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It would seem to me, that the only people for whom there's a "risk" that might affect them would be OSA sufferers who's OSA is strictly weight related. Anyone else would have some sort of structural issue that would require treatment, even if they were skinny.

This is just a hypothetical, but in the case of the "weight only" group, it might be possible that the muscles in the throat would need to "relearn" to not cause obstruction, if that person lost sufficient weight.

bv1800 wrote:It would seem to me, that the only people for whom there's a "risk" that might affect them would be OSA sufferers who's OSA is strictly weight related. Anyone else would have some sort of structural issue that would require treatment, even if they were skinny.

This is just a hypothetical, but in the case of the "weight only" group, it might be possible that the muscles in the throat would need to "relearn" to not cause obstruction, if that person lost sufficient weight.

It doesn't work that way in terms of muscles "learning" to keep the airway open.

Another plausible scenario: I have an enlarged thyroid. It's approx 3x as big as it's supposed to be (but 5 years ago it was 4x, so that's better, eh?) I have regular biopsies because it is always possible that it could turn into thyroid cancer.

Ok, so IF my obstruction is totally caused by my thyroid pressing on my windpipe, and IF I get thyroid cancer in the future and have to have my thyroid removed, then it's possible that I MIGHT not have OSA anymore. So it is not impossible to imagine that I could end up needing to learn how to sleep without an xPAP after learning how to sleep with it. The interesting question to me -- is the machine data good enough to pick up on the fact that I no longer have apnea?

That's going to be a pretty rare sort of scenario, though... If I get thyroid cancer I'll be sure to come back and report!

CF unlike you I don't need glasses at all. I only wear mine when I want to see.

In a similar fashion I don't need my PAP I only use it when I want to breath.

Moderate-to-severe OSA is rarely a matter solely of one physical obstruction. Once the airway has become collapsible, and a pattern of collapse has set in over the years, physically fixing the collapsibility in one location is unlikely to solve the entire problem. That is because the nervous system, including the brain, adapts, and there is no known way to unadapt it.

Untreated OSA begets more OSA. The problem usually worsens over time.

On the other hand, successful treatment appears to stop the progression of that rewiring, if I understand what I've read.

But fixing one area of obstruction (even if that area is the likely location of the genesis of the physical problem) may not solve the problem entirely. That is one reason (of many) that UPPP surgery rarely solves the problem longterm--the throat simply begins closing in another location after a while.

When an anatomical deformity or a sudden weight gain appears to initiate OSA, there is a relatively small window in which to remove the deformity or extra weight (or to initiate PAP therapy) before the brain and nervous system start rewiring themselves to adapt, from what I understand.

You see, all humans have occasional apneas and airway changes. If the apneas and airway changes don't disrupt sleep significantly or affect breathing significantly, those apneas are no big deal and the body doesn't need to change what it does to survive. The problem for those of us with moderate-to-severe OSA is that the body/brain has learned to ignore the status of its own airway so that those apneas aren't detected until they are doing damage, and then undoing the apnea causes even more damage. That is the sinister nature of the syndrome. And once that adaptation begins to take place, the only lasting effective solution is PAP, since it keeps the ENTIRE airway stabilized all night so that the adaptation process can stop.

Or something like that.

archangle wrote: It doesn't work that way in terms of muscles "learning" to keep the airway open.

Was pretty sure that this was the case, but thought that I'd offer some fodder to fertilize the discussion.