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How do I know if I can stop using cpap
#1
I am up to a 40 ld weight loss. After 30 lbs I switched from an S-8 set at 12 cm to the Autoset A-10. My 90% pressure is coming in around 7.5 with an average pressure around 6.

Is there a point where I should start looking into discontinuing treatment?

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#2
Some people are able to reduce or eliminate dependence on CPAP with weight loss. That is not normally the case, but it may be for you. While a sleep study would be more definitive, a recording oximeter is inexpensive and would let you know if you have desaturations without CPAP. You could obtain a baseline with CPAP, then see what happens without it. If you feel good and don't experience SpO2 below 88, then you might be one of the lucky ones. Good luck.
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#3
What's your AHI over the last 30 days? If it is less than 5, you may do the following strategy:
1) Go to a straight pressure of your 90% pressure. Evaluate your AhI over 7 days. If still good, lower the straight pressure by 0.5cm. Evaluate it for a week. And repeat lowering until you either reach the pressure of 4cm OR AHI increases over 5.

If pressure is 4 and AHI is < 5,
Then {
go the pulse ox route Like sleep rider mentioned
OR
Get a full sleep study or a home sleep study.}
Else
You still have sleep apnea. Keep using the machine.

My 2 cents. YMMV.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#4
(04-09-2015, 03:19 PM)AshSF Wrote: What's your AHI over the last 30 days? If it is less than 5, you may do the following strategy:
1) Go to a straight pressure of your 90% pressure. Evaluate your AhI over 7 days. If still good, lower the straight pressure by 0.5cm. Evaluate it for a week. And repeat lowering until you either reach the pressure of 4cm OR AHI increases over 5.

If pressure is 4 and AHI is < 5,
Then {
go the pulse ox route Like sleep rider mentioned
OR
Get a full sleep study or a home sleep study.}
Else
You still have sleep apnea. Keep using the machine.

My 2 cents. YMMV.

Is it even possible to breathe at a pressure of 4? I sure can't... not even awake!
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#5
While weight loss certainly lowers the pressure needs, there are a variety of factors that affect OSA, and once you have, due to weight gain, arrived at the form of laxity in the soft tissue that produces the commonest forms of OSA, it does not so easily resolve itself completely - for common forms of OSA, weight loss must be combined with methods of toning the tissue of the throat in order to eliminate OSA to the level where a CPAP is no longer necessary - the most common and successful form of throat toning is learning to play the digeridoo.

This is not to discourage you from losing weight - quite the contrary - well done and keep it down! The health benefits from such a weight loss are immense in all areas of your body, not just your throat. You will have extended your healthy life (we don't talk about life expectancy any more in this context, as that is uncertain, but the level of health during the life is extended considerably) to a great extent and you will reap the benefits gradually and not so gradually over the next few years.

While I do not think that you will be free of the CPAP without other therapeutic methods as I mentioned above, checking to see how you are doing is not a bad idea, and all the methods mentioned by my esteemed fellow fora denizens are well worth considering, if for no other reason to see just where you are right now in terms of your OSA.

Again, well done indeed!
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#6
(04-09-2015, 03:19 PM)AshSF Wrote: What's your AHI over the last 30 days? If it is less than 5, you may do the following strategy:
1) Go to a straight pressure of your 90% pressure. Evaluate your AhI over 7 days. If still good, lower the straight pressure by 0.5cm. Evaluate it for a week. And repeat lowering until you either reach the pressure of 4cm OR AHI increases over 5.

If pressure is 4 and AHI is < 5,
Then {
go the pulse ox route Like sleep rider mentioned
OR
Get a full sleep study or a home sleep study.}
Else
You still have sleep apnea. Keep using the machine.

My 2 cents. YMMV.

Thanks for the advice, my AHI has been under 2 for the last month.
(04-09-2015, 05:06 PM)DocWils Wrote: While weight loss certainly lowers the pressure needs, there are a variety of factors that affect OSA, and once you have, due to weight gain, arrived at the form of laxity in the soft tissue that produces the commonest forms of OSA, it does not so easily resolve itself completely - for common forms of OSA, weight loss must be combined with methods of toning the tissue of the throat in order to eliminate OSA to the level where a CPAP is no longer necessary - the most common and successful form of throat toning is learning to play the digeridoo.

This is not to discourage you from losing weight - quite the contrary - well done and keep it down! The health benefits from such a weight loss are immense in all areas of your body, not just your throat. You will have extended your healthy life (we don't talk about life expectancy any more in this context, as that is uncertain, but the level of health during the life is extended considerably) to a great extent and you will reap the benefits gradually and not so gradually over the next few years.

While I do not think that you will be free of the CPAP without other therapeutic methods as I mentioned above, checking to see how you are doing is not a bad idea, and all the methods mentioned by my esteemed fellow fora denizens are well worth considering, if for no other reason to see just where you are right now in terms of your OSA.

Again, well done indeed!

Even if the digeridoo does not help, it will be worth it to drive my daughter crazy.

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#7
(04-09-2015, 02:32 PM)r_mermel Wrote: I am up to a 40 ld weight loss. After 30 lbs I switched from an S-8 set at 12 cm to the Autoset A-10. My 90% pressure is coming in around 7.5 with an average pressure around 6.

The machine only raises the pressure to head off apneas and hypopneas. If it's running up from 4 to 7.5, you still need it.



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#8
(04-09-2015, 02:32 PM)r_mermel Wrote: Is there a point where I should start looking into discontinuing treatment?

When their giving me my Last Rights, or when we see the grim reaper.
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#9
(04-09-2015, 03:26 PM)DariaVader Wrote: Is it even possible to breathe at a pressure of 4? I sure can't... not even awake!

I would have problems with it at 4. When I first got my S-9 they had the blasted ramp feature turned on. First time I put it on and fired it up I thought "What the frack!" while thrashing about. I can't tolerate the mask at minimum pressures. Can't start out at anything less than 8.

OMMOHY
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#10

(04-09-2015, 02:32 PM)r_mermel Wrote: Is there a point where I should start looking into discontinuing treatment?

Hey R_M, you're doing really great! Just the fact that you are thinking maybe you are "healed," and could stop treatment says your program of exercise, weight loss, cpap, whatever is working wonderfully.

I don't think I'd rock that boat if I were you. I do know that if I were me, and come to think of it I am, then the day will not come that I would want to give up my machine...... And my AHI is always under 1, and a large percentage of the time zero.

I just enjoy sleeping so much now (when I'm supposed to) and staying awake during the day (when I'm supposed to do that) that I can't envision going back, or even creating a possibility of going back, to where I was.

(04-09-2015, 10:54 PM)Napmeister Wrote: When their giving me my Last Rights, or when we see the grim reaper.

Which brings me to wonder once again; who said the reaper is grim? I mean, maybe he's not grim at all.... or she.......... or it................ Maybe he's really a jolly old guy with a big white beard and a sack full of toys..
Or maybe he is grim. It's just that I don't know anyone that really knows for sure. Maybe we should start a poll.
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