OSA Occupational Health

[dmc1927]

Good Morning,

I was diagnosed with OSA a while ago and had a CPAP 'One' machine, which gauged my levels back on 14th Feb fot 2 weeks, during which time I noticed an immediate improvement in my levels of alertness during the day. I am now working with a fixed level machine and i'm not convinced its having the desired effect, the mask seems to be leaking air where the silicon is a bit softer. I have an appointment in a few weeks so will deal with that then. at the moment the headaches back and im tired.

My place of work have now decided to act on my condition, despite me falling asleep at work for months and them being aware of my lack of sleep for some time. They've arranged a Occupational Health Review over the telephone tomorrow.

Has anyone experienced one of these previously? if so what sort of questions are asked.

What kind of recommendations could be made?

I work as a case manager and my current productivity levels are as low as theyve ever been. Trying to manage a caseload with little sleep is near on impossible.

Thanks

[zoocrewphoto]

Good Morning,

I was diagnosed with OSA a while ago and had a CPAP 'One' machine, which gauged my levels back on 14th Feb fot 2 weeks, during which time I noticed an immediate improvement in my levels of alertness during the day. I am now working with a fixed level machine and i'm not convinced its having the desired effect, the mask seems to be leaking air where the silicon is a bit softer. I have an appointment in a few weeks so will deal with that then. at the moment the headaches back and im tired.

My place of work have now decided to act on my condition, despite me falling asleep at work for months and them being aware of my lack of sleep for some time. They've arranged a Occupational Health Review over the telephone tomorrow.

Has anyone experienced one of these previously? if so what sort of questions are asked.

What kind of recommendations could be made?

I work as a case manager and my current productivity levels are as low as theyve ever been. Trying to manage a caseload with little sleep is near on impossible.

Thanks

It sounds like your machine is not set to an ideal level for you. I've never done any kind of interview like you mentioned, but I would tell them you had initial improvement with the trial machine, and not feeling that with your new machine. It sounds like you need to get back to the doctor sooner than the scheduled appointment if possible and find out why they chose the settings they did and have them make some adjustments.

Can you tell us what machine you are currently using? If it has data, we can help you see if your therapy appears good or not. It sounds like the pressures may need to be adjusted. And you may need some help with the mask or a different mask. Though it sounds like you had the same mask during the first machine setup?

[Todzo]

I do feel the pain of what you are going through.

I have never had such a review but did find something along the lines of what you requested[3].

Obstructive Sleep Apnea does cause brain damage[2].

Sleep Apnea affects executive functioning[1]. Executive functioning is exactly what we need to do any job. We cannot be productive without it.

From the article[1]:

“All 5 domains of executive function demonstrated medium to very large impairments in OSA independent of age and disease severity. Furthermore, all subdomains of executive function demonstrated small to medium improvements with CPAP treatment.”

So CPAP treatment, if well managed, can help but is no cure.

In my case I was a Broadcast Technician (23 years), re-trained to be a cook and worked as such (6 years) but after acquiring Post Traumatic Stress from an assault and robbery I ended up on disability.

In terms of a path toward productivity I recommend that you learn to manage your own treatment and pursue metabolic health. Learn to download and use your nightly CPAP data and acquire the services of a good dietitian and personal trainer (shop well). I have found that with well managed CPAP treatment and with learning how to eat and move well you can make improvements over the years (I have been on CPAP for over ten years now).

[1] Olaithe M; Bucks RS. Executive dysfunction in OSA before and after treatment: a meta-analysis. SLEEP 2013;36(9):1297-1305

[2] http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2491498/

[3] http://www.oshrc.gov/about/2013_FEVSQue ... ponses.pdf

[chunkyfrog]

If your silicone is getting too soft to seal well, (and did before) your mask may only need a replacement cushion.
If the headgear is stretched out, that, too can be replaced.
It infuriates me that so many patients are not told that most masks can be made like new with a relatively inexpensive part.

[Julie]

My silicone cushion firms up with wipes.

[dmc1927]

Good Morning,

I was diagnosed with OSA a while ago and had a CPAP 'One' machine, which gauged my levels back on 14th Feb fot 2 weeks, during which time I noticed an immediate improvement in my levels of alertness during the day. I am now working with a fixed level machine and i'm not convinced its having the desired effect, the mask seems to be leaking air where the silicon is a bit softer. I have an appointment in a few weeks so will deal with that then. at the moment the headaches back and im tired.

My place of work have now decided to act on my condition, despite me falling asleep at work for months and them being aware of my lack of sleep for some time. They've arranged a Occupational Health Review over the telephone tomorrow.

Has anyone experienced one of these previously? if so what sort of questions are asked.

What kind of recommendations could be made?

I work as a case manager and my current productivity levels are as low as theyve ever been. Trying to manage a caseload with little sleep is near on impossible.

Thanks

It sounds like your machine is not set to an ideal level for you. I've never done any kind of interview like you mentioned, but I would tell them you had initial improvement with the trial machine, and not feeling that with your new machine. It sounds like you need to get back to the doctor sooner than the scheduled appointment if possible and find out why they chose the settings they did and have them make some adjustments.

Can you tell us what machine you are currently using? If it has data, we can help you see if your therapy appears good or not. It sounds like the pressures may need to be adjusted. And you may need some help with the mask or a different mask. Though it sounds like you had the same mask during the first machine setup?

Hi I have a Phillips One machine.

Yes it was the same mask as the trial. The fit before was good, seemed to work... Yet the longer I've worn it the more gaps etc during the night, more air escaping.

How do I check the data?

[jaye8898]

Hi DMC,

I'm an HR professional who has evaluated and made decisions on quite a few requests for reasonable accommodation under ADA (Americans with Disabilities Act). I am not familiar with the type of interview you are seeking information on but I do know that sleep apnea can be considered a disability under ADA in some situations. Have you requested any type of accommodation? It may be a good idea to think about what your employer could do to help you do your job. I did case management many years ago and know I would have a very hard time doing it now because I don't have the organizational or memory skills I had back then due to my condition.

Here are a couple of links with information on sleep apnea and ADA. You may have seen them before but if not, it may help you with managing the questions you will be asked.

http://www.eeoc.gov/eeoc/foia/letters/2 ... apnea.html

http://www.apneasupport.org/post-52782.html

I know what it's like to have issues at work due to sleep apnea and other disabilities and my heart goes out to you. I wish you the very best!

[Pugsy]

Hi I have a Phillips One machine.

How do I check the data?

Sounds like you have a Phillips Respironics (PR) System One machine of some unknown model.
Not all the models with gather useful information though. To find out exactly which model you are using look on the bottom of the blower unit for a little sticker with a 3 digit model number on it...may have DS or REF in front of the 3 digits.
Tell us what that model number is and we can then tell you if you can use software to evaluate your data.
Some machines have a SD card but only gather hours of use.
If you have a full data machine you can use software (links in my signature line) to see just how things are going.

[Janknitz]

DON'T turn your machine upside down until you remove the water tank!!!!!!!!!!!!!!!!

Just a friendly reminder, because a sleepless brain can forget!

[jencat824]

Not everyone will have the same reaction I had to your post, but the words 'Occupational Health Review' sent up some little red flags in my mind. I would let them do any initial discussion, answer questions truthfully - but with shortest answer possible. Keep in mind your employer either wants to HELP you or HURT you (by demotion or firing). Any info that is gathered in the interview can be used either way.

I had a boss who once caused me to nearly be fired. He required me to be tested for ADHD because he found a few typos in some of my work. He had recently been diagnosed with Adult ADHD, so thought there must be cases in his own dept. My problem turned out to be severe stress - I had 11 family members, most of my family, die within a 9 month period. I also later realized some of the problem must have been due to my then undiagnosed sleep disorders. Just wish that man had OSA instead of ADHD.

My point here is protect yourself until you can tell if the spirit of the interview is to help you...or something else.

Good luck & let us know how it goes.
Jen

[munkyBeatz]

Good Morning,

I was diagnosed with OSA a while ago and had a CPAP 'One' machine, which gauged my levels back on 14th Feb fot 2 weeks, during which time I noticed an immediate improvement in my levels of alertness during the day. I am now working with a fixed level machine and i'm not convinced its having the desired effect, the mask seems to be leaking air where the silicon is a bit softer. I have an appointment in a few weeks so will deal with that then. at the moment the headaches back and im tired.

My place of work have now decided to act on my condition, despite me falling asleep at work for months and them being aware of my lack of sleep for some time. They've arranged a Occupational Health Review over the telephone tomorrow.

Has anyone experienced one of these previously? if so what sort of questions are asked.

What kind of recommendations could be made?

I work as a case manager and my current productivity levels are as low as theyve ever been. Trying to manage a caseload with little sleep is near on impossible.

Thanks

It sounds like your machine is not set to an ideal level for you. I've never done any kind of interview like you mentioned, but I would tell them you had initial improvement with the trial machine, and not feeling that with your new machine. It sounds like you need to get back to the doctor sooner than the scheduled appointment if possible and find out why they chose the settings they did and have them make some adjustments.

Can you tell us what machine you are currently using? If it has data, we can help you see if your therapy appears good or not. It sounds like the pressures may need to be adjusted. And you may need some help with the mask or a different mask. Though it sounds like you had the same mask during the first machine setup?

You can in no way make the assumption of needing pressure adjustment, from what's been posted in the OP. Majority of patients with moderate to severe OSA for example, notice a huge gain in energy/alertness/etc immediately, then after a short period will plateau and later normalize. People really shouldn't be so quick to recommend pressure changes, especially before complete acclimation.

[zoocrewphoto]

Good Morning,

I was diagnosed with OSA a while ago and had a CPAP 'One' machine, which gauged my levels back on 14th Feb fot 2 weeks, during which time I noticed an immediate improvement in my levels of alertness during the day. I am now working with a fixed level machine and i'm not convinced its having the desired effect, the mask seems to be leaking air where the silicon is a bit softer. I have an appointment in a few weeks so will deal with that then. at the moment the headaches back and im tired.

My place of work have now decided to act on my condition, despite me falling asleep at work for months and them being aware of my lack of sleep for some time. They've arranged a Occupational Health Review over the telephone tomorrow.

Has anyone experienced one of these previously? if so what sort of questions are asked.

What kind of recommendations could be made?

I work as a case manager and my current productivity levels are as low as theyve ever been. Trying to manage a caseload with little sleep is near on impossible.

Thanks

It sounds like your machine is not set to an ideal level for you. I've never done any kind of interview like you mentioned, but I would tell them you had initial improvement with the trial machine, and not feeling that with your new machine. It sounds like you need to get back to the doctor sooner than the scheduled appointment if possible and find out why they chose the settings they did and have them make some adjustments.

Can you tell us what machine you are currently using? If it has data, we can help you see if your therapy appears good or not. It sounds like the pressures may need to be adjusted. And you may need some help with the mask or a different mask. Though it sounds like you had the same mask during the first machine setup?

You can in no way make the assumption of needing pressure adjustment, from what's been posted in the OP. Majority of patients with moderate to severe OSA for example, notice a huge gain in energy/alertness/etc immediately, then after a short period will plateau and later normalize. People really shouldn't be so quick to recommend pressure changes, especially before complete acclimation.

There are LOTS of people who join this forum with less than ideal therapy because their doctor / sleep study did not determine the best settings for them. It could have been a difficult sleep study or just different sleep situation at home. And since most doctors and DMEs don't bother to actually check the data, nobody notices.

In case you didn't notice, the original poster stated that they used an auto machine for 2 weeks and felt good. Then got a straight cpap and doesn't feel so great anymore. Seems to me that the auto was getting the job done, but the straight pressure they selected is not doing the job. They either need to pick a better straight level setting or go back to a pressure range. Obviously, the test range was doing a lot better than the current setting.

[dmc1927]

Hi all,

Had a good review with the doctor this morning. He certainly seemed on my side and asked what recommendations would I like to be made.

We agreed that I shouldn't be expected to carry a full workload at the moment and not have the responsibility of a whole team.

He recognised that I have a serious issue that is affecting my work and said until the cpap issues are resolved there is likely to be a constant decrease in my abilities, however long term with a correctly working cpap I should be much improved.

Ill come back with the cpap model details later today.

Thanks

[jencat824]

Hi all,

Had a good review with the doctor this morning. He certainly seemed on my side and asked what recommendations would I like to be made.

We agreed that I shouldn't be expected to carry a full workload at the moment and not have the responsibility of a whole team.

He recognised that I have a serious issue that is affecting my work and said until the cpap issues are resolved there is likely to be a constant decrease in my abilities, however long term with a correctly working cpap I should be much improved.

Ill come back with the cpap model details later today.

Thanks

I'm glad to see your review went well. Also glad to see it was with an actual doctor. I was worried for you, but it seems you work for a very caring company.

[chunkyfrog]

Good news; however I would urge you to lobby to change to an automatic machine,
as all APAP's can also be used in single pressure mode.
Ask the doctor to Rx a machine that gives leak data in numeric form
so you can be sure your therapy air is getting where it needs to go.