Long term effects of CPAP therapy

[Sleepster]

My sleep study documented an AHI = 32, which is in the severe apnea range; however, many of those must have been hypopneas rather than apneas because my wife says I rarely snored, except on weekends when I generally enjoy alcoholic beverages.

I would tend to think just the opposite. Hypopneas are caused by a partially blocked airway, so I would associate those with snoring. You should be able to get a copy of the sleep study and find out.

There are a lot of variables here. It could be that your wife was sound asleep when you were snoring and didn't hear it, but on weekends perhaps she wasn't sleeping as well as on week nights for some reason. Perhaps she also had a drink or two, or perhaps she's just more tired on week nights because she can't sleep in like she can on weekends.

Now she says as soon as I fall asleep without a mask, I snore.

I doubt this has anything to do with an alteration caused by CPAP therapy. As we age we lose muscle tone, so that could be it. Also, it could be that your brain has now convinced itself that it's ok to let you fall asleep. Before CPAP therapy it had to constantly wake you up to breathe, so it never let you fall fully asleep. Now you are sleeping deeper and that's the reason you are snoring more.

Anyway, if you monitor your data you can lower your pressure as you lose weight and see if your AHI stays low. You really don't have any options, anyway. You know you need CPAP therapy now, so you'd just be killing yourself if you stopped while you know you still need it.