Well I went for follow up on sleep study

Jason S. wrote:By and large most CPAP users receive successful therapy as initially prescribed by their doctors. You wouldn't know that basing your opinion solely by reading this board, but that is a fact. They just don't come on a message board and obsess over this and obsess over that. The take their treatment nightly and go about their lives.

I'm sure there are many people who successfully use normal, non-data, what the doctor prescribed CPAP on a daily basis. But there are many who give up on CPAP also, who haven't even seen this forum.

I know two other people besides myself that have tried CPAP to treat sleep apnea. One gave up on treatment a long time ago. The other gave up for several months because he was unknowingly ripping the mask off at night. He is finally starting to have some success thanks to the advise I gave him that I got from this board. The fact of the matter is sleep studies are expensive. If something goes wrong then can you really afford to go back for another sleep study? I know I can't. Two was expensive enough even after insurance.

On that note, something did go wrong in the process for me. The pressure I was prescribed wasn't near enough to prevent apneas for me. I could tell without a second breath that the 8cm that was prescribed for me was too low. Much of the time I can't even breathe through my nose at that pressure. Plus, the doctors got it horribly wrong the first time so why would I pay them another HUGE sum of money (even if I could afford it) to get it wrong a second time? Well fortunately I had done research at this forum already when I got my machine (an Auto thanks to the advise of this forum) and knew just how to fix it. Now, even though I was titrated originally at 8, my nightly 90% pressure usually ranges between 11 and 13.

So out of the only 3 cases (including myself) that I am personally familiar with, all three cases had a major issue that either stopped treatment or would have stopped if it wasn't for this forum.

If the insurance code is the same regardless of the machine .. and insurance will not replace a machine for 5 years .. I want to be dang sure the pressure is correct for me for that full 5 years. It just might be that I am the type of person who has to quantify how I feel? And, in another thread it was discussed the compliance rate for a basic machine or an auto .. it was pretty telling as well.

But seriously, people have to do what works best for them ..
I have settled in to my "new way" of sleeping and "new found" energy .. and hope others "get there" too.
AuntieNae

Jason S. wrote:I am happy your machine readings have helped you with your therapy. My point is that a data capable machine is not imperative to achieving good results, as others have proferred.

I never got that impression from anybody on this board. Ever.

The rest of your post is certainly correct. 99% of CPAP users probably never see the first bit of data. Good for them. I love seeing the data and it's actually making the whole CPAP experience a kick in the ass for me, regardless of the health implications. That's right; I said it! I'M HAVING FUN!!!!

Jason S. wrote:By and large most CPAP users receive successful therapy as initially prescribed by their doctors.

Ah. That, then, is why something like 50% of people who are prescribed CPAPs fail to use them -- their therapy is so successful exactly as prescribed.

You wouldn't know that basing your opinion solely by reading this board, but that is a fact. They just don't come on a message board and obsess over this and obsess over that. The take their treatment nightly and go about their lives.

I'm well aware of that. I've been involved in on-line communities since 1992. I work with special diets on another couple of boards. The people who need help come, stay until their issues are resolved, and then go on about their lives. To read the boards, you'd think it was an on-going series of crises. But it's actually an on-going series of successes. Most people do go on about their business. Some experienced folk are kind enough to stay to help the newcomers -- and sometimes, a newcomer becomes an educator on their own, paying forward, as it were.

Having said that, I want to say that most people on this board are extremely helpful, friendly, and open-minded about how CPAP can work, and are not force-feeding what has worked for them onto others under the guise of experience.

Everyone is different. What works for one person may not work for another. But with multiple people providing their solutions, a person can choose from among them which ones to try. That's the benefit of Community.

Kiralynx wrote:

Jason S. wrote:By and large most CPAP users receive successful therapy as initially prescribed by their doctors.

Ah. That, then, is why something like 50% of people who are prescribed CPAPs fail to use them -- their therapy is so successful exactly as prescribed.

Good point, Kira.

Jason, I'd agree if you'd said, "by and large most CPAP users are prescribed an effective therapy pressure by their doctor." But, to say that most CPAP users actually receive successful therapy -- gotta look at how many are using the machines/masks every time they sleep. I don't think by and large most CPAP users are receiving successful therapy out there in the world. Not every time they sleep, all night long.

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http://www.highbeam.com/doc/1G1-151606094.html

Sleep study demonstrates poor CPAP compliance.(Continuous positive airway pressure)(Brief article)

Article from:
Family Practice News
Article date:
August 15, 2006
Author:
Worcester, Sharon
More results for:
cpap dropout rate | Copyright informationCOPYRIGHT 2006 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group.

Salt Lake City -- Continuous positive airway pressure adherence rates are suboptimal, findings from a study of sleep clinic patients suggest.

Of 528 adults diagnosed with obstructive sleep apnea and followed for a mean of 5 months, 63% had relatively poor adherence (use of less than 4 hours per night), 21% had adequate adherence (use of 4-6 hours per night), and only 16% had optimal adherence (use of more than 6 hours per night). Mean adherence was 3.1 hours per night, Carl Stepnowsky Jr., Ph.D., reported at the annual meeting of the Associated Professional Sleep Societies.

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I wouldn't call 4 - 6 hours a night "adequate adherence" -- not if the people are turning the machine off and going back to sleep for 2, 3, 4 more hours without CPAP each night. Four hours is generally considered "adequate" to justify insurance continuing to pay for the machine, but that's not "adequate treatment", imho. Nor is six hours of use in an eight hour night...imho. What they call "adequate" is two to four hours of suffocation time each night.

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http://www.highbeam.com/doc/1G1-171952627.html

CPAP success undermined by poor adherence.(Pulmonary Medicine)(continuous positive airway pressure )(Brief article)

Article from:
Internal Medicine News
Article date:
November 15, 2006
Author:
Johnson, Kate
More results for:
cpap dropout rate | Copyright informationCOPYRIGHT 2006 International Medical News Group. This material is published under license from the publisher through the Gale Group, Farmington Hills, Michigan. All inquiries regarding rights should be directed to the Gale Group.

MONTREAL -- Only 65% of sleep apnea patients agree to begin continuous positive airway pressure, and there is a 5% annual dropout rate, according to an 8-year follow-up study.

"Only one-third of those who accepted were still using the therapy at the end of our study," Dr. Per-Olle Haraldsson reported at the 8th World Congress on Sleep Apnea. And among the patients still using continuous positive airway pressure (CPAP), only 40% were fully compliant--meaning they used it for 90% of their time asleep.

The study included 221 patients for whom CPAP therapy was recommended. A total of 144 initiated the therapy and 59 of these discontinued at some point during the study, ...

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http://www.une.edu.au/news/archives/000341.html

As many as half of all patients who have been prescribed CPAP stop using the machine within the first year, despite the health benefits of the treatment.

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http://www.ncbi.nlm.nih.gov/pubmed/14592213

Determinants of nasal CPAP compliance.
Stepnowsky CJ Jr, Marler MR, Ancoli-Israel S.

Department of Psychiatry (0804), University of California, San Diego and Veterans Affairs San Diego Healthcare System, 9500 Gilman Drive, San Diego, CA 92093-0804, USA. cstepnowsky@ucsd.edu

BACKGROUND: Obstructive sleep apnea is a prevalent condition with potentially serious medical and psychosocial consequences. Nasal continuous positive airway pressure (CPAP) is the treatment-of-choice and has been shown to reduce the frequency of nocturnal respiratory events, improve sleep architecture and decrease daytime sleepiness. Patient compliance with CPAP is disappointingly low.

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[URL=http://74.125.95.132/search?q=cache:Jdi ... cd=3&gl=us
Excerpt from an HTML version of a Power Point presentation[/URL]

CPAP ADHERENCE - Is it too much “pressure”?
Shanon Takaoka,M.D.
February 7, 2007

A review of the past 50 years of adherence to medical treatments concluded that the poorest adherence was associated with the treatment of sleep disorders. The majority of these studies involved treatment with CPAP. Using liberal definitions of adherence, 65% of patients were adherent with CPAP therapy compared to an overall average of 75% for all medical disorders.
DiMatteo, M. R. (2004). Variation in patients' adherence to medical recommendations: A quantitative review of 50 years of research. Medical Care, 42(3), 200-209.
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Notice...."Using liberal definitions of adherence" ... which probably means 4 hours a night, five nights a week is considered "adherence."

Rested Gal,

I agree the dropout rate is high and if one considers those dropouts in the numbers then yes, I suppose most patients aren't successfully treated. I was referring to the effectiveness of the treatment of data versus non-data machines by those who chose to use CPAP regularly.

I wish they had taken the data further. I want to know WHY nearly 50% stop using CPAP. No doubt it is a combination of:

1. side effects
2. mask discomfort/claustrophobia
3. actual/perceived lack of positive results

But how do the numbers break down for 1,2,3?