borderline apnea?

I have been OSA free for 7 months. Seven months without using my CPAP machine. That was made possible by losing 70 lbs (I ate sparingly and worked out everyday). I feel great and I lost mass from my airway (more open now) along with the rest of my body so no OSA I thought. But lately I have been waking with feelings of unease like I wasn't getting enough air. Though nothing like the times I woke with heart pounding, gasping for breath when I was heavy and pre-CPAP. Still I am not sleeping like I think I should and I wonder if I have borderline apnea (the real kind not OSA). I had a colonoscopy last week and in the recovery room I was on an O2 monitor which kept going off saying I was under 90%. That got me to thinking I might have real apnea in which you just stop breathing for long periods without the airway being blocked. Anyway, last night I did not sleep well, I kept waking up every hour or so and felt groggy. I had a stressful evening which I thought was the cause but in the early hours I decided to get on the CPAP machine..... and I slept for 5 hours! Oh no, am I a borderline apneaic (my word for it)? I have not yet looked at the data recorder on the CPAP. I feel a bit like the girl who has missed her period and is afraid to take a pregnancy test for fear of confirming what she doesn't want to see. If I am having apnea episodes now, at this really good physical condition and weight, then I may have to go back on the CPAP permanently.

-LM

Lineman wrote:... I wonder if I have borderline apnea (the real kind not OSA).

It's all "real" apnea, whether it's obstructive, central or complex. Further, if you had a diagnosis of (and successful treatment for) OSA prior to your weight loss, it's highly unlikely you'd suddenly develop central apnea. Now if you were continuing to use your CPAP machine at too high a pressure, that might trigger central apneas that should resolve upon lowering pressure to an optimal level.

It's rare that weight loss completely cures OSA. Even significant weight loss generally results in the ability to lower your pressure. It's more likely you still need that CPAP machine and should either retitrate yourself using an APAP or preferably see your doctor for a sleep study referral.

It's rare that weight loss completely cures OSA. Even significant weight loss generally results in the ability to lower your pressure. It's more likely you still need that CPAP machine and should either retitrate yourself using an APAP or preferably see your doctor for a sleep study referral.

Oh, then a weight loss "cure" for OSA isn't likely? I am sorry to hear that. I have been thinking I was very lucky to be able to sleep without the CPAP but perhaps that was just wishful thinking. The machine I am using is an APAP but the settings (min/max) are the same as when I was using it previously (10/15). I can do some more nights on the APAP with lower settings and see what the results are ... but I really don't like the idea of having to use this thing again. Some nights I seem to sleep just fine so maybe I can restrict use to those nights when I am more sleepless than other nights.

thanks,

-LM

If you want to be sure about your condition, you might want to test yourself with a recording Oximeter.

The bottom line question is, "What are your O2 levels at night?"

Unless you test....preferably multiple nights....with an Oximeter that'll give you a printout of what happened while you were asleep, you're only guessing as to your real condition.

I can recommend the following tool......I've used one for over a year....and I'm very happy I purchased it.

http://www.turnermedical.com/SPO_PulseO ... imeter.htm

The software that comes with it is excellent.

Gerald

Gerald wrote:
I can recommend the following tool......I've used one for over a year....and I'm very happy I purchased it.

http://www.turnermedical.com/SPO_PulseO ... imeter.htm

The software that comes with it is excellent.

Gerald

Great! thanks for the tip. I will look into that oximeter.

-LM

Don't let dread cause you to delay doing what is best for your health. You've done a commendable job on losing weight and and getting healthier. If weight caused your OSA, losing weight could resolve it. Problem is, many of us have structural causes for our apnea, and weight just exacerbated it enough to make the symptoms more apparent.

Just take this a step at a time. Check your data at the current settings for a few nights. If you're not having events, you could lower the bottom pressure a little for a few days and check the data again. I'm not sure what pressure with a mask is considered the equivalent of regular breathing (don't go too low). You may want to consider trying a dental device for sleeping, but do make sure it really is effective and not assume. Also, you could experiment with a few nights of forced side sleeping and check your numbers vs back sleeping. Elevating the head of the bed a few inches also might help. If you need to use the machine, using the lowest effective pressure can lessen irritations like mask leaks and air in the belly. But kinda get a better idea what you're up against, then deal with it.

Then again, you could get another sleep study. It wouldn't tell you if a dental device would work, just give you a better idea what your odds are based on the severity of your apnea. But using a machine only if you have trouble is not a reliable plan, as most sleep thru most of their apneas. Based on what you've said, you know you have to act on this. Do what you've gotta do.

Lineman wrote:Oh, then a weight loss "cure" for OSA isn't likely?...

Not according to my sleep doc. I started at a pressure of 11, lost 53#s including like you much excess airway tissue, and doc had me re-set my CPAP to 9. This doc and cardio think that when I get the rest of wt off (got a lot more to lose), that my OSA will disappear. Your story is encouraging. I am not 100% convinced they are right but hope so! Time will tell. If nothing else, I'll settle for even less pressure.

if I were in your situation, I'd repeat what my sleep doc had me do this past July 4th (he loaned me an APAP), namely, set the APAP wide open (4-20) for 5 nights. And, boy, was 4 really tough...I hadda get really, really relaxed and practice slow calm breathing before I masked up. But that experience did show that I only went to 10.2 one time. I also had a recording oximeter to check desats; if I had one of those nifty things, I'd use it too when home titrating.

Best of luck with this. Since you had desats last week, it makes me wonder if you might still have some lingering breathing issues that are causing these episodes? If it were me, I'd investigate.

Hi. congrats on the weight loss and excercize program. I will head that way myself soon. (when there is energy). My question is this: I had a 2nd study that was inconclusive due to not being able to use the nasal mask due to congestion and then the mouth nasal replacement didn't seem to fit and per the tech "everytime he increased the pressure (to 15 tops) he said I woke up. so the doctor is not ordering a 3rd study and has ordered a smart card set at 7, Resperonics 510 series, Zest mask with a chin strap. This does not allow any flexibility, so i called the DME and they suggested getting an auto mode card with a range of 4-20. and they will titrate me via their office in my own home.......... does this sound good to you? My apneas happen in the 2nd half of the night. 2-3 am. during that REM sleep. they recorded 26 per, with an average of 19... something about this doesn't feel kosher to me. and, on top of this, i have post nasal drip and really couldn't continue on the nasal mask very long in the 2nd sleep study, so this sounds really strange to me. your input appreciated. thanks.