Subconciously addicted to my CPAP machine

ericdryden wrote: ↑

Wed Oct 02, 2019 7:36 pm

These devices in hospitals environments can save lives and once used they spend several days to ween a person off the device. NO hospital will remove the Ventilator from a patient except in increasing duration until they are comfortable the patient can breath on their own.

As others have noted, there are significant differences between between vents and PAP. At least as important is understanding why and how vents are used.

First, surgery patients under general are typically intubated before surgery and extubated after surgery -- no weaning required. Second, when patients are typically on vents longer term it is because of trauma, infection,or some other disease process. The vent is there as part of the recovery process. And in many of those cases the vent is doing everything -- breath initiation, setting tidal volume, peep, etc. The settings vary with the patient and the disease.

Typically, the underlying issue (and not the use of the vent per se) is what causes the need for a weaning period (when one is necessary). It is also worth noting that a PAP system for apnea is deployed for about 8 hours -- not 24/7 like a vent is typically applied.

Enough with the red herrings: do you have any journal articles or data (tidal volumes or sats)to support your claims?

Eric, you came on a forum dedicated to x (where x is something beneficial) and basically said "x can kill you", so you'd have to expect some level of antagonism! Statements like "it seems if I am on the machine long enough the human body may not be able to survive if removed" do a disservice to others.

That being said, you are correct that CPAP (and especially Bi-Level) reduce the effort necessary to breathe a given quantity of air. Pure CPAP is well-known to increase lung volume, and although work of breathing is increased overall, this is mainly during exhalation against pressure - the increased lung volume makes inspiration easier. Increased tidal volume and oxygen consumption result: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4796612/

The situation is even more plain with Bi-Level as the pressure differential between IPAP and EPAP is directly proportional to increased tidal volume for any given breathing effort - one can obtain the same amount of air with less effort (as anyone who's set their PS to 8 and trigger to very high can attest!). This is also well-known and basic physics, but for those who like sources: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5720219/ (here they decreased the IPAP/EPAP differential and tidal volume decreased, demonstrating the inverse).

I don't want to discount your experience but rest assured, barring something seriously otherwise wrong with you, you would not have died. Had you achieved deeper stages of sleep, in the absence of obstruction, automatic processes would've assured appropriate ventilation. If there were some habituation to decreased breathing effort, as you speculate, I'm guessing it came into play in the delicate stage between wakefulness and sleep. If you only slept for 20 minutes at a time, you never really got beyond this stage. Because ventilatory needs are decreased during sleep, a shift into wakefulness combined with the absence of air pressure, might have caused you to feel that you weren't breathing well enough. This would've released adrenaline, further lowering your threshold for arousal, increasing the likelihood of drifting back out of sleep during the next transition, perpetuating an unpleasant cycle. At the time, medication to raise the arousal threshold (i.e. a sedative) would've probably been helpful. I'm glad you made it through though!

chunkyfrog wrote: ↑

Sun Feb 01, 2015 12:00 pm

Your wife may have lost some hearing acuity, due to lying next to a chainsaw for . . .
-----How many years have you been married?

FYI...Eddie has not been around for 4 years. This is a 2015 post