How do I know if I don't need CPAP anymore?

[Lizistired]

I don't know why people on CPAP have a tough time accepting that someone can be "cured" or that they'd want to find out if they are.

I completely agree. I think after so many years on CPAP and significant weight loss, it would be a natural thing to think about.

Ditto, and congratulations on the weight loss and getting off the meds!
How do you feel at the lower pressure? Have you noticed any difference?
Do you get graphs in your data or just stats?
I don't think lowering your minimum is a problem. If you get too low I think you would notice it being difficult to breathe through the mask while awake.
If you have an apnea the pressure will increase.
Since you already have an appointment scheduled, I would experiment and gather more data before your appointment.
I think the oximeter is a good idea but I'm sure your sleep doc is going to order a P$G anyway.
Good luck! Keep us posted.

[RocketGirl]

I'm already off diabetes and high blood pressure medications, all of those things are now normal, which blows me away, so its natural to wonder about the apnea. My neck circumference is down 3 inches, the pressure is just too much for me anymore at the setting I used to run, it blows me away now, when I never used to notice it.

Reading this bit makes me want to cheer out loud - congratulations on getting off your medications, and all best luck with your sleep study. Warm fuzzies all around!

[Pugsy]

Congratulations on the weight loss. I know that has been a very difficult war to fight.
Obviously a follow up PSG study is the best way to know for sure if you have been lucky enough to not need the cpap machine.

That said...if I were in your shoes I would be chomping at the bit wanting to have some idea....
and I would be testing things with as low as possible pressure that the machine will offer.
Granted there is therapy value even at 3 or 4 cm of pressure so it isn't a perfect test to see if absolutely zero apneas occur but it would give you sort of an idea.
So I wouldn't even use APAP unless the range was very, very tight. I would use either 3 (does your machine go down to 3 cm...I think some Devilbiss machines will) or 4 cm pressure in cpap mode or apap with only 1 cm range...just to see if any events occurred...and not worry about apap increasing in response during the experiment because all I want to see is if apnea events are occurring at all at this point and worry about pressure that might be needed later.

To use 6 cm...well there is even more therapy value at 6 cm than at 4 cm but it can be difficult to feel like enough air is moving at 4 cm. So you may be limited with how low you can comfortably go. If it were me..I would try cpap mode at the lowest pressure I could sleep at for one night and just see if any apneas occurred (and of course do the proper follow up with doctor and PSG for confirmation).

[robysue]

To the OP:

Congratulations on the weight loss. And sincere wishes that you'll be able to keep the weight off long term

As to whether you're cured of OSA: In my humble opinion as a patient the answer is Maybe.

What your experiments with your APAP have shown is that if you still have OSA, then your pressure needs have gone way down.. But that does not necessarily mean that you need no pressure at all. There are plenty of people out there (and even some on this board) who have moderate to severe OSA and only need 4--6cm of pressure to prop their airway open. But take the CPAP away, and their OSA returns immediately.

So the only way to tell whether your OSA is truly cured or not is through another sleep study done WITHOUT the PAP on your nose. So---get the sleep study done. And try to insist that the study be done without a CPAP.

And if the new diangostic study shows that you no longer have OSA, then be grateful that your OSA was indeed weight related and confidently toss the CPAP in the closet. But remain vigilant about any return of OSA symptoms because as happysleeper points out, as we age the tissues in our throats can become more lax and more prone to collapsing.

And if the new diagnostic study shows that you've still got OSA, then the APAP data clearly indicates that you now need substantially less pressure to manage the OSA. And in the long run, less pressure may mean more comfort in sleeping with the hose.

So get a new sleep study done: It's a win-win situation for you.

[ohwhatanight]

I didn't see anyone answer your question about surgery for the deviated septum. I had that done about 7 years ago. I won't lie, it was really painful for about a week or so, but it was very much worth it. I was averaging 4-5 really bad sinus infections a year before having the surgery because I had almost complete blockage on one side. Straightening things out has virtually eliminated sinus infections for me. I am also now able to be a nose breather at night.

Good luck with your sleep study. I hope you get the answer you are looking for!

[Maxie]

Great job on turning your health around. Please let us know how your sleep study goes.

[glassjules]

"I travel a lot, and while I have a fun little travel CPAP, would still be nice to not have to take it at all."

Hello glassjules
Could you please name your travel CPAP machine and give some detail about it? (Weight, battery requirements etc.). I am desperately looking for information on one that is light weight with low battery power requirements. Humidifier not required.
Also - good luck with your investigations. I have also noticed that after 5 yrs on CPAP, my AHI index has dropped alot over the past year. Some weight gained, not lost, however, over this past year.
Thanks!
jandi

I have a Transcend machine. It works great for me. Its tiny, lightweight (almost too lightweight, and has an integrated HME which means it requires no humidifier, how I don't use it that way, I just use no humidification. It comes with two different types of battery -- a short life one and a long life one. My DME ordered me the long life one. It just looks like a power adapter type deal that youd have for your laptop. Just google for transcend cpap. You'll find it. It weighs less than a lb, and has a small case.

[Guest]

Glassjules

Just a thought....Do you use a recording pulse oximeter at night sometimes?

You might want to record a couple of nights using your CPAP and then if you decide go without the CPAP for a couple of days record it then and check to see if there are differences?

While going the Sleep Study route is definitely better, this might give you some clues as to where you stand/lay in regards to the effectiveness of your CPAP therapy.

-BIll

Bill that is a great idea, I don't have the pulse ox, though. Do you know if the ones you can pick up at walgreens wouldw ork for this purpose? While my consult is in two weeks, I am told they are scheduling out on sleep studies from 6-8 weeks, so I have 8-10 weeks yet before a followup sleep study.

[glassjules]

I don't know why people on CPAP have a tough time accepting that someone can be "cured" or that they'd want to find out if they are.

I completely agree. I think after so many years on CPAP and significant weight loss, it would be a natural thing to think about.

Ditto, and congratulations on the weight loss and getting off the meds!
How do you feel at the lower pressure? Have you noticed any difference?
Do you get graphs in your data or just stats?
I don't think lowering your minimum is a problem. If you get too low I think you would notice it being difficult to breathe through the mask while awake.
If you have an apnea the pressure will increase.
Since you already have an appointment scheduled, I would experiment and gather more data before your appointment.
I think the oximeter is a good idea but I'm sure your sleep doc is going to order a P$G anyway.
Good luck! Keep us posted.

Thank you Liz, I feel great at the lower pressure, no issues so far. I get graphs in my data, I should PDF it and share it. I really am geeky overall around this, so the idea of (safely) experimenting given it will take awhile before I get to my sleep study, is interesting to me.

[glassjules]

Congratulations on the weight loss. I know that has been a very difficult war to fight.
Obviously a follow up PSG study is the best way to know for sure if you have been lucky enough to not need the cpap machine.

That said...if I were in your shoes I would be chomping at the bit wanting to have some idea....
and I would be testing things with as low as possible pressure that the machine will offer.
Granted there is therapy value even at 3 or 4 cm of pressure so it isn't a perfect test to see if absolutely zero apneas occur but it would give you sort of an idea.
So I wouldn't even use APAP unless the range was very, very tight. I would use either 3 (does your machine go down to 3 cm...I think some Devilbiss machines will) or 4 cm pressure in cpap mode or apap with only 1 cm range...just to see if any events occurred...and not worry about apap increasing in response during the experiment because all I want to see is if apnea events are occurring at all at this point and worry about pressure that might be needed later.

To use 6 cm...well there is even more therapy value at 6 cm than at 4 cm but it can be difficult to feel like enough air is moving at 4 cm. So you may be limited with how low you can comfortably go. If it were me..I would try cpap mode at the lowest pressure I could sleep at for one night and just see if any apneas occurred (and of course do the proper follow up with doctor and PSG for confirmation).

Pugsy, this is a GREAT suggestion. I think this is a more controlled way to continue with my experiment. Per Roby Sue's notes, I'm running at the bottom of my experimental range I've dropped too so far, but I haven't dropped any lower, I think continuing to drop it lower and lower and see what happens is the best way to see "how low I can go" on my own, and then see what happens on a sleep study without CPAP.

I didn't see anyone answer your question about surgery for the deviated septum. I had that done about 7 years ago. I won't lie, it was really painful for about a week or so, but it was very much worth it. I was averaging 4-5 really bad sinus infections a year before having the surgery because I had almost complete blockage on one side. Straightening things out has virtually eliminated sinus infections for me. I am also now able to be a nose breather at night.

Good luck with your sleep study. I hope you get the answer you are looking for!

ohwhatanight, this is encouraging, because i get lots of sinus infections too and was told I had almost a complete blockage on one side too. Did you look like you'd been in a bar fight and for how long? I do a lot of speaking in front of clients so if I'm going to do it, I need to schedule for a time when I won't be in front of people

You guys have been extremely helpful. We'll see what happens, but I will update on my experiment, with tighter ranges as suggested by Pugsy, until I can get my followup sleep study done.

[soundersfootballclub]

I've been told by my sleep doc my deviated septum has no connection to my OSA. I also question weight and OSA. I have a BMI in the low 20s and in great shape yet still have OSA. I think it's a throat anatomy issue and we just have to deal with it.

[Lizistired]

I don't know why people on CPAP have a tough time accepting that someone can be "cured" or that they'd want to find out if they are.

I completely agree. I think after so many years on CPAP and significant weight loss, it would be a natural thing to think about.

Ditto, and congratulations on the weight loss and getting off the meds!
How do you feel at the lower pressure? Have you noticed any difference?
Do you get graphs in your data or just stats?
I don't think lowering your minimum is a problem. If you get too low I think you would notice it being difficult to breathe through the mask while awake.
If you have an apnea the pressure will increase.
Since you already have an appointment scheduled, I would experiment and gather more data before your appointment.
I think the oximeter is a good idea but I'm sure your sleep doc is going to order a P$G anyway.
Good luck! Keep us posted.

Thank you Liz, I feel great at the lower pressure, no issues so far. I get graphs in my data, I should PDF it and share it. I really am geeky overall around this, so the idea of (safely) experimenting given it will take awhile before I get to my sleep study, is interesting to me.

Please share your graphs!
Consider too that if a PSG shows less that 5 apneas per hour you will be diagnosed as not having sleep apnea. My monthly average now with cpap is 0.4 and I still don't feel great. I hate to think what I would feel like with an AHI of 4.0 and deemed not to have sleep apnea. Arousals were my biggest issue and that is somethig you will only see after a PSG. Just be sure to get copies of the reports and graphs.

[ohwhatanight]

ohwhatanight, this is encouraging, because i get lots of sinus infections too and was told I had almost a complete blockage on one side too. Did you look like you'd been in a bar fight and for how long? I do a lot of speaking in front of clients so if I'm going to do it, I need to schedule for a time when I won't be in front of people

I don't think I looked like I'd been beaten, but I sure felt like it for about a week. I had to rinse my sinuses about 3 times a day after surgery for a while to get out all the dried blood (yuck). I wouldn't imagine you would want to be in public for at least a few days after having this done. Some ENTs believe in packing and some don't. One thing that was immensely helpful during recovery was this nice wedge pillow from Bed, Bath & Beyond. http://www.bedbathandbeyond.com/product.asp?SKU=101538 I actually bought two and used them both for the first couple of nights.

[DrPepper00]

Glassjules

Just a thought....Do you use a recording pulse oximeter at night sometimes?

You might want to record a couple of nights using your CPAP and then if you decide go without the CPAP for a couple of days record it then and check to see if there are differences?

While going the Sleep Study route is definitely better, this might give you some clues as to where you stand/lay in regards to the effectiveness of your CPAP therapy.

-BIll

Bill that is a great idea, I don't have the pulse ox, though. Do you know if the ones you can pick up at walgreens wouldw ork for this purpose? While my consult is in two weeks, I am told they are scheduling out on sleep studies from 6-8 weeks, so I have 8-10 weeks yet before a followup sleep study.

The one from WalGreens won't do. I bought one that recorded 24 hrs of data but did not download to the computer. It was a pain to page through the display in 4 sec increments and try to figure out what was going on. I would recommend the Contec CMS 50D+ or one of the higher CMS Oximeters that download to the computer. They have software to view the data. The data can also be downloaded to SleepyHead and matched up with the nightly CPAP data. There are several recent threads about Oximeters that should prove enlightening. Websites to order from are included.

[glassjules]

Thanks DrPepper! I'll look that up. ohwhatanight, ew, packing is the thing that is making me absolutely shudder. YUM YUM. I do have a wedge already, so that is perfect then, I had it for reflux which is now gone too, but I could use it during recovery. Coolio!