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Thats largely true. Unfortunately, especially the pulmonary crossovers into sleep medicine. They bring with them this hammered in, dogmatic thinking that if you just lose a bunch of weight, sleep apnea goes away. I proved it does not go away. You can take a look at my pressures and I have a top of the line APAP.

I also believe "they" are the health insurance industry, who look for any reason they can find to not pay for sleep apnea diagnosis and treatment. To the health insurance industry, they blame EVERYTHING on being overweight or obesity. EVERYTHING. "Have a headache? LOSE SOME WEIGHT!"

Im surprised the insurance industry has not tried to use the obesity claim on psychiatry stuff. "Depressed? LOSE SOME WEIGHT!" LOL

Anyway, I really believe there is a lot of patient abandonment going on these days. Especially in cases where a patient has managed care health insurance or medicaid or a lower tier health insurance plan like United Healthcare. Doctors have a contractual and a fiduciary duty to their patients to make sure their diagnosis and treatment is proper medical care, thorough and so on. Breaching that is not negligence or a tort, its criminal and as I said, I believe more doctors need to start getting prosecuted in the criminal system for patient abandonment or not following through thoroughly, poor follow on, etc.

LSAT wrote:

MrGrumpy wrote: THEY do not know what they are talking about.

I'm a happy camper this morning.



I'm not sure what my sleep dr's issues were/are, but if they continue in this vein, I will go elsewhere, I discussed it with my primary yesterday. I like the sleep dr, and will give her some slack to see if she's willing to see me as the individual I am. I have already told her that sleep hygiene is NOT my problem, but she's an advocate of that. I have enough health issues (and good insurance, for which I actually had to retire 3 years before I wanted to) that I don't stay with any doctor who doesn't "get" me.

So happy for you. I know what it's like to wake up and check the reports and see improvements..
It looks like you had a good night with only one wake up. That's an improvement. And the leaks are less.
I'd leave the pressure at 13/20 for 5 nights. And if the obstructions are still there, try 14/20. Your machine is at a median of 14.7 now. If you keep up the chart, it is easier to see which pressure is best.

I got more help on this forum than I ever got from my dr. and sleep specialist combined. They just don't have the time to monitor things like you are doing now . What I don't understand is, why don't they teach us how to monitor the treatment.

At least you are in the zone now of actually being treated. (AHI below 5).

I thought I'd go ahead and post this for you. How to adjust your upper pressure:

AFTER you have gotten your lower pressure perfected, eliminating as many obstructions as possible, you can work on your upper pressure. By lowering the upper pressure, your CA events may decrease, because high pressure and pressure spikes can cause you to wake up. Try lowering the upper pressure one point to 19 and track what happens. Watch to see if your CA events go down. The other thing to watch for is if the obstructive events rise. If that goes well, you can try lowering it to 18.
The process is similar to what you did to get the bottom pressure number perfected. The general idea is that you are trying to eliminate CA events without increasing obstructive events.
(This is where that chart comes in handy)
Any changes you make, live with them a few days to evaluate.
Hope this helps. There is a low AHI in there somewhere. The process works, you just have to stay with it.

And don't be satisfied with AHI of 5. Many people on here get it to 1 or 2. At 5, you are still waking up 5 times every hour.

Are you having any improvements?

Yes and no. My AHI has been lower, but the leaks are high, so I don't know how valid anything else is. I still haven't found the right mask, or the right modifictions to make a mask work. I had two good nights with P10 for her pillows - no leaks there - but the lip leaks are off the charts. Its very discouraging; I don't think I've had one night yet where I an say the CPAP really did what its supposed to. But I'm not giving up, not at all. If tonight's mods work, I'll post my success story tomorrow.

Thanks for sking!

What is your AHI hovering around? I hope it's staying near or below 5.
Every night is a success when you are learning what works.

Yes, no higher than 5.5, usually below 5.

Getting the mask right is a big struggle. I went through 4 different masks to find the one I like.

I changed topics a bit so I started a new thread here: viewtopic.php?f=1&t=110500&p=1058786#p1058786