How does CPAP work? Doesn't make sense

Another way to think of it. (Another imperfect analogy). The same force (air pressure) that can be used in air bags to lift a vehicle in an emergency situation is MORE than capable of keeping our airway open. We become (for all intents and purposes) the airbag that's being inflated and it helps keep our airway open. That air pressure presses equally against the airway in all directions, splinting it open.

Air Bag Car Lift Demonstration:
https://www.youtube.com/watch?v=RrURv87csSE

I think the spring is a good analogy. We see a lot of commercials selling gadgets designed to help the tongue stay out of the way, but that is only one cause of sleep apnea. For some people, the tongue isn't an issue at all.

For me, I already have a narrow airway which gets even more narrow with allergies, and congestion, which often leads to asthma. On rare occasions, I have felt my airway collapse while awake. Also, some of my worst snoring is while I am sitting upright, falling asleep as I watch tv. So, I know that for me, it is not just about the position of my throat and tongue.

I have the physiology built for sleep apnea. Small mouth, small chin, small airway. It doesn't take much of a collapse to close off my airway.

My cpap machine has been wonderful for me. Yes, still a challenge too. I skipped it the night before last, and I paid dearly. Nasty headache. And a dream where I was at a medical clinic and the doctor gave me a cpap machine to use. Clearly, my brain, while trying to sleep, was aware of what was wrong and was trying to fix the problem.

For years, I assumed my sleep apnea wasn't that bad, and that a cpap machine wouldn't help me. I wasted a lot of years avoiding the diagnosis and treatment that I needed. I wish I had gotten serious about this years ago. I understand what it is like to doubt treatment will help, and to look for reasons not to use it. But give it a try. Let it help you.

Spring? No.

But while analogies are being thrown around, try this.

Take a half roll of unrolled toilet tissue. Throw it in the porcelain. When you fall asleep, flush.

Now for the CPAP.

Use a plunger. Have the maid gently push on the plunger all night long.

rkuntz123 wrote:49er,
My apologies about suggesting the possiblity of Trolling. But Mr RPM who after leading with the term "tidal volume' which is a pretty exact physiological concept seems to be playing dumb to multiple well reasoned explanations of the mechanical concepts involved.

Perhaps it is my bad, but IMO it's time Mr RPM decides if he's going to follow his Doc's advice or not and stop using the I Don't Understand whine.

If he does start he may discover that a BIG problem with PAP therapy is the sometimes user unfriendliness of the hardware and you guys here on CPAPTALK dot com are absolutely great at helping people like he and I get started. So, 49er a big Thank YOU to you and all the other wonderful caring folks that frequent this locale.

As has been stated before, it doesn't take a genius to Google "breath volume" or a few other terms to get some relevant terminology. Good name too, since our breathing mimics the ebb & flow of the tide.

Also, asking questions of people that should know, and stumping them, should not be grounds for them to simply say use or lose it. These things are tested by people that know, etc, etc. I make things for a living, & part of what I do, is make things people will buy, whether they work or not is not up to me. I do make things that will work, and work well for years, I also make things that will likely never work, rather are just to get someones money & make them feel as though they got a good deal. You'd think that this does not happen with medical devices, I would hope not, but I'd bet it does. It does with our food, guarantee there is someone at McD's that has a job just to see what they can come up with to sell, for minimum cost. I would guarantee these machines have shortcuts built in, to cut costs, some maybe more cost cutting than others. We have already discovered that some machines have a check valve, & some do not.

I have stated that the machine keeps me awake, I'm trying to figure out exactly how this setup works, in an effort to figure out the problem. I was thinking that this machine is supposed to make me sleep better, so far, it keeps me awake, I cannot understand how my sleep is going to improve, if I'm not sleeping. So, using the machine would require sleeping, would it not? I would love to put mask on, not wakeup until I'm fully rested, but that's simply not happening. The doctor said to sleep with the mask on, I tried, but I can't sleep with it on. I can get at least some sleep without it. I have a dr's appt in the morning, we'll see what she says.

I have seen way too many quack doctors in my day, I have a cousin right now, almost dead from misdiagnosed testicular cancer. They initially told him it was an infection, prescribed antibiotics, now it's chemo.

I think it probably makes more sense for us to focus on helping you with your real problem which is that you can't get to sleep with your CPAP machine rather than on trying to explain how the therapy actually works. It appears that we are unable to explain it to your satisfaction anyway and I suspect that isn't where the solution lies in any case. You could have the best understanding of the therapy in the world and still be unable to sleep with it. It is very common for new users to struggle getting to sleep with the mask on and lots of support is available here to help you get adjusted. You are certainly correct that the machine cannot work unless you are asleep so that has to be job one. I never had any trouble adjusting to my therapy so I can't make any suggestions from my own personal experience. Others here will though I am sure.

As for your doctor, I won't be surprised to hear that he isn't much help but you may be lucky and have one who is. I wouldn't accuse the average sleep doctor of quackery because the treatments they prescribe are sound but, that said, the ones I've seen really didn't seem to do very much other than write out a prescription. Then it's over to the young ladies at the DME you choose who, in my experience, aren't much better.

Good luck to you and let's see if we can get you on track.

SleepyBobR wrote:I think it probably makes more sense for us to focus on helping you with your real problem which is that you can't get to sleep with your CPAP machine rather than on trying to explain how the therapy actually works. It appears that we are unable to explain it to your satisfaction anyway and I suspect that isn't where the solution lies in any case. You could have the best understanding of the therapy in the world and still be unable to sleep with it. It is very common for new users to struggle getting to sleep with the mask on and lots of support is available here to help you get adjusted. You are certainly correct that the machine cannot work unless you are asleep so that has to be job one.

+100 to everything SleepyBobR says there.

I never had any trouble adjusting to my therapy so I can't make any suggestions from my own personal experience. Others here will though I am sure.

I on the other hand have struggled right from the start to make this crazy therapy work.

My best advice is to talk to the sleep doc about the CPAP-induced insomnia you are currently experiencing. It helps if you can describe exactly what kinds of things are bugging you and keeping you from getting to sleep or what kinds of things you think are waking you up.

My big issues were the sensation of the air being blown down my gut making it tough to relax and lots of problems with painful aerophagia waking me up at night.

MRRPM,
I also agree with Bobs statement. You've been given some good explanations and analogies and even Chunkyfrogs misguided fart-logic ...yet you remain unconvinced.

I thought I'd give you a couple of cpap stats. It is a very difficult therapy and over 50% of initial users abandon treatment out of frustration and go back to their previous bad sleep. We all wish there were a better option, but at this point cpap is the best hope of relief from OSA.

And if 4 or 5 hours is all you can do right now...it isn't perfect but it will still give you some solid sleep with noticeable improvement in how you feel. Of course you should shoot for full time use...and most users here won't even nap w/o cpap. But 4 or 5 hours is way better then nothing.

There are many experienced people here waiting and willing to help you...but like Bob said, you have to step up to the plate and want to. I urge you to not be one of the quitters.
Jamis

SleepyBobR wrote:I think it probably makes more sense for us to focus on helping you with your real problem which is that you can't get to sleep with your CPAP machine rather than on trying to explain how the therapy actually works. It appears that we are unable to explain it to your satisfaction anyway and I suspect that isn't where the solution lies in any case. You could have the best understanding of the therapy in the world and still be unable to sleep with it. It is very common for new users to struggle getting to sleep with the mask on and lots of support is available here to help you get adjusted. You are certainly correct that the machine cannot work unless you are asleep so that has to be job one. I never had any trouble adjusting to my therapy so I can't make any suggestions from my own personal experience. Others here will though I am sure.

As for your doctor, I won't be surprised to hear that he isn't much help but you may be lucky and have one who is. I wouldn't accuse the average sleep doctor of quackery because the treatments they prescribe are sound but, that said, the ones I've seen really didn't seem to do very much other than write out a prescription. Then it's over to the young ladies at the DME you choose who, in my experience, aren't much better.

Good luck to you and let's see if we can get you on track.

SleepyBobR,

There aren't any young guys at the DME? Sorry, as a female, I couldn't let that go by.

All jokes aside, you make some excellent points as I have learned from personal experience that you have to accept that there are some situations you're not going to understand to your satisfaction and it is just best to decide on a game plan, go with it, and reevaluate as necessary. Hopefully MRRPM will heed your great advice.

49er

LOL! I kind of walked into that one didn't I? But really, my DME actually is staffed 100% with twenty something young women. I don't know why that is but I'm sure it's not the reason for any service deficiencies. Young men in the same job with the same minimal training would be no different.

Besides, I kind of like it. Maybe that's the plan...

In another agreement with Bob:

MRRPM, you seem to be approaching the problem of the machine's noise keeping you awake by finding reasons not to accommodate to the machine. In other words, instead of trying to figure out why the machine keeps you awake and deal with it, you appear to be looking for any and every reason to claim the machine's use isn't the right fix for you.

BTW, that might be the case ... there are people here that have had to find alternate solutions. But you're not even close to that trip yet. If everyone that found the new treatment kept them awake abandoned it that fast, there'd be 3 people in all the world on xPAP! You know exactly what I mean...

So, instead of focusing all of that energy on "how the machine works" and "why it isn't for you", how about focusing it on sleeping properly with the machine on.

These machines, as a whole, are very quiet. What noise they DO make is affected by (at least on my machine) exhaust relief (EPR, CFlex, AFlex, whatever) because it makes the tone of the machine change with each breath. If a steady tone would make it less of a problem for you, try turning that part off.

But rather than have us "guess" at how it keeps you awake, it'd be better for you to explain the issues and work with us on the solution.

Also, if you are interested in the science behind it, that's cool too! Personally I think you'll get more bang for your buck if you have two threads: one on how to adjust and the other on the science of it.

Well, I have never said this was/is not for me. As an engineer, I need to understand how something works before I can accept it, whatever it is. If I can understand how it works, I can use it's principals to use it.

I went to the Dr. today, she said me waking up with the mask on, is me having an apnea. Ok, I'll go with that, but it's still confusing, since I don't wakeup without the mask on. How can sleeping with a mask, & waking up with apneas, be better than not waking up?

Arousals (waking up) may be caused by apneas, but it is not the only cause.
Consider that mask noise, and vibration on your face may also wake you up.
This why so many suggest a mask liner or a fabric mask.
My Pad-a-cheek liner helped me when I was getting used to my full face mask.
I'm thinking of getting one for my Wisp. Winter's coming, and silicone is cold.
Note: "NOT waking up"; do you mean staying asleep, or not waking up--ever?
The line is a skinny one.

MRRPM wrote:Well, I have never said this was/is not for me. As an engineer, I need to understand how something works before I can accept it, whatever it is. If I can understand how it works, I can use it's principals to use it.

I went to the Dr. today, she said me waking up with the mask on, is me having an apnea. Ok, I'll go with that, but it's still confusing, since I don't wakeup without the mask on. How can sleeping with a mask, & waking up with apneas, be better than not waking up?

Did she read your data, make any adjustments to your pressure settings, suggest another mask,etc.? Sounds like you're having some of the usual problems that occur at the beginning. Can you post your pressure settings,Aflex/Cflex settings, name of mask,titration RX? Sometimes the right bed pillow or a hose management system can solve a lot of problems. Good luck and keep us posted.

chunkyfrog wrote:Arousals (waking up) may be caused by apneas, but it is not the only cause.
Consider that mask noise, and vibration on your face may also wake you up.
This why so many suggest a mask liner or a fabric mask.
My Pad-a-cheek liner helped me when I was getting used to my full face mask.
I'm thinking of getting one for my Wisp. Winter's coming, and silicone is cold.
Note: "NOT waking up"; do you mean staying asleep, or not waking up--ever?
The line is a skinny one.

When I wakeup with the mask on, I feel as though I can't breathe, this is when she, (the Dr.) said that was an apnea.

When I don't wear the mask, I don't wakeup feeling anything wrong with my breathing. I sometimes will wakeup, but for other reasons, like to go to the bathroom, other times, I will just wakeup for seemingly no reason.

DoriC wrote: Did she read your data, make any adjustments to your pressure settings, suggest another mask,etc.? Sounds like you're having some of the usual problems that occur at the beginning. Can you post your pressure settings,Aflex/Cflex settings, name of mask,titration RX? Sometimes the right bed pillow or a hose management system can solve a lot of problems. Good luck and keep us posted.

She didn't read my data, said it wasn't enuf to mess with.
No idea what pressure I'm at, I can figure it out, but right now, I don't know.
My mask has "ResMed Mirage FX" on the bottom.