(05-08-2013 03:26 PM)racprops Wrote: It is reported that this treatment, CPAP has a 50% drop out rate or failure.
I wonder why. Could it be many are treated that don’t really need treatment?
Could the Doctors be rushing everyone within reach into treatment?
When I was shopping around about a sleep study I would ask if they would be testing and considering a Dental Appliance as a possible treatment of OA.
They said no. I was told If I wanted to look into that line of treatment go see a Dentist.
Sadly the Dentist are also very costly with their $3500.00+ appliances…(there are some of these kind of appliances for sale as snoring aides for under $100.00, and for some work very well, for apneas too I believe…)
The massive rise in obstructive sleep apnea diagnosis has a clear link to a rise in obesity. The unvarnished truth is that the fatter we get, the more likely we are to have OSA. Nobody wants to listen to that fact, but it's there, nonetheless. Yes, skinny people can develop OSA and anyone can develop CSA or complex sleep apnea. But the majority of OSA patients have developed OSA simply because they are overweight. Not everyone - but the majority of them. That's a fact that is hard to argue with.
Are the doctors "rushing everyone within reach into treatment"? I don't think so. I think that what they have on their hands is a an epidemic of overweight patients who have not complied with their doctor's request to lose the pounds. The result is a massive increase in OSA patients. I truly believe that for the majority
of OSA patient who are overweight, losing that extra weight will do as much towards reducing their AHI as any kind of xCPAP, plus losing weight has other health benefits as well. But, as a society, we seldom choose the hard way as our first option. We want a machine to solve our problems for us, when in many cases, if we only fixed the machine of our own body
(lose weight) - we'd be far better off. I realize no one wants to hear that.
As far as the drop-out rate for CPAP users, even though people want simple solutions, no one likes to sleep with an ugly, air-pushing contraption strapped to their head for the rest of their life. I sure don't. I'm surprised that the drop-out rate isn't higher, frankly.
On AHI, you have to ask yourself - is using your machine actually raising your AHI or lowering it (when compared to not using the machine at all)? If it's lowering it, it's a net gain for your health. The truth is that there are some patients who have treated AHI levels in the 10-20+ range using any form of xPAP, and they just can't get their AHI down to the <5.0 level, no matter what they do. But they continue using xPAP, because an treated AHI of 20 is still massively better than an untreated AHI of 80+.
Yeah, your pressure needs for the OSA may be triggering unwanted CSA events, but you have to look at the bigger picture - is the treatment lowering your AHI, yes or no? If yes, then no matter what, it's still a net gain for you to continue with the therapy, even though your AHI levels are not down to that "magic <5.0" level.
I also think there is something to the generally-talked-about advice of not changing your settings for a long period of time and then checking stats over a a week or two before making additional changes. Your body does react to all the changes, and needs time to acclimate to those changes. If you're constantly making adjustments and changes every few days, you are not getting an accurate read on what those changes are doing to the treatment.
I understand your frustration... chasing the AHI numbers down every day can sometimes be quite counter-productive. It's kind of like when you're sick with an infection, and the doctor gives you an antibiotic and tells you to take one capsule 3 times a day over the next two weeks, and after 2 days, you triple the dosage to 9 capsules per day to make the infection go away quicker. That would not be logical, since you need those antibiotics to be in your system for the entire 2 week period in order to kill all the remaining bacteria. Time is a factor in that scenario. I fear what you might be doing is not considering time to be a factor in your ASV treatment.