[CPAP] Worsening OSA After Bariatric Surgery

[Ibrumley]

Just curious if anyone else has developed worsening OSA after Bariatric surgery (Vertical Sleeve Gastrectomy).  Overall I have lost 115 lbs. yet my sleep apnea is worse; so much so that during two recent sleep studies the doctor ended up prescribing a BiPAP with much higher pressures than I had with the Airsense 10.  Frustrating as I had hoped for improvement in my apnea instead I got worse.

[SarcasticDave94]

I was initially diagnosed with sleep apnea in 2015, tried straight CPAP on a RemStar. As this was set to 18 and before I found Apnea Board, it didn't go well and the CPAP was returned when I failed compliance. In 2016 weighing 300 lbs., I began the process of qualifying for bariatric surgery, a sleeve. I had 6 months of monitored diet, getting down to 275. Sleeve done 9/16, and in early 2017 I went back to sleep doc to get a BPAP as I still wasn't sleeping well.

I qualified for the sleeve as I was obese and had a diagnosis for COPD at that time. A year after the sleeve, and starting on ASV therapy for Central Apnea, I was doing ok. In 2019 I had both pneumonia and bronchitis and soon after my ASV therapy wasn't compatible.

Weight loss always benefits your health, but that alone doesn't eliminate the need for CPAP therapy.

[OpalRose]

Losing 115 lbs. still has to have a positive effect on your health.

It could be that you need some tweaking with your Bipap settings.

Download the OSCAR software and post some data. We may be able to help you optimize your therapy.

Use the links in my signature line below to guide you.

[Ibrumley]

I have been using a CPAP machine for over 20-years and never heard of ASV Therapy until I read your post.  Had to look it up to read about "Adaptive Servo Ventilation (ASV)" for Central Sleep Apnea.  Were you able to get therapy that is compatible with your current conditions?  From what I've read for non-intrusive methods only the CPAP, BIPAP, and ASV exist.  Hope you are able to get the rest you need too.

[SarcasticDave94]

No therapy just yet, had to change doctors recently to facilitate the need.

There's along with ASV an ST, and ST-A, each specialized versions. After that it's ventilators. I'm probably headed to the ST-A. It's in the CPAP class but uses ventilator modes. While the ASV is a ventilator in name, its specialty is Central Apnea.

[Ibrumley]

What I still find odd is that my OSA was "better" (for lack of any more useful term) back when I weighed in at 388 lbs.  Now I'm down to 270 and now using the RESMED AirCurve 10 VAuto Bi-Level Device.  Still too soon to really tell if that is working better as I've only used it thus far for 14 hours total.  Best wishes (and prayers; if that's okay for you) to you and for you to get the equipment that can improve your symptoms and condition.

[SarcasticDave94]

There's a way that's totally free to be able to gauge how well your VAuto therapy is doing. Download the OSCAR app, and inserting an SD card in your VAuto before you sleep, you'll be able to see the data. Then you can attach the charts to posts within this thread. Members can suggest edits with this info.

[dwedward]

I didn't have bariatric surgery, but lost about 120 pounds by using Mounjaro.  I found the same thing.  My AHI didn't double, but my flow limitations dramatically increased to the point where I too moved to a bi-pap and higher pressures.

I've noticed more saggy skin on my body since the weight loss, so I attribute it to saggy airways! 

Also, the weight loss seemed to uncover more of the FLs caused by my deviated sceptum, and so now I'm going for a septoplasty to see if that'll improve my situation.

There's a tendency to tag CPAP needs with obesity, and while there's a relation, it's not a causal relation.  I've accepted I'll be using a bi-pap or CPAP for the rest of my life.  But my sleep is worth it.

[SevereApnea]

Those are really good wt loss results by the way. Congrats.

Soft Cervical Collar?

Just thinking laterally (always fun): thin skinny folk like me have very flexible necks, flexion/lateral flexion/rotation during sleep induces OSA in some by kinking the airways

Is it possible to lose enough weight so that there is more flexibility in the neck?

(Charts will usually show up clustered events)