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Lost weight but still having events
#1
I have gotten my weight under control and dropped over 60 lbs.  one of the benefits I was hoping for was that the weight loss would be that I could stop Cpap therapy.  I have tried a few times sleeping without using my machine.  I believe I am still having a significant number of events per night (based on complaints from from my wife).

1 being overweight is not the only cause of sleep apnea?
2 Is there a way to check short of a new sleep study.?

I shouldn’t complain.  I lost a lot of weight and I get excellent results with my Cpap therapy.
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#2
First of all, congratulations on your weight loss. That is absolutely great!! The benefits of the weight loss would be entirely across your whole health from your heart to all your other organs. I have known of Type 2 diabetics who achieve remission from it after substantial weight loss and coming off insulation injections and other medications. All this of course achieved and confirmed with the medical profession. I have known of people who potentially would have serious heart problems and come off the risk register after weight loss.

So CPAP or not, that level of weight loss is not to be sniffed at, so give yourself a massive pat on the back.

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1 being overweight is not the only cause of sleep apnea?

I do not believe I was overweight when I developed sleep apnea, having always been very trim and petite. For me, I am sure it is genetics as I inherited being petite but with a thicker than normal neck. I believe it was the exhaustion from untreated apnea for many years which finally helped me pile on the weight and that only within the last couple of years. Many members also testify to being slim and yet have sleep apnea.

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2 Is there a way to check short of a new sleep study.?

I would suggest that the definitive confirmation of whether you finally still suffer from sleep apnea is a sleep study. However, as you have been using CPAP for a bit now, can you not assess how you feel with the nights where you have not used the machine? For myself, I notice adverse effects ie feel crap even when I have less than 7 hours sleep with the machine. And if I so much as sleep without the machine, the fog descends.
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#3
Drop your pressure to 5cm or 6cm and see if your having obstructive events. If so than you still suffer from apnea. If not than I'd order a home test online and confirm it.
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#4
(06-02-2018, 04:26 AM)PMD1953 Wrote: I have gotten my weight under control and dropped over 60 lbs.  one of the benefits I was hoping for was that the weight loss would be that I could stop Cpap therapy.  I have tried a few times sleeping without using my machine.  I believe I am still having a significant number of events per night (based on complaints from from my wife).

1 being overweight is not the only cause of sleep apnea?
2 Is there a way to check short of a new sleep study.?

I shouldn’t complain.  I lost a lot of weight and I get excellent results with my Cpap therapy.


Good job losing the weight!  Although 60lbs will make a hugh difference in appearance and how you feel, it doesn’t necessarily mean you are cured of sleep apnea.  

Being overweight is not the only reason for SA.  I know a couple thin folk who have sleep apnea.  Doctors just haven’t caught up to that yet.  

I think it’s pretty easy to tell if you’ve tried going without your machine and what you feel like by morning. Sad    

If you are looking for a definite answer, then a sleep study is the only way that I know of.

One positive note...many that have lost alot of weight report that they can use a lower pressure.  Why not try that?  Your profile says you are using 12, so lower it by 1cm every couple days, watch your data to be sure there is no increase in events.  If there is, you can notch it back up slowly.

Good luck!
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#5
I envy your weight loss. That said, we have had many member that lost weight, but not the need for their CPAP machines. Sometimes they tolerate lower pressure. There are a considerable number of people using CPAP that are of normal weight and fitness, or even above average in fitness. While fat, especially in the neck area can contribute to airway restriction it is far from the only cause. The weight stereotype is just that. It is a co morbidity, but not a deciding factor in apnea.

I think you will probably have a continuing need for CPAP, and your case is an excellent argument why everyone should have auto CPAP. If you need more or less pressure, the auto CPAP will adjust, while you are left guessing with fixed CPAP.
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#6
(06-02-2018, 04:26 AM)PMD1953 Wrote: I have gotten my weight under control and dropped over 60 lbs.  one of the benefits I was hoping for was that the weight loss would be that I could stop Cpap therapy.  I have tried a few times sleeping without using my machine.  I believe I am still having a significant number of events per night (based on complaints from from my wife).

1 being overweight is not the only cause of sleep apnea?
2 Is there a way to check short of a new sleep study.?

I shouldn’t complain.  I lost a lot of weight and I get excellent results with my Cpap therapy.

Wow, that's GREAT!  I'm one of the elite group who struggles with weight so I'm really impressed and delighted with your success.

I also happen to have been overweight when I was diagnosed with OSA and religiously used my CPAP for years.  After almost 10 years, I discovered that my weight loss and fairly trim physique had the benefit of allowing me to get off the machine when I traveled home on weekends, and eventually entirely off.

But.  In '12 I was diagnosed again and though over the next couple of years got my BMI down to ~26, I still had to rely on the PAP, and have continued to since, regardless of my weight.  As others have said, we can't tell, and you won't know without some history and various tests.

Enjoy the PAP, it's a wonderful friend and not at all demanding — very different than my 4-legged companion (who fortunately cant read!   Dielaughing )
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#7
What the others have said.  To be clear, weight gain and OSA are fairly strongly correlated, or maybe associated is a better term for some to take as the nature of the relationship between them.  Strictly on the basis of probability as a predictive statistic or measure, if a person is decidedly obese, the probability...the chances are...is that the person may also have OSA.  May.......probably.......not by any means certainly.

Unfortunately, it works precisely the same way in reverse.  You lose weight and hope that your troubles of all kinds will also slip away.  Not so.  Adipose deposits, visceral fat, they will likely have a deleterious effect or three over time, but some apparently healthy-weight, even thin, people also have unmanageable OSA unless they submit to the various appropriate interventions.

I am relatively healthy, and have not gained an unreasonable amount of weight in my retirement.  Maybe 15 pounds.  I still run and cycle most days.  But, somewhere in the past four years or so I started to develop OSA.  Last summer, while visiting my daughter and son-in-law at their remote cabin, my daughter told me I snored all night long.  I was unaware, and it didn't seem to affect my wife unduly...WHEN we slept together, which was not often.  A subsequent lab polysomnography revealed that I am placed at the very bottom of the 'severe' category for OSA.  And that's my life unfolding.

As the others have quite rightly urged you to do, keep up the great results...on both fronts.  You'll get a lot more years out of that carcass. Who wants an engine rebuild ahead of its time?!
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#8
Hi PMD1953,
Unfortunately, losing weight does not result in a 'cure' very often. I think it is about 5 or 10%.
Fortunately, it probably reduced the severity of your OSA significantly.

There are some other exercises you can do to increase your chances for a cure. Throat and tongue exercises have been shown to reduce AHI by 40 to 50%. You have done the hard part, losing a lot of weight, the easy part are the throat and tongue exercises. I believe it will significantly increase your chances for a 'cure'.

https://academic.oup.com/sleep/article/38/5/669/2416863
Quote from study:
"Current literature demonstrates that myofunctional therapy decreases AHI by approximately 50% in adults and 62% in children. Lowest oxygen saturation, snoring, and sleepiness outcomes improve in adults. Myofunctional therapy could serve as an adjunct to other OSA treatments."
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#9
While losing weight does often help OSA usually when we lose weight a small part of it is muscle unless we are
getting exercise too.   And as was pointed out throat and tongue exercises can often help OSA  I just wonder if 
incorporating those tongue and throat exercises while we lost weight  might stop any loss in the muscles needed
to keep our airway open.   Those exercises are a little time consuming but I stumbled upon this article about using
a little exercise device that may be more efficient time wise.                                             https://www.sciencedirect.com/science/ar...4816303408
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#10
Congrats on the weight loss!!!!! yay!!! My BIL's son also lost about 60 lbs. It can take a year for your body to recover from a 60 lb. weight loss. During that period, your cpap needs will change. The paper from the VA recommends waiting at least 6 months before scheduling a follow-up sleep study. BIL's son has an apap which makes it easy to see that his pressure needs are lower, but still above 8 (which is his minimum setting).

Since the Elite does track data, my suggestion is - if it's been at least 3 months since you reached your goal, try going down 1 unit for a couple of weeks. If no events, go down another unit. Keep doing this every couple of weeks to see where you stand. Remember, one night is nothing. You need to look for a trend so a couple of weeks works. This is a conservative approach without spending the money (YET) for a sleep study.

FWIW, the people who have been most successful at eliminating CPAP after weight loss were under 30 years old because body parts snap back for the young. Us older folks, not so much, if at all.
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