Do I still need my cpap?

[BrianCD]

So I was just talking to someone on another forum that mentioned he no longer needed his Cpap machine after loosing significant amounts of weight. I have been on mine with 100% compliance for the last 6 years. I have lost about 60 pounds over the last 4 months and my neck size has gone from 21" to 16.7". I have been having very bad dry mouth for the last couple months, so bad that I have to wake up several times per night and drink water. When I look at my Respironics report for the beginning of this month, it shows my AHI is down to 0.9 and my RERA index to 0.3. Looking back at the first days I was on this, these numbers were much higher, around 8.6 or so. What else should I be looking at on this report to tell if I still need to be using this machine? Can I upload the report to have someone take a quick look? If so, how many days worth of data is needed?

Thank you.

[zoocrewphoto]

So I was just talking to someone on another forum that mentioned he no longer needed his Cpap machine after loosing significant amounts of weight. I have been on mine with 100% compliance for the last 6 years. I have lost about 60 pounds over the last 4 months and my neck size has gone from 21" to 16.7". I have been having very bad dry mouth for the last couple months, so bad that I have to wake up several times per night and drink water. When I look at my Respironics report for the beginning of this month, it shows my AHI is down to 0.9 and my RERA index to 0.3. Looking back at the first days I was on this, these numbers were much higher, around 8.6 or so. What else should I be looking at on this report to tell if I still need to be using this machine? Can I upload the report to have someone take a quick look? If so, how many days worth of data is needed?

Thank you.

It sounds like you really should have a new sleep study. Some people are lucky to get off cpap with weight loss. Some can reduce their pressure which tends to improve comfort. And some have to increase their pressure. Really, the only way to know is a new sleep study.

My treated ahi is usually less than 2, often less than 1, yet my untreated ahi is 79+, so there is no way to know from the treated ahi how the untreated ahi would be.

[TangledHose]

Brian,

What cpap or apap pressure do you run on your machine now? Why not lower you pressure and monitor what happens to your ahi over a few weeks time, if you lower your pressure somewhat and your ahi average goes up then that would be a good indication that you still need pap to treat your apnea. If you can get your pressure down fairly low without a corresponding increase in ahi then maybe your weight loss is working to reduce your apneas. Not all that scientific, but this little home test might give you more information about your apnea situation without time and expense of new sleep study for now.

[BlackSpinner]

Dty mouth = mouth breathing. If you us a nasal mask of some sort this means your therapy is screwed up.

Loosing weight does not guarantee not needing cpap - some people need more pressure when they lose weight. Only a sleep study will tell.

[Wulfman...]

So I was just talking to someone on another forum that mentioned he no longer needed his Cpap machine after loosing significant amounts of weight. I have been on mine with 100% compliance for the last 6 years. I have lost about 60 pounds over the last 4 months and my neck size has gone from 21" to 16.7". I have been having very bad dry mouth for the last couple months, so bad that I have to wake up several times per night and drink water. When I look at my Respironics report for the beginning of this month, it shows my AHI is down to 0.9 and my RERA index to 0.3. Looking back at the first days I was on this, these numbers were much higher, around 8.6 or so. What else should I be looking at on this report to tell if I still need to be using this machine? Can I upload the report to have someone take a quick look? If so, how many days worth of data is needed?

Thank you.

If you're using a nasal mask, it sounds like you're leaking your therapy air out your mouth. If that's the case, your numbers are probably bogus.

Please add your equipment to your profile, including your pressure and other settings (humidity, Flex and whatever).


Den

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[kaiasgram]

Brian, there is really nothing that your machine reports that would tell you (or us) if you no longer need to use it. The improvement in your report numbers does not tell you anything except that the machine is now more effective in controlling your apnea (dry mouth issues aside). Some people have brought up possible mouth leaking, but whatever your leak numbers look like, the issue remains the same -- even if you run at the lowest possible pressure and all your numbers still look good, there's no way to determine how you'd do off the machine except to get a new sleep study. Because even at the lowest pressure setting you are still getting some PAP therapy.

The improvement in your reports might mean that your weight loss has resulted in your cpap being more effective and maybe it also suggests that you could get by with less pressure now. That would be worth trying by slowly decreasing your pressure and seeing if your numbers stay down.

I saw on another board just yesterday where someone lost weight and had a new sleep study and was told he (she?) doesn't need to use cpap anymore. I was envious, to be honest, but at the same time I realized I wouldn't feel totally comfortable to abandon cpap based on one night in a sleep lab. I'd probably still want to spot check with an oximeter for a while and make sure I was feeling ok.

[BrianCD]

I added my equipment and pressures to my profile. I am running the "PR System One REMStar 60 Series Auto CPAP Machine". It is about a year old now. I am using the Swift FX nasal pillows. My pressures are set between 6 and 14. Looking at the pressure graphs, most nights I stay well under 10, however sometimes it does bump up against the 14 mark for very short periods. It was originally set to a higher number (20 I think), but I turned it down because the mask would start leaking at anything above 14. This is a pretty typical graph for my nights.





For a comparison, here is the same chart from a few months before I started loosing weight,




As far as leak numbers, it shows 0.0 % for large leak. Average Leak shows between 20.0 and 24.0. Is that what is causing the dry mouth?

[70sSanO]

I think your charts say yes, you still need your CPAP.

John

[robysue]

While your average and 90% pressures are down quite a bit from before lost weight, they are NOT insignificant levels of pressure: Your average pressure is 7.7 and the 90% is 8.9. There are a lot of people out there with very severe OSA who only need 7-9 cm of pressure to completely control their OSA. So the pressure range being down in the 7-9cm range is no guarantee that your OSA has disappeared with the weight loss.

It looks like your minimum pressure is about 6cm. So something is causing the machine to increase your pressure during the night. Since your AHI is low, that something is likely flow limitations and/or snoring. Both of which are strong indicators that without a PAP, you'd probably still be having a significant number of obstructive events.

Still---once you reach your target weight and you keep your weight at the target for six months or so, it would be well worth having another sleep study done. You might be one of the lucky few whose OSA fully resolves with substantial weight loss. Or you might simply find out that you now need a whole lot less pressure to treat your OSA. But only a sleep study will tell for sure which it really is.

[chunkyfrog]

If you turned your pressure way down, you would get an idea how many events are being treated/prevented.
You would be essentially sleeping without therapy, a situation which is normally done in a sleep lab,
with someone watching you, ready to intervene if you get in trouble.
But it's your call; do you feel lucky?

[jencat824]

I think your charts say yes, you still need your CPAP.

John

I agree. I think if your machine was detecting no events, your line would be flat at the minimum number (I think a 6). You still have some activity, just at a lower pressure than before weight loss. Another sleep study wouldn't hurt, you would be able to compare to before weight loss & see what your pressure actually needs to be now, but I personally think your results will show a need for some PAP therapy.

Congrats on the weight loss. I'm working on that now & its harder than it looks!

[Wulfman...]

I would suggest increasing the minimum pressure to 8 or 9 for awhile and see what the reports look like.
Your mouth is probably dropping open a little......causing the dry mouth. You could try using some 3M Easy Release blue painter's tape, to tape your mouth shut.


Den

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[BrianCD]

Thanks for the responses. I will follow the advice to get down to a maintenance weight and wait about 6 month to see where I am at.