Curing apnea and getting off CPAP?

Not all people with OSA experience desats.

Not all people who experience desats have OSA.

You might want to suggest to her to have a followup PSG. It would be awful if she discontinued CPAP therapy because she thought she was cured and it turned out she still had OSA.

Not all people with sleep apnea are overweight...

Take me for example, I am 135lbs soaking wet...yet I have severe OSA. I have gone through one surgery thus far, and it failed...perhaps made it worse, I don't know. On January 18th, I will find out when (hopefully) I will have my MMA done. That has a 75% cure rate, and after looking at my X-rays, I figure...it can't hurt....

I am 27 years old, very healthy minus the OSA, don't smoke, hardly drink, or at least not as much as I would like ;p...

Yet my life insurance premium is twice that of my wife due to the OSA.

Oh, and a tracheotomy, although probably least desirable, is a 100% cure of OSA....or so I have been told. And I have thought about it...

I too have been on CPAP for 2 years now. I cannot sleep without it. Yet I don't think it is as effective as it could be. So with that, I am determined...committed...to being cured. I cannot have OSA be a factor in my life any more. Am I sad because I'm tired? Am I anxious because I'm tired? These are the factors I need to rule out.

Anyway...sorry about my rant.

[quote="josh"]Not all people with sleep apnea are overweight...

Take me for example, I am 135lbs soaking wet...yet I have severe OSA. I have gone through one surgery thus far, and it failed...perhaps made it worse, I don't know. On January 18th, I will find out when (hopefully) I will have my MMA done. That has a 75% cure rate, and after looking at my X-rays, I figure...it can't hurt....

I am 27 years old, very healthy minus the OSA, don't smoke, hardly drink, or at least not as much as I would like ;p...

Yet my life insurance premium is twice that of my wife due to the OSA.

Oh, and a tracheotomy, although probably least desirable, is a 100% cure of OSA....or so I have been told. And I have thought about it...

I too have been on CPAP for 2 years now. I cannot sleep without it. Yet I don't think it is as effective as it could be. So with that, I am determined...committed...to being cured. I cannot have OSA be a factor in my life any more. Am I sad because I'm tired? Am I anxious because I'm tired? These are the factors I need to rule out.

Anyway...sorry about my rant.

I may be the exception, but I had severe OSA!!!! Read my posts that date back 1 1/2 years ago.

My AHI was 67. I wore my Remstar Auto with an Activa mask faithfully. Had my tonsils/uvula taken out back in February but was too scared to sleep without my cpap so I had another sleep study done and my AHI was 1-2!!!!!!!!!!!!!!!

THERE IS A GOD!!!

neversleeps wrote:Not all people who experience desats have OSA.

Please trust that I'm not looking to be argumentative, my motivation is to better understand my condition.
Absent any problems with one's heart (rhythm, rate, output) and absent pulmonary function issues (pneumonia, asthma, etc) what would be causing transitional nocturnal desaturations? Are these causes detectable by neans other than PSG?

Flip side of the coin:

neversleeps wrote:Not all people with OSA experience desats.

I may already have my mind set (perhaps incorrectly) that desaturations cause the heart to increase rate and blood pressure in an effort to compensate for a decreased oxygen level. So, beyond not getting a restful night’s sleep, and absent desaturations, what other consequences suffer the patient with OSA?

dataq1 wrote:Absent any problems with one's heart (rhythm, rate, output) and absent pulmonary function issues (pneumonia, asthma, etc) what would be causing transitional nocturnal desaturations?

Yep, those are the reasons I can think of too. Hence the statement: not all people who experience desats have OSA.

dataq1 wrote:So, beyond not getting a restful night’s sleep, and absent desaturations, what other consequences suffer the patient with OSA?

Here's a list from Wolk R, Somers VK. Cardiovascular consequences of obstructive sleep apnea. Clin Chest Med. 2003;24:195-205.

Medical Consequences of Sleep Apnea

Cardiovascular consequences of OSA
hypertension (high blood pressure)
heart failure
atherosclerosis (heart attacks, angina)
atherosclerosis (stroke)
atrial fibrillation
ventricular arrhythmias
pulmonary hypertension

Other consequences of OSA:
trauma (traffic accidents)
glaucoma
snoring spouse syndrome
diminished libido
in children: illness like attention deficit hyperactivity disorder (ADHD)
in children: slowed growth

Other associations with OSA:
obesity
obesity syndromes, such as Prader-Willi syndrome
polycystic ovary disease
renal failure
hypothyroidism
Marfan syndrome
Charcot-Marie-Tooth disease
post-polio syndrome
gastro-esophageal reflux
worsening of epilepsy

The following is from http://pennhealth.com/sleep/newsletter/ ... heart.html

With sleep apnea, very high levels of the stress hormone epinephrine are released hundreds of times each night. This “fight or flight” hormone puts a tremendous strain on the heart, blood vessels and other organs and also disrupts sleep. This may be one mechanism by which sleep apnea can injure the heart and blood vessels.

The National Guidelines (JNC VII) used by physicians to treat high blood pressure list OSA as a major cause of refractory high blood pressure. Recently, more worrisome connections linking OSA to an increased risk of stroke and heart attack have been published. Even after eliminating other risk factors, those with OSA are much more likely to suffer either a stroke or heart attack making sleep apnea a potent risk factor that should be aggressively treated. Sleep apnea is also associated with a variety of other cardiovascular disorders including heart failure, atrial fibrillation and sudden cardiac death.

The following is from
http://www.medscape.com/viewarticle/508954

Naresh Punjabi, MD, PhD, of The Johns Hopkins University, Baltimore, Maryland, examined the growing literature linking OSA with the metabolic syndrome: the combination of abdominal obesity, hypertension, glucose intolerance, insulin resistance, and elevated triglycerides. The metabolic syndrome carries significant morbidity and mortality implications because it increases the risk for cardiovascular disease and type 2 diabetes mellitus.

I wish the consequences weren't so numerous and potentially deadly, but I guess we should feel fortunate to know what we're up against. Certainly gives one incentive to don the mask every night.

Thanks for the references, really appreciate it. Obviously I'd like to study the conditions to see if oxygen desaturations are coorelated.

As to incentive, Yes, the list is frightening enough to make me want to "don the mask" even if my diagnosis for OSA were inconclusive.

Thanks again, This forum is a real treasure of information!

jklewis54 wrote:

Goofproof wrote:Apnea, is for life in most cases. The most successful way to cure apnea is to die, that's 100% effective. Snoring is a symptom of apnea and other problems. Snoring inidcates a problem, sometimes apnea. The worst problem of apnea is not breathing, due to airway closure or other problems.

The best way to handle apnea is with successful treatment. Jim

There are many sites that explain that weight loss, reduction of allergies, not using sleep medications or relaxants, etc. and other actions can greatly reduce - or eliminate - apnea. I was only slightly overweight, and I only had problems when sleeping on my back. I was forced to sleep on my back during the test, thus indicating the worst case scenerio. There are also methods of forcing side-sleeping.

I mean no offense, but I am looking for comments from those who have successfully reduced their apnea, not nay-sayers.
Thanks.

My situation is very similar to yours. My reason for taking the sleep test was severe snoring. I was diagnosed with mild apneas in the lateral position and severe apneas in the supine position. I was prescribed a Bi-Pap (14/10) and a full face mask, because I was a mouth breather. I believe that mouth breathing was my primary problem.

Over the last four months, I have used this website and others to educate myself on what was happening. I just wish I had done everything in reverse order.

I tried 2 full face masks, before deciding that they were not for me. I tried a nasal mask and lost all benefit through mouth leaks. I ended up with a Breeze, which worked best for me if I taped my mouth. I read everything I could on tongue placement and made a DIY mouthpiece and finally ordered Dr. Sue’s nose breathe device.

By consciously practicing proper tongue placement during the day and before going to sleep, I was eventually able to use a loose fitting chin strap, in conjunction with the Breeze, and taping was not required. The Bi-Pap was lowered to 12/8, with an overall improvement in comfort and efficiency.

I have used the Bi-Pap faithfully for 4 months, but for the last 3 nights I haven’t used it at all. I sleep on my side and my mouth is closed. My wife tells me that my breathing is rhythmic and quiet, apparently uninterrupted, and I’m not snoring.

I won’t say that I’m cured, but I will say that I no longer have the original symptoms that prompted the sleep study to begin with.

I was diagnosed with moderate sleep apnea (29.6 AHI) a few months ago. My weight has remained at the very bottom of the weight chart for my height for years. Obviously, losing weight isn't going to improve my sleep apnea. I'm told that a big part of my problem is the anatomy of my throat but I have decided not to pursue any type of surgical treatment right now.

My general plan for handling my sleep apnea is to work with the simple (CPAP) before moving to the complex (surgery). Fortunately, I'm getting comfortable with the CPAP and don't mind the therapy at all. In fact, I think I'm sleeping better now than I have in my whole life (even as a child, my sister would punch me awake to tell me to stop snoring.) I am incredibly grateful that I was finally diagnosed and treated.

When first diagnosed it was very important to me to have the hope that with weight loss I will be cured, despite my doctor's pointing out that it is not that likely in my case. He had made the diagnosis based on the shape of my airways, didn't have otehr obvious symptoms, being tired when working till late doesn't count—it is normal.
As time has gone by, I have lost weight... I do notice ups and down on my APAP which may corelate to my weight.... but I also have tried not to let my mind dwell on this. I have to get down to a healthy weight to avoid the possibility of diabetes and other problems. If I am lucky my sleep apnea my improve, if not I will cope anyway. We all should try to get slim for overall health, some of us will either be cured or lessen the level of OSA. It seems much more common for people who lose weight to go from extreme OSA to fairly mild OSA than to be completely cured.
I work for a hospital and see lots of bariatric surgery patients who stop using CPAP after losing a lot of weight (60-70 lbs+) but not many have had themselves retested in a sleep lab to prove they really don't need the CPAP anymore.

I am hoping I may be able to answer this question for you soon.

I have a sleep study scheduled for end Fe & by then expect to have lost 40 lbs & be down to approx 186 lbs (lowest I will have been in 10+ years).

In 1989 I went for a sleep study & was told I did not have apnea. I was about 193 lbs then.

If this study in end Feb says I don't have OSA then technically losing weight will have changed my diagnosis.

DSM

Congrats on your weight loss Doug. I'm walk'in right behind 'ya but if you get cured of your OSA ... I'll be runn'in instead of walk'in

To be honest, I am not certain that the weight loss will do the trick but it will be interesting to see the report.

Also I have *no* illusions about how hard it will be over time, to keep the weight down.

I am not even sure I will give up my xPAP machine even if the sleep study says I am 'clear'.

Am thinking I may devise my own sleep study & keep monitoring the differences in AHI after a dinner party or after any weight changes etc:.

Sure have the gear to do it

DSM

Just to toss in another data point or two.....

I have a brother in law that "cured" his apnea by dropping a considerable amount of weight. He did NOT confirm it with a followup sleep study and I do sometimes wonder if he is just in denial.

I have a friend who was cured of apnea by a well done UPPP...Cured for about 10 years when the apnea came back with a vengeance. He now has his apnea under control with a dental device, which is lucky since he can't afford CPAP and sleep studies due "early retirement".

I was driven into a sleep study, by my wife, JUST for snorning. She figured a snip here and there and I would be all fixed up. Much to her dissappointment, my research figured otherwise. I am NOT overweight, and my apnea is structural NOT weight driven, but it does seem my weekend headaches and the start of irregular heartbeats were actually Apnea related.

I tried every trick on the forum to get along with APAP. Never did sleep well on APAP.

I did FINALLY go to an ENT, which I wish I had done much earlier. I got my severely obstructed sinues roto-rootered and keep them clear with twice a day saline flushes. I recommend this for anyone no matter how they treat their apnea. For me it got the APAP working, with reduced pressure.

Such great success from sinus surgery got me thinking about other surgery. But research and my ENT discouraged that approach. Luckily some thick hided people on this forum were willing to take the abuse of mentioning the dental device approach, which I investigated and am now as close I can get to "cured" in that all I need is a tiny portable dental device, and not lugging around a plug in APAP. I am hoping the dental device approach continues to work at least long enough until a TRUE CURE comes along, or some other better approach.....which is why I will continue to at least skim and lurk the apnea forums, searching for that actual CURE.

For some people weight loss or an MMA MIGHT cure them, but the odds are not good and the MMA requires more time than I could possibly take off work even if I wanted to do that.

SNORK,

Very interesting. I have wondered about nasal clearing but as a pre teen I went to hospital to have a deviated septum worked on (have had nasal difficulty most of my life), so am sort of feeling it may achieve little.

When nose is normal - no problems. Am thinking it would be awful to get my nose 'rotor rooted' only to find out it was caused by GERD related reactions.

Was this process painful ?

When you jog or exercise to you still breathe through your nose ?

Tks

DSM