, most of us are pretty much stuck with xPAP or nothing particularly effective. And yes, dry mouth can be treated---I've done the Biotene stuff off and one for months now---but it's not the same as not having dry mouth in the first place.

Yeah, the dental problems caused by dry mouth are not as serious as not breathing hundreds of times a night, but they are not trivial either and they can lead to substantial reductions in quality of life; and in the case of periondontal disease in particular, there are real, substantial health concerns as well as the more nebulous quality of life issues.

Aerophagia, gas, and stomach problems are side effects with serious quality of life implications and have the potential to be implicated in a CPAPer's developing GERD or LPR, both of which are real medical conditions that cause real damage to the body. And the connections between GERD/LPR and aerophagia don't seem to be that well understood. There's an underlying assumption (here at least) that somehow pre-exisiting GERD/LPR causes or leaves one prone to aerophagia problems when you start xPAP, but as someone who NEVER had GERD type problems and who had no real chronic symptoms of LPR before starting xPAP, but who has had and continues to have real problems with aerophagia, I can't help but wonder if I'm going to develop GERD or LPR because the xPAP's pressurized air makes it harder for those sphincters of the esophagus to stay shut the way they are supposed to stay shut at night, all night long. And if it's possible that xPAP can lead to GERD or LPR, it would be nice to be made aware of that fact by the docs who prescribe the treatment. It may be that I've just had bad luck with sleep docs and their PAs, but in 10 months of seeing these folks and complaining of aerophagia, not a one of them has bothered to suggest that I get tested for GERD/LPR. No---that idea has come only from listening to others here at cpaptalk.com.

[robysue]

Part of the justification of using xPAP therapy is to make us feel better in some way than we did with our untreated OSA---or at least not make us feel any worse.

And the (medical) significance of many of the side effects on archangle's list is that they can cause enough real and significant deterioration in quality of life for those unlucky enough to suffer them to feel as though CPAP is destroying their life rather than improving it. And that in turn leads to the very real problems with getting OSA patients to stick with CPAP long enough to actually adjust to it so that it can do them some good.

After all, in just about any other chronic medical condition (HBP, diabetes, arthritis, migraines, thyroid problems, depression, COPD, asthma, etc.), if the first path of treatment leaves you more miserable than you were before you started the treatment, the doc suggests an alternative treatment. But with moderate or severe OSA, all the unlucky patient is told is "Give it more time." And for some of these unlucky, miserable new CPAPers, when the side effects of CPAP really seem intolerable and they are given little or no meaningful help from their docs and DMEs, they rationally decide to trade the misery caused by the side effects of CPAP for the risk of untreated OSA. And throw the machine into the closet ...

Unless, of course, they get lucky and find a forum like this where they can get some support for dealing with those intolerable side effects ....

[NightMonkey]

We know about a number of potential side effects with CPAP.
Dry mouth
Stomach and intestinal gas problems
Headaches
Cough, lung irritation
Sleep disturbance
Increased central apneas
lifestyle changes from fatigue and sleep deprivation
psychological (embarrassment, shyness, claustrophobia, fear of bedtime, depression)
Difficulty of taking naps
Pain or other problems from changing your sleep position
Problems with relationships
Irritation, rage, insanity from dealing with anyone
Shrinkage of the wallet
heart disease
stroke
dementia
type 2 diabetes
early death

With just a little editing of the list, anyone with a reasonable brain will see that these are all effects of not using CPAP. You can also understand that they are much more severe.

May I suggest that there is a physical problem behind the two worry warts in this thread? Sleep apnea causes the body and mind to produce excess quantities of adrenalin and go into a hyper alert condition. This is the fight or flight condition. Many people channel the hyper alert condition into worrying - worry warts.

[archangle]

May I suggest that there is a physical problem behind the two worry warts in this thread? Sleep apnea causes the body and mind to produce excess quantities of adrenalin and go into a hyper alert condition. This is the fight or flight condition. Many people channel the hyper alert condition into worrying - worry warts.

On the other hand, denial that problems and side effects of apnea exist is one of the things we really hate from incompetent medical "professionals." Denial and reluctance to deal with the problems of CPAP is one of the the things that leads to a high failure rate for CPAP.

Inability to understand questions is one of the signs of brain damage. This thread was about the possible side effects of CPAP if you don't need it. Perhaps you need to pay attention to the subject of the thread. For your convenience, it is shown in big letters at the top of the screen you type your post into.

Most of us are convinced of the dangers of untreated apnea, otherwise we wouldn't be here. It would be foolish not to admit the risks and side effects of CPAP and refuse to deal with them.

[napstress]

Yikes! I believe I have trolled. I had to look up what "to troll" actually means in the context of a discussion group, and it appears that my drawing out and responding to archangle's possible long-term side-effects list as a topic only marginally related to the original has upset the apple cart, and I regret it. I had been wondering about possible long-term side-effects for some time but hesitated to start a new post on it b/c I understand that many people on this forum have worked hard to make CPAP therapy work for them and might feel irritated/annoyed b/c this forum is supposed to be a place of positive support. I apologize for disrupting that spirit with my fears. I hope that those I offended recall that generally my posts are positive/constructive!

Where I'm coming from:
-I've very sincerely tried to make CPAP therapy work for me (for 3 months), and while I have experienced some short-term side-effects and was even pleasantly surprised by some unexpected benefits, I have only once felt what I was hoping to feel by using it. I am very much in the stage of weighing if going through all of this is worth it.

-In the past 11 months, two of my relatives have gone into the hospital and come out either permanently injured or dead—both of things unrelated to what they went into the hospital for in the first place. Many people in my family are wishing right now that the doctors would have communicated the consequences of the treatments they recommended. I was pretty distrustful of doctors before all that, and these two short-view-induced snafus have aggravated that in me. I'm still very sad and so deeply angry about those two situations.

So I'm grateful for archangle's and robysue's responses: they, too, have considered some possible negative consequences, yet persevere with CPAP therapy. I'm very much taking that into account. Also, they have given me the support I need to raise these issues with my sleep dr at my appointment on Tues.

Sleep apnea causes the body and mind to produce excess quantities of adrenalin and go into a hyper alert condition. This is the fight or flight condition. Many people channel the hyper alert condition into worrying - worry warts.

Yes, darling girl. My hopes of alleviating this tendency is part of the allure of CPAP therapy, and why I keep trying.

[ameriken]

Where I'm coming from:
-I've very sincerely tried to make CPAP therapy work for me (for 3 months), and while I have experienced some short-term side-effects and was even pleasantly surprised by some unexpected benefits, I have only once felt what I was hoping to feel by using it. I am very much in the stage of weighing if going through all of this is worth it.

Did you google what oxygen deprivation does to your body?

I don't know about you, but I like to breathe, and that includes night.

I think SA is pretty serious business. I've got severe SA with all kinds of breathing and respiratory issues. And that is exactly what sleep apnea is: it is a respiratory problem where a person doesn't breath during their sleep. By not breathing, one is depriving their brain, heart, and vital organs of oxygen, and as a result can do devastating damage to their body which could result in heart failure, stroke, and other fine life threatening problems. Of all the things this oxygen depletion does to a person, deprived sleep is perhaps the most benign. The fact that I know I am getting oxygen every night and am extending my life span is enough to keep me going, even if I don't always feel the greatest.

Ask anyone if they had a choice between breathing all night, and breathing only 3/4's of the night while holding their breath the other 1/4 of the night, obviously any sane person would prefer to breathe the entire night. I know, it's really a stupid question to ask. So when someone wonders if staying on CPAP and breathing the entire night to provide life giving oxygen to their body is worth it, I've got to wonder what they're thinking?

[SleepingUgly]

I have been trying for some time to recruit "normals" to wear APAP and thereby provide norms that can be used to screen for OSA. I was first put on CPAP as an empiric trial before my diagnosis, and I kept saying, "If the pressure goes up, does that mean I have SDB?" or "If my AHI isn't very low at the lowest pressure, does that mean I have SDB?" The answer is always that APAP can't be used to make a diagnosis of SDB (and I would have settled for a good guess in lieu of a sure diagnosis). So let's recruit a bunch of normals and put them on 4-20 and see what happens.

[Twentysix]

Maybe yguion's friend is into bondage and discipline.



Bons, maybe you can play that angle with your hubby. Either convince him CPAP is kinky or get him to let you cuff him to the bed and then hook him up.

Maybe there's a whole new cottage industry here. Those of us with CPAP could start selling CPAP bondage sessions. We could develop a line of bondage themed CPAP masks. We could definitely come up with some killer chin straps.

Chin straps? Tape? that's for wimps. Us hard core CPAPers use safety pins. (No, I'm not going to post a safety pin image...)

[archangle]

Yikes! I believe I have trolled.

Nonsense, my dear, you're 5 levels on the arrogance scale below what's required to qualify as a troll.

I don't have real misgivings about CPAP for people with apnea, I just understand there are some side effects, risks, and problems that we have to deal with.

In terms of CPAP side effects, look at it this way:

Apnea kills, CPAP annoys and irritates.

Apnea kills. Slowly. Even worse, sometimes it doesn't kill, it simply saps your energy, causes heart trouble, strokes, leaves you an invalid, makes you fall asleep at the wheel and kill someone else, etc.

A large percentage of the posts on this board are about how to make CPAP less annoying and irritating. Even the few potential medical side effects of CPAP are many times less likely and less serious than the effects of apnea.

Congratulations, you're a married woman now. You don't want to leave your hubby caring for an invalid. Or to have a wife who's sleepy or listless all the time. Or sick all the time. Without CPAP, you're a lot more likely to end up in the hospital or otherwise in the evil clutches of the medical establishment for problems caused by apnea or aggravated by it. Even if you're not feeling better with CPAP right now, without CPAP, apnea will be slowly destroying your organs.

[saltyk9]

I have been trying for some time to recruit "normals" to wear APAP and thereby provide norms that can be used to screen for OSA. I was first put on CPAP as an empiric trial before my diagnosis, and I kept saying, "If the pressure goes up, does that mean I have SDB?" or "If my AHI isn't very low at the lowest pressure, does that mean I have SDB?" The answer is always that APAP can't be used to make a diagnosis of SDB (and I would have settled for a good guess in lieu of a sure diagnosis). So let's recruit a bunch of normals and put them on 4-20 and see what happens.

I have a PR System One REMstar BiPAP Auto with Bi-Flex on the way. I got tested for sleep apnea and did not get a diagnosis. Had an AHI of 2.1. Still have all of the horrible symptoms of sleep apnea so I bought a CPAP regardless. Maybe I could be your guinea pig for this...

[SleepingUgly]

I have a PR System One REMstar BiPAP Auto with Bi-Flex on the way. I got tested for sleep apnea and did not get a diagnosis. Had an AHI of 2.1. Still have all of the horrible symptoms of sleep apnea so I bought a CPAP regardless. Maybe I could be your guinea pig for this...

I'm sorry, but we'll have to exclude you from our study of "normals". Normal people with an AHI of 2.1 don't order a bipap. j/k