do you ever get "tolerance" to CPAP?

Strange idea, but can't stop thinking about it.
Everyone who is indefinitely on some drug/treatment for a chronic issue always has to at some point increase their dosage.
For example, someone with chronic depression starts out on an SSRI with no plans of ever stopping, but eventually the initial dosage stops working and needs to be increased.

Does this ever happen with CPAP? Like, you may start out great at 7 cmH20, but after 6 months, your body gets a "tolerance" to that pressure, and the pressure needs to be increased to maintain your AHI < 5?

Another concern from a difference angle, is that i am afraid that since the CPAP is holding my soft tissue open, my throat and neck muscles will atrophy, since they are not working to keep my airways open. I am scared that this in turn will cause the apnea to worsen over time, thus requiring an increase in pressure over time to maintain AHI < 5.

I am scared that over time, the pressure required to maintain AHI < 5 will creep up to 9, then 11, then 15, then 19, then 20, then 30+ until there are no machines that can provide the pressure.

Anyone experienced anything like this?

First of all you do plenty of exercise during the day so there is nothing to worry about that way. If it still concerns you, take singing or flute lessons. ETA: (Or you could take up the tuba - your neighbours will love that)

You will not build a tolerance to the pressure however you will get older. I started at 9 5 years ago now I am at 10 on average, I am 65 currently. There are people who have been on xpap therapy for over 20 years on this board. Their changes have been due to disease progression and/or general ageing.

alexxshadenk wrote:Strange idea,

indeed.

alexxshadenk wrote: Another concern from a difference angle, is that i am afraid that since the CPAP is holding my soft tissue open, my throat and neck muscles will atrophy, since they are not working to keep my airways open.

this is a non issue, because, if you think about it, your 'throat and neck muscles' weren't doing any work in the first place to keep your airway open.

if they had been, you wouldn't need cpap. eh?

The tissue in your throat is soft, not the muscular type that keeps your head up and turning. And all that Cpap does is blow a little room air into you... nothing more sinister, nothing more complex. You're really getting yourself worked up over nothing and you should see your doctor for some type of help such as CBT that can relax you without drugs.

And as usual PR has a point - you wouldn't need Cpap if things worked well to begin with.

alexxshadenk wrote:Strange idea, but can't stop thinking about it.
Everyone who is indefinitely on some drug/treatment for a chronic issue always has to at some point increase their dosage.
For example, someone with chronic depression starts out on an SSRI with no plans of ever stopping, but eventually the initial dosage stops working and needs to be increased.

Does this ever happen with CPAP? Like, you may start out great at 7 cmH20, but after 6 months, your body gets a "tolerance" to that pressure, and the pressure needs to be increased to maintain your AHI < 5?

Another concern from a difference angle, is that i am afraid that since the CPAP is holding my soft tissue open, my throat and neck muscles will atrophy, since they are not working to keep my airways open. I am scared that this in turn will cause the apnea to worsen over time, thus requiring an increase in pressure over time to maintain AHI < 5.

I am scared that over time, the pressure required to maintain AHI < 5 will creep up to 9, then 11, then 15, then 19, then 20, then 30+ until there are no machines that can provide the pressure.

Anyone experienced anything like this?

NO, NO and NO!

(and, it might even go the other way)

I haven't changed my pressure (12 cm.) since 2006......or needed more.......and my AHI and other "numbers" are lower now than they were then.


Den

.

I have increased my pressure 2 points over the course of 8+ years, a change I attribute to aging. And that increase was to keep my AHI around 1 or below. I could have left it alone and still had an AHI considered acceptable as it never went much above 2. So I guess I've gone over 8 years without "needing" to increase my pressure. I figure if it were even possible for my needs to increase beyond a machine's ability to manage, I'll have way bigger problems than that going on, but at the current rate, I'll be long gone before it would get that high. Compared to some of the long-time users on here I'm still new at this experience. I just know I've never seen what you're concerned about reported to happen to someone on this forum, and this forum seems to get the "problem children".

Eventually, we all stop breathing entirely.
I like breathing, and will use this machine as long as it helps delay that.

Not to alarm anyone but I have been addicted to O2 every since my very first breath. So yea addiction could be a problem.

So, what would you suggest in the alternative??? NOT using CPAP clearly wasn't working for you.

There are some researchers exploring implanted electrodes that shock your tissues in the throat to get them to contract--maybe you would prefer that torture to CPAP? Not me!

I have lost weight over the last 5 years. My pressure went up a little. I regained some of that weight, and my pressure hes dropped a little. In both cases my AHI has dropped. It is now less than 1 most nights, so telling the benefit of a pressure change one way or the other is going to be very difficult. I might discuss getting an APAP as my new primary machine, but Tully expect to have it operate in a very narrow range around my current pressure. Your mileage may vary, but I think the anecdotal evidence is enough to say that your pressure may change a little bit, but it is highly unlikely that it will go off the chart crazy. So, calm down, and get some sleep. You'll feel better in the morning.

alexxshadenk wrote:Strange idea, but can't stop thinking about it.
Everyone who is indefinitely on some drug/treatment for a chronic issue always has to at some point increase their dosage.
For example, someone with chronic depression starts out on an SSRI with no plans of ever stopping, but eventually the initial dosage stops working and needs to be increased.

Does this ever happen with CPAP? Like, you may start out great at 7 cmH20, but after 6 months, your body gets a "tolerance" to that pressure, and the pressure needs to be increased to maintain your AHI < 5?

Another concern from a difference angle, is that i am afraid that since the CPAP is holding my soft tissue open, my throat and neck muscles will atrophy, since they are not working to keep my airways open. I am scared that this in turn will cause the apnea to worsen over time, thus requiring an increase in pressure over time to maintain AHI < 5.

I am scared that over time, the pressure required to maintain AHI < 5 will creep up to 9, then 11, then 15, then 19, then 20, then 30+ until there are no machines that can provide the pressure.

Anyone experienced anything like this?

I would think those parts get plenty of exercise during the wake hours but if you Google "exercises to illuminate sleep apnea" or something similar to that, you'll find all kinds of exercises you can do that supposedly will strengthen the uvula. Personally, I think it's a waste of time and a non issue. My AHI has improved since I started a year ago but it could be that i'm learning better technique to manage the equipment and mask to my advantage. My friend has been on CPAP for 20 years with everything identical from day one.

Think about how nice it is to be breathing filtered air while you sleep. Not everybody is that lucky? Ok, I'm pushing it a little but that has to benefit your lungs over the long term.

You actually want a tolerance to cpap. That tolerance is being tolerant to the mask on your face and breathing against pressure.

As far as needing more pressure, that shouldn't be a problem unless you got degenerative brain disease that makes breathing while sleeping more difficult and irregular. At that point, I guess you goto a machine that is a hybrid bipap and ventilator. Anyone know anything about the degenerative brain disease route?

borgready wrote:Anyone know anything about the degenerative brain disease route?

is THAT why you keep posting such nonsense?

palerider wrote:

borgready wrote:Anyone know anything about the degenerative brain disease route?

is THAT why you keep posting such nonsense?

+100

49er

It does not seem that there would be tolerance in the strict definition, because that refers to your body compensating for a chemical change by adjusting to a "new normal" chemically. IOW, if you regularly ingest something not normally in your system, your body can sometimes adjust by either adjusting the normal amount of related hormones or other things to compensate, to make the net result more closely match what it was expecting before.

For instance, methadone builds tolerance quickly, which makes it a seriously dangerous drug, even more dangerous than heroin. There is an epidemic of folks who upped (or supplemented) the dosage because they became tolerant to the effect, but did not become tolerant to the CNS depressant effect, meaning that they took more to get the same relief, but often the increased CNS depressant effect becomes extremely dangerous resulting in death.

But CPAP is essentially air, just hopefully a little more of it whenever you need it. So I think while there may be some adjustment and some familiarization, in the sense of tolerance I don't think that really happens. The effect of CPAP therapy does not wane with constant use, the efficacy remains the same.