Weight Loss and Pressure Adjustment

echo wrote:

redd5000 wrote:My CPAP was set at a pressure of 10. In the last 4-5 months I have lost 40 lbs. I started having trouble with air being forced out of my mouth while I slept (really bad dry mouth) and wondered if my weight loss was causing me not to need as high a pressure. I have gradually reduced the pressure down to 7, but not sure if I am doing the right thing or not. I usually judge how well I sleep by where my blood pressure is in the morning and it is higher than I would like, as if instead of resting I am not getting enough oxygen. My blood pressure is always low at bedtime. Sleeping is going to kill me! LOL. Has anyone experienced this type of thing after weight loss?

Yup, I went from a pressure of 10.5 to 7.5 after losing 25+ pounds. I was getting wicked chipmunk cheeks, which is what prompted me to see if a lower pressure was better. If you do lower the pressure, then be sure to check your data to confirm that you're not having any apnea events (or get a sleep study at your new pressure) - I don't know how reliable measuring BP is.

I don't expect further weight loss to eliminate the need for cpap, but a lower pressure sure is nice - my FFM fits better now.

Moving to a new city where the nearest grocery store is a mile away (and about 150' of vertical transition – steep hilly) sped up my weight loss and probably redistributed some weight as well needing more muscle to pull the hills. As well, at the end of summer as we moved into fall my vitamin D levels likely dropped.

So I dropped 5” in belt size which likely took much weight off the belly and so made it easier to breath (raised the ventilatory system gain). My CPAP data and morning feel both told me that I likely needed to lower pressure. I did find that placing weight on my belly (I sleep most of the time on my back) did help with breathing stability. I also found that spending time with the machine during the day helped as well.

But it was becoming clear that I needed to be using reduced pressure and I could not connect with a new doctor in my new city. So over about sixty or so days I dropped my level starting at 15 cm/H2O – by one cm/H2O each 7 to ten days – down to 7 cm/H2O where three days of CPAP flow data gave me enough “obstruction looking” flow data information to decide to raise my pressure back up to 8 cm/H2O.

I think that it is necessary to look at your CPAP data several times a week and drill down to the details when there are events. So you pick up the problems and can respond to them before they bring about the stroke or heart attack or affect your daytime performance such that you drive off the road or snap at your boss and get fired!

I think that shedding weight quickly makes for too many changes in the body which are likely to make CPAP use problematic.

Todzo wrote:I think that shedding weight quickly makes for too many changes in the body which are likely to make CPAP use problematic.

I think shedding (& potentially gaining) weight *at all* makes CPAP difficult. I've had to forego my Activa nasal mask for my FFM (that previously never fit well at the higher weight & pressure). I spent many nights with poor sleep trying to adjust my setup.