Can ineffective xPAP be worse than no CPAP at all?

I'm just getting back into XPAP after a period of very bad compliance (bad me).

For the first few days I was feeling really good again, but then I had two bad nights in a row in which I woke with a significant headache and had lots of bad EDS.

I felt much, much worse than I ever did when I was being non-compliant.

When I woke up after the second night, my hand grabbed the hose right on top of a leak. No idea when the leak actually started of course.

By coincidence, my new CPAP and hose arrived that same day and this morning I feel good again (new CPAP set to the same settings as the old).

So, how likely do you think it is that I could feel worse with a leaky CPAP as opposed to no CPAP at all?

One possibility I can imagine is that I sleep more on my back with the leaky CPAP instead of no CPAP, but the leaky CPAP can't break through the OSAs which are much worse on my back than my side.

I think ineffective CPAP is worse--not because you're not getting good treatment (SOME treatment may be better than NO treatment), but because ineffective CPAP treatment for whatever reason (leaks, wrong settings, etc) will discourage people (like you) who are new or poorly compliant from using the machine at all. Such individuals make a blanket conclusion that CPAP "doesn't work" and therefore refuse to use it. CPAP therapy doesn't work with the machine sitting in the closet, garage, or basement.

That's the clear and present danger and it's why support and follow-up is so crucial. Unfortunately, most people don't get that, which accounts for the dismal "failure" rate of CPAP. It's not the CPAP that fails, it's the people who are supposed to provide quality support and follow-up to the new CPAP user.

What you say is undoubtedly true.

I was actually very, very compliant for a long time and it was good. But the non-compliance snuck in sometime after 6 years: just one night without that horrid mask, I don't really need to lug that machine and my laptop through airport security for just a one or two day trip, do I? For me it didn't seem too bad playing hooky from the hose once in a while (I think my fitness /muscle tone had improved enough to make a difference), but before I knew it, I had drifted into non-compliance land . It's a bad place.

I did just read somewhere in the wiki/sticky threads that sleep with the hose is the new normal. Has to be I agree. So support and follow-up are actually important to all CPAP users, not just the new ones.

However, I was more interested in the reason (if it can ever be known) or reasons that I felt so much worse on the two days when I perhaps had the leaky hose compared to at least most of the days when I wasn't using the CPAP at all.

My theory (and it's only a theory) is that feeling that bad without CPAP before crept upon you slowly ( like boiling a frog) but when you are used to feeling SO much better the contrast is sharp.

Since your machine is capable of collecting and recording detailed data, you may want to have a look at what is going on. Looking at the reports that you can generate from that data will let you set specific objectives (e.g., reduce the leaks to below x l/min) and let you see whether you are moving towards those objectives.

On the subject of leaks, I find that nasal pillows do a much better job getting the air where it needs to go. Have you given that type of mask a try?

JointPain wrote: One possibility I can imagine is that I sleep more on my back with the leaky CPAP instead of no CPAP, but the leaky CPAP can't break through the OSAs which are much worse on my back than my side.

You are absolutely right ineffective CPAP can be worse than no CPAP - especially since you seem to have positional sleep apnea, viewtopic/t40307/viewtopic.php?f=1&t=40 ... 94#p352594 , and you state you sleep more on your back with CPAP than without.

Do two things immediately - 1. Quit sleeping on your back, and 2. get the software for your machine so you can see breathing events and mask leak.

If you need tips on avoiding backsleeping just ask.

It seems to me that if xPAP therapy is so lame that it does little to prevent OSA, then it would be worse than nothing because all the disadvantages of the therapy would still be there. If you add the distractions of the mask, hose, leaks, noise, etc to largely untreated OSA, you'll sleep worse than you would off the hose. Of course the answer is not to stop therapy, but to fix it. Then the advantages will again outweigh the disadvantages.

roster wrote:Do two things immediately - 1. Quit sleeping on your back, and 2. get the software for your machine so you can see breathing events and mask leak.

If you need tips on avoiding backsleeping just ask.

Thanks.

I only just upgraded to my new S9 Autoset last night (it was good AHI = 1.9) and looked at the graphs (for brief details see viewtopic/t63568/First-night-with-new-S9-Autoset.html). So much better information about what's going on compared to my old dataless machine .

I thought perhaps those two nights might have been caused by the lack of pressure from the hose leak, because it hasn't been anywhere near as bad as that before (I was very compliant for a long time, just not recently). I can lie there awake on my back without issues as long as the CPAP is on, but have issues otherwise.

I will try avoiding the back if my numbers do show something.

TooGroggy wrote:Since your machine is capable of collecting and recording detailed data, you may want to have a look at what is going on. Looking at the reports that you can generate from that data will let you set specific objectives (e.g., reduce the leaks to below x l/min) and let you see whether you are moving towards those objectives.

On the subject of leaks, I find that nasal pillows do a much better job getting the air where it needs to go. Have you given that type of mask a try?

Thanks. I was actually pleasantly surprised by my first night's leakage data. I had one major leak event, but the rest of the night was good and well below the machine's limit.

I also got a set of nasal pillows to try, but I wanted to collect about a week of baseline data using my old set up first (sans the broken hose of course).