Does Relieving Sleep Apnea Achieve Anything Useful?

mikemoran wrote:Have to admit, like jim I am extremely disappointed in CPAP. I mean it hasn't waxed my car, done the grocery shopping, cured baldness, enlarged anything, given me the winning lottery numbers, returned me to my 20s or any of the other grand claims. Don't even try to get me started on that world peace thing it offered.

. . . Yep it just isn't worth it. Gonna take up smoking again atleast it will deliver the cancer it promises in addition to making me look cool.

Sarcasm and ridicule don't address issues. They're ways to avoiding uncertainty and critical thinking.

Okay not to be contradictory but that's where I said you have to also take into account the validity of the study and such. (Not saying that this study is invalid in any way).

But there seems to be a lot of studies that say OSA does cause some nightime events in BP, and heart rate. What doesn't seem to be clear in these studies is how that directly relates to heart attacks and serious health issues etc. I mean exercise also raises your BP and heart rate and in some cases causes a heart attack. So a study could be created that showed that exercise is unhealthy. (Yeah, I know. I'm using hyperbole)


If you look at the last line of the above referenced study it says

"The level of SDB that requires treatment in order to prevent cardiovascular consequences is an important clinical question that is, as yet, unanswered."

So even the experts are saying "we don't know exactly what level requires treatment".

Which is what makes me a little hesitant to buy into CPAP making things "better". I wish I had the same experience as others did with a real solid and verifiable change in symptoms but I didn't. Maybe I haven't been on it long enough but I still think 4+ months of 100% compliance should be enough to either a drop in BP or something.

Having said all that, yeah I still believe in the therapy and will keep at it. Maybe if it did was my car?

Happy Weekend everybody. I'll stop dissin on my fellow hoser's parade now.

My intent was to make a point humorously. I face this question every night I put on my mask but my expectations are evidently more in line with the possible. If something is doing me some good I don't give it up because it isn't giving me all the potential bells and whistles everyone else is experiencing. But that is my choice.

I do want to mention that like your wife my wife says she missed my snoring when I was on travel. However, she has not complained aobut my not snoring with CPAP. Additionally, the anxiety she experienced listening to me not breath at night is also gone.

I hope you don't give up and wish you well in your struggles.

ehusen, I see your point. It's interesting what stands out in the article to each reader. The part that gets to me is:

Cerebral autoregulation is insufficient to protect the brain from these hemodynamic changes and cerebral perfusion pressure declines, particularly early in apnea when increased intrathoracic pressure is associated with a fall in systemic blood pressure and a rise in central venous pressure with a concomitant increase in intracerebral pressure. Continuous positive airway pressure (CPAP) therapy of SDB has been shown to improve many of these transient hemodynamic changes.

I agree, I still believe in the therapy and will keep at it. Now if only we could get it to wax our cars, return us to our 20's and take care of that world peace thing...

mikemoran, you crack me up, as usual! Good one!!!

i_am_jim wrote:So, are the effects shown in the chart a result of obesity or sleep apnea?

The answer is YES. Sleep apnea can cause or trigger obesity. And obesity can cause sleep apnea.

You are looking for a simple "A causes B" relationship, but what has been learned, mostly in the past few years, is that sleep apnea has a nasty relationship with obesity that is best described as a feedback loop. Plus, both obesity and apnea spin off even more problems.

The human body seems to be a carefully balanced system with checks and feedbacks designed to keep us alive an healthy. The problem is that sometimes these go wrong and then our health can spiral out of control. It is important to get to the root of problems and correct them there if possible, instead of just treating the symptoms.

Sleep apnea may not be at the root of all these problems in every case, but it is certainly a major contributing factor in many cases.

Okay, this is a little tongue in cheek as well....mixed with some reality...

For all you guys who say their wives tell them they miss their snoring when they travel, etc.......my hubby doesn't snore, but I've always told him I miss him when he travels. And the truth? NOOOOOO, I didn't miss him at ALL. I lived the first 10 years of my adult life alone and I LOVE a few days alone here and there. I look FORWARD to him traveling (which is just a few short trips a year in our case).

But that's not what I tell HIM....better for the marriage to tell him I miss him constantly, lol, lol....we gals aren't STUPID, you know!

Oh and by the way, he's never told ME he missed my snoring, lol!

Jan in Colo.

Jan in Colo. wrote:if you choose to dwell on it, CPAP is a pain in the rear.

Jan, I'd suggest that if CPAP is a pain in the rear, that you've got your mask strapped to the wrong body part! .

All right, smartypants! Geez....

Jan in Colo.

I’ve been using my latest CPAP setup for about a month. In recent years I become sleepy during the day. If I try to read or watch TV I go to sleep. I had hoped this was a side effect of the apnea. I started having PAC arrhythmias a few years ago which I though might be relieved if I stopped the apneas. Apparently not, because there has been no change in either of these conditions.

[SNIP]

Sarcasm and ridicule don't address issues. They're ways to avoiding uncertainty and critical thinking.

In reading your first posting on this thread and then the last one, I couldn’t help but hear some of the same arguments I experienced, but in my case your 50-years makes my 15-year struggle seem like a cake walk.

I arrived at xPAP only after I had spent a lot of mental energy on researching and testing the logic of what I read and heard. I went through that process because I needed to stop face-planting my keyboard if I didn’t take a nap break several times during the day.

When I decided to consider that sleep problems were affecting my performance about 8-years ago, I came away from my first sleep study jaundiced at the poor performance of the sleep center. After that test experience I said to myself, I’ll just sleep on my side and that will solve it. Unfortunately, I didn’t have the data to validate that side sleeping was a solution and didn’t even look at that issue. Instead, my mind locked down because I didn’t want to consider having the noise a CPAP machine created and I didn’t want a mask blowing my eyes open. Both left me worse than when I didn’t have any CPAP pressure.

In the early stages of those last 8-years I believed my solution was working, but I didn’t notice what was happening to me and I wasn’t collecting objective data. Instead, it was getting more difficult to wake up and function, and in some cases I would leave the bedroom without the horsepower to get past the couch. All too often I would find myself taking a nap after waking and before working. I also didn’t see the trend of increasing naps needed to survive a workday.

In my work creativity is critical to being successful, but without rest I kept finding myself getting more forgetful and less creative. I also noticed my ability to suffer fools was on serious decline. Not too long ago that lack of patience started to show in my overall disposition. Being cranky was beginning to affect my relationships. I noticed how much I was changing when I chomped on someone for something simple. Going out my always in control norm surprised me and got me looking at my sleep problem solution with different eyes.

For me, problems sometime surface as opportunities, but most often as unwelcome distractions. Critical to problem solving is problem definition and solution selection. Once a solution is selected the next important step is a definition of goals and that are tested against known and critically reviewed trials. If the goals are in line with the solution, then realistic timelines are needed to provide guidelines that the process is in control and working towards resolution.

In your original posting above, there isn’t any explanation that your goals of performance are realistic or even possible. For me they aren’t important to this discussion, but to you they should be one of the more critical questions you should be asking. For example, there are articles by a doctor in Australia that indicate that blood pressure in titrated patients will drop over an extended sleep study. I don’t remember there being any causal information to indicate all patients with Hypertension will experience a drop in BP. Because there wasn’t, I took the information that xPAP won’t make Hypertension worse, but probably won’t make it much better.

There are also studies that show how low oxygen desaturation levels cause the heart to pump harder and that over time enlargement and other heart damage usually results. However, I don’t believe that in any of those studies did they state that heart damage is repaired by xPAP titration.

My point in all this is to say a couple of things. First, some of us have the same concerns but some of us have decided that quality of life each time we wake each day must be better for us to continue. My second point asks if your expectations are realistic and in line with what has been proven. Having heart repair on your list of expectations might be a bit over the top, but I’m only guessing. Are you?

If I were you, I would begin asking what is the minimum expectation I should expect from this to put up with the aggravation of living with a hose. If your relationship with your wife is important and you care about how she feels, give that some weight. From what you’ve written so far she would be basket case if you went belly up next to her, and with your heart issue, that likelihood is higher now than it was years ago. Especially in your case with what you’ve said about your heart.

For me, relationships are one of the most critical component in my quality of life calculation. I really want to be here to aggravate my wife , guide my children and be a grandfather to some future grandkids if that happens. My kids look up to me and see me as a mentor. My bride thinks of me as her best friend. How does your wife see you, and how do you see her. More importantly, what can you do to make this work so she can feel secure a little longer. Giving up is a option, but it may take more courage to not to let go right now.

Thanks for your reply.

Roger... wrote:

In recent years I become sleepy during the day. If I try to read or watch TV I go to sleep. I had hoped this was a side effect of the apnea. I started having PAC arrhythmias a few years ago which I though might be relieved if I stopped the apneas.

In your original posting above, there isn’t any explanation that your goals of performance are realistic or even possible. . . . they should be one of the more critical questions you should be asking. . . . My second point asks if your expectations are realistic and in line with what has been proven. Having heart repair on your list of expectations might be a bit over the top, but I’m only guessing. Are you?. . . . Especially in your case with what you’ve said about your heart.

You quoted my only two "expectations." Really, they are better characterized as hopes than expectations.

At the top of my list was relieving the daytime sleepiness. Your comments suggest you saw me as trying to relieve a serious heart problem. I must have explained this poorly. I was hoping it might relieve the occasional episodes of PACs (Premature Ventricular Contractions) I experience. A cardiologist indicated these are not life threatening. But, they are very annoying and anxiety producing. I don't think these were unrealistic (over the top, as you say) expectations as Sleep Apnea articles repeatedly mention daytime sleepiness and cardiac arrhythmias as typical side effects of this malady, and the many claims of this type were my reason for hoping they would be relieved.

Anonymous wrote:I don't think these were unrealistic (over the top, as you say) expectations as Sleep Apnea articles repeatedly mention daytime sleepiness and cardiac arrhythmias as typical side effects of this malady, and the many claims of this type were my reason for hoping they would be relieved.

And they still might be relieved given more time with CPAP therapy. Determining it isn't working after only 1 month may be a bit premature.

Hello Jim,

I may have misread your posting so I’ll own that issue.

Your response about daytime sleepiness reminds me of what my MD said about sleep debt. “Don’t expect to get this debt paid off anytime soon. You’ve ignored it for 15-years and it will take your body a while to believe you are really serious about sleep deficit reduction.” I took this to mean that while I may find some things get better sooner than others, the sleep debt might not go away as soon as I would like, or need.

He also mentioned one of the goals of my titration was to get me into sleep stage 3 & 4. My latest sleep test shows I have almost no time in sleep stage 3 and no time at all in sleep stage 4. It also showed I only got 5-minutes in REM sleep after being in bed for over 7 hours. My sleep efficiency came in at 60.3%

Without getting into sleep stage 3 or 4, the likelihood I’ll pay off more than the interest on my sleep debt is rather low. It seems only stage 3 & 4 contribute to the principle balance so unless I get some of that time, I shouldn’t expect much.

In another posting on this forum about "Fraction of Night in Variable Breathing" there is an indication that variable breathing doesn’t happen in sleep stage 3 or sleep stage 4. To me this means I need to keep an eye on this value to see if I’m getting any sleep debt reduction if I want my naps to go away. In my case my machine reports I spent ~43% of my sleep time in variable sleep last night. Not a good number when I’ve got such a large bill to retire. My current average for the week is 29.3% for the last 6-days. In some of the same post, my average is good, but 6-days isn’t statistically significant so I’m just taking it to mean nothing right now, and hope I don’t have many nights at or above 43%.

It would be interesting to hear if you are watching your titration data to monitor your treatment. In my case it was critical for me to know what is happening so I could take some of the black magic and guessing out of what we are doing. Without it there is no way I could justify the aggravation of happily dealing with my mask all night long.

I got onto this thread a bit late, but I wanted to respond to the first posting. Does it objectively help. Of course it does. If you are someone like myself who during his sleep study had an AHI of 51 and is now down to under 3 there is objective evidence of a change. And I feel subjectively better as I get used to the therapy. If your AHI has gone down and you still feel lousy then it is possibly due to other factors or you need to persist a while longer.

With all due respect, I get the feeling you are seeking to be provocative and enjoy so being. If you are not experiencing improvements that is one thing. But why assume that nobody else is or that we have al self-suggested ourselves into so feeling?