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2018 Resolution. 'Cure' myself of Sleep Apnea.
#11
I hope things work out the way you want them to. Sadly, my experience over losing 60 lb and getting in shape was my AHI got worse. :-(
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#12
Mogy Wrote:I am a 60 year old male diagnosed with moderate OSA Feb 2016. 19.5AHI and 21.5RDI. 6.0ft tall and 215lbs at the time. Resmed ApneaLink Level3 in home test. 4hour test, 3hrs and 45min of test SpO2 below 90 percent.
Lost a bunch of weight and was retested early May at 185lbs. ... I feel that I can get to 160lbs, a BMI of 22, close to the middle of normal weight.

The odds are against you in more ways than one, not least of which is that it is VERY uncommon for a 60 yo person to lower BMI from 29.2 to 21.7 and sustain that weight loss.

However, I think it's a good plan which is likely to have health benefits which extend beyond whether or not you cure your sleep apnea. You've already gone from apparently moderate sleep apnea to apparently mild sleep apnea, most likely as a result of your weight loss.

And while there are many thin people with sleep apnea, there are many more overweight and obese people with sleep apnea. You started out nearly obese, and in that setting weight loss alone usually does help sleep apnea and in some cases can resolve it to an AHI < 5.

A recent review: https://www.ncbi.nlm.nih.gov/pubmed/28185772

Quote:In summary, medical weight loss optimistically achieves about 14 kg of weight loss (106 to 92 kg) with an AHI fall from 23 to 12 eph, and bariatric surgical weight loss achieves about a 53-kg loss (154 to 101 kg) with an AHI fall from 54 to 19 eph. In both groups, about 70% to 90% of patients will have an AHI that remains > 5 eph.

Which means that 10 - 30% of those patients do achieve an AHI ≤ 5 through weight loss, and likely those odds would be improved further by exceeding what are generally considered to be "optimistic" weight loss expectations.

I would like to have some weight loss as well this year. And I am hoping that if I can lose weight that I won't need quite as high pressure settings on my BPAP.
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#13
Thanks again for all your feedback.
Shin Ryoku, I agree that it will not be easy. I can lose weight fairly easy, but until now I have not been able to keep it off long term. I feel better when I lose the weight, but then my focus shifts and I don't spend the required effort to meal plan and exercise to keep it where I want.
I will be semi-retired shortly. Hopefully then I will have the time to give my health the attention it deserves.
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#14
Another thing to keep in mind is that there is no solid evidence that treatment of mild sleep apnea helps prevent death, stroke, heart attack, car accidents...

https://www.ncbi.nlm.nih.gov/pubmed/27128710

So if you can keep your AHI well under 15 without PAP and feel very well including an absence of excessive sleepiness, then I would say you have achieved something! Especially when you have a great difficulty tolerating PAP.

On the other hand, there is plenty of evidence that having a mid-normal BMI will help you enjoy better health, sleep apnea or not. So definitely a good goal to have!

I personally would stay on PAP even if I had an AHI under 15, but I don't mind PAP one bit (especially at sub-15 cm H2O pressures).
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#15
(01-04-2018, 04:06 AM)srlevine1 Wrote: And, BTW, research has found that it is far better to concentrate on building productive habits rather than setting goals. More bang for the buck. 

Best of luck with your experiment.

Hi srlevine1,
Thanks. I am interested in the research. Do they tell how to go about building the productive habits?
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#16
(01-04-2018, 07:43 PM)Mogy Wrote:
(01-04-2018, 04:06 AM)srlevine1 Wrote: And, BTW, research has found that it is far better to concentrate on building productive habits rather than setting goals. More bang for the buck. 

Best of luck with your experiment.

Hi srlevine1,
Thanks. I am interested in the research. Do they tell how to go about building the productive habits?

I suggest that you start with a survey article which provides a decent overview of habits relating to health improvement. Making health habitual: the psychology of ‘habit-formation’ and general practice which appeared in the British Journal of General Practice (http://bjgp.org/content/62/605/664).

Then you can follow some of the reference links and start on your own exploratory journey.

The reason habits are more effective than goals is primarily that they are binary and not-subjective: or as Yoda might say, "Do! Or Do Not! There is no Try!"  Best of luck on your journey.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#17
I weight 115 pounds and I am 5'8.... good luck.
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#18
I am glad the OP put quotes around the word cure, because I don't know if you ever truly cure sleep apnea. I think you can most definitely reduce it to the point to where you no longer need CPAP treatment, but I don't think one can necessarily cure it unless they do facial reconstructive surgery. Even then, there isn't a guarantee that it is completely cured, but greatly reduced. Then again, I'm probably coming from a perspective of one having severe OSA and CSA. I've used CPAP for five years now, and I still hate it, but I feel I have no other choice. My only other option would be surgery, and I am currently trying to get my insurance to help cover some of the cost. Even if I'm able to get the jaw surgery, there's no guarantee that I can completely get off of the CPAP, but I would say if I didn't need the CPAP all the time, then that's a win for me.

I mean, naturally, none of us are meant to sleep hooked up to a machine and wearing a mask. It's quite limiting and it can be difficult for your spouse to get used to as well. While I've done my best to be compliant, I've struggled. I will have stretches where I have little issue with CPAP, and then I'll have stretches where it's like the first night all over again. I feel claustrophobic, can't breathe through my nose, and just have a lot of struggles with it. And then, if the power goes out, well, no machine! Battery packs for these machines are outrageous in price - more expensive than what I paid for the CPAP machine itself!

So, whenever I hear about someone having moderate Sleep Apnea and wanting to get off of CPAP, I tend to feel that they have a better chance at it than me. Certainly losing weight can't hurt, and you can try positional sleeping, but think about this: Sleep Apnea isn't just about not getting a good night's rest, it causes all sorts of major health issues, including death. So, getting off of CPAP should be a tiered approach. First thing is to lose the weight. And to lose the weight, change your diet and exercise (same song and dance!) And once the weight is lost and your in better shape, get another sleep study done and see if your Sleep Apnea has decreased under the dangerous level. If it's close but still enough to where it would require CPAP or a mouth appliance, I would step down to the mouth appliance and see what that does for you.

But, take it from someone who has very severe OSA, as much as I hate CPAP, I recognize that it's keeping me alive - which is the most important thing for me. Quality of sleep? Quality of life? Well, that's a whole different thread.
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#19
I'll try to limit myself on being overly wordy. Probably you've read my history, so I'll give just the basics on it all when it comes to xPAP therapy. I was diagnosed with severe sleep apnea in the spring of 2015, and placed quickly onto what looks like it would have been a REMstar CPAP. One of my biggest regrets, looking back, is that I didn't educate myself on CPAP and apneas. I predetermined I'd hate CPAP. Truthfully, I was going to find it very difficult to just "get used to" CPAP on the setting of 20 prescribed or the 18 it was set for. I could not breathe out on this setting. Naturally, I struggled to use it, and in short order, failed compliance.

I had several office visits afterwards with my Primary Care Physician. As best I recall, we discussed options including surgeries to reduce apnea. No option available seemed a good fit for me, except weight reduction surgery. I was near 300 pounds and 5' 11". So having failed miserably at CPAP, we pursued weight loss surgery in the form of a bariatric sleeve procedure. Insurance required a 6 month monitoring of weight loss attempts with guidance via an approved dietitian. She gave me things to do to not only lose weight, but also to prepare me for life after the sleeve surgery. This successfully caused a weight loss of about 23 pounds.

Skipping ahead to the surgery day, 9/18/16, I weighed 277. And skipping again to 3 months ago, I weighed in at 199. Excellent results. Unfortunately, other illnesses have spoken up and required medication changes, and of course the COLD winter weather and COPD makes it very difficult for me to exercise now. I have gained back 20 pounds.

OK Dave add some shortening. Going by the results, bariatric surgery overall had me lose 1/3 of my highest weight, and due to that, my AHI halved from about 70+- to about 35. Again, good results. Now, the thing is it couldn't keep me from still needing xPAP, as 35 AHI or so is still severe. So, another PSG and on to BiPAP. And on to compliance fail 2.

The BiPAP PSG revealed that I have lots of Central Apnea when on BiPAP. So, here comes the dance to get ASV. blah, blah, blah. Finally got it of course. AHI NOW is 1.9 or LESS, many times a ZERO even. Success finally.

What's the point, Dave? Weight loss alone may not be enough. For you, I hope it is, but with my severe apnea count, it wasn't. I am acknowledging your AHI isn't as bad as mine was. Here's to hoping yours may be low enough to succeed with weight loss alone.

Dave
lots-o-coffee
Dave

Even a 1,000 mile trip requires a first step. My recommended first steps are getting good shoes and 2 cups o coffee

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Sleepyhead Chart Organization
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#20
Hi Walla Walla, kiwii and Opal Rose,
I hope to answer some of your questions in this post.
I don't post much of my data because it is a major pain to go through all of the steps. I don't have internet at home. I live in the country, they want $80 a month, I spend enough time on the internet as it is. I have 2G data on my phone. If I need the internet, I go to the library. Sleepyhead is on a older computer at home, it doesn't communicate with my phone. Any Sleephead data needs to be put on a flash drive, move to my laptop, connect to my phone, do the Imgur thing on my phone, make a mistake somewhere, go back to the beginning. I don't enjoy it. Why not put Sleepyhead on my laptop? The resolution on my laptop does not work well with Sp02 Assistant. I am fine with not posting my data. That being said, the next post will include some on my data I have on Imgur.
Walla Walla, you are correct when you say that I don't put much effort into being compliant. I wanted to be compliant for the first week, then I installed Sleephead, looked at my data, and threw compliance out the window. I had treatment emergent apnea, now my apnea was twice as bad as before APAP. Did I have CSR, central apnea?
So I went through the anxiety, decided that my best bet was to deal with the OSA by losing weight, exercise and other things.
I continued to use my S10 Autoset, but typically just the first sleep cycle(90min). I lost weight, 20lbs the first month after diagnosis, 10 lbs the second.
What I was doing was working, I started to feel much better, and using the machine more and more. My treatment emergent apnea settled down. Things are good.
At this point I don't know whether the APAP treatment or the improvements in lifestyle contribute more to my improved health. I suspect weight/exercise.
I think the gsykes says my opinion well. "I mean, naturally, none of us are meant to sleep hooked up to a machine and wearing a mask. It's quite limiting and it can be difficult for your spouse to get used to as well."
I don't hate my APAP, I see it as a tool. If I helps me, I am all for it. If I can do just as well without it, it will be put in the closet.

Currently, my apnea is mild. According to the studies, PAP therapy does not necessarily help me. Compliance to therapy that does not necessary help me is not my goal.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2564770/

In retrospect I should not have mentioned the compliance thing. I was hoping the thread would be more focused on alternate therapies.

I find this thread inspirational.
http://www.apneaboard.com/forums/Thread-...didgeridoo
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