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OSA w/o Cpap? Help!
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sir_sleeps_alot Offline

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Post: #1
Surprised OSA w/o Cpap? Help!
I have severe sleep apnea and hypoventilation. I'm supposed to be getting a cpap but it's taking forever. In the meantime, it seems like my sleep / energy / wakefulness / etc. is getting worse. I'm so tired and so out of it all the time. I'm really scared that I'm going to end up accidentally burning my house down or killing myself or someone else. I really need some help.

Can anyone give me advice on treating OSA without CPAP or oral appliances?

What do you do when you can't use your cpap?

I've seen lots of DIY and commercial products for keeping someone *off* their back, but nothing for keeping someone *on* their back. Anyone have any ideas or suggestions?

My AHI decreases by almost 50% when I am on my back vs. my side. I know that sleeping on my back isn't going to solve all my problems, as my AHI is still over 50, but it should help some... right?

For people who use a pulse ox, is it reasonable to think it would be helpful to set it to alarm when my O2 dips? I don't wake up (that I am aware of) during desats so I am worried that waking myself up more will mean feeling even worse. But maybe having higher 02 for more of the night will make me feel better?

If anyone has any thoughts or suggestions, I would be most grateful.
10-30-2013 07:16 PM
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Tez62 Offline

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Post: #2
RE: OSA w/o Cpap? Help!
sir_sleeps_alot, like you have identified try and sleep on your side versus your back either using pillows or even tennis balls sown into a t shirt or try to sit yourself up as much as possible but still be comfortable enough to be able to sleep. Just try to get your CPAP as soon as possible, good luck.
10-30-2013 07:26 PM
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PaulaO2 Offline
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Post: #3
RE: OSA w/o Cpap? Help!
Even the cheaper ones have an alarm that can be set to go off when the O2 goes below whatever level you set.

My theory is your AHI appears to drop when you are on your back because they are lasting LONGER.

Let's say you have an AHI of 60. That's one event a minute. You are on your side. When the event happens, you don't have to wake up very much for the muscles to "tense up" and reopen the airway. Now you are on your back. The airway closes. Your brain screams at you to wake up. You kinda do but now your muscles are also fighting gravity. The event lasts a few seconds longer. Your brain continues to yell. Your leg twitches. You wake up further. You finally wake up enough to open the airway completely. More than a minute has passed. You fall back asleep. You have another event. Repeat. So the AHI is less and it looks like it is better but, really, it is not.

If you have your sleep report, look to see if it tells you the length of time the events lasted while you were on your back.

Meanwhile, sleep in a recliner or some other method to stay off your back.

If you can, check Craigslist or some other local sales paper to see if someone has a used CPAP for sale. Before you buy one, though, check with us to make sure you get one that is good for you to use!

PaulaO2
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-30-2013 07:33 PM
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justMongo Offline

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Post: #4
RE: OSA w/o Cpap? Help!
I pretty much agree with PaulaO2. It doesn't make sense that you would do better on your back.
(Not impossible; but from the standpoint of physiology, it's counter-intuitive.)
Also, many OSA patients have central obesity that makes the diaphram work harder when the weight of the belly is working against it.
My apnea index is certainly lower on my side -- and I confess to central obesity.

Sleeping in a recliner is a good idea. One of my friends does that.

There should be a source of machines out there. I donated my old Respironics BiLevel machine with the hope it would help someone.

Can you get your doc to write a letter of compelling need (sort of a threat to the ins co that they'll be responsible for any complications caused by their delay.) Ins companies will act in their best interest; and can get off their behinds when the cost of inaction is potentially costly (i.e. -- lawsuit!)

I don't know if I would set an oximetry alarm. You may wake up more tired from alarms. However, a recording oximeter is a valuable tool in treating and evaluation OSA.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-30-2013 08:22 PM
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trish6hundred Offline

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Post: #5
RE: OSA w/o Cpap? Help!
Hi sir_sleeps_alot,
What Paula amd justMongo said.

I'm sorry you are having to wait what seems like forever to get your CPAP machine.
I would try to sleep in a recliner 'till you get it.
Best of luck.

trish6hundred
10-30-2013 09:03 PM
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sir_sleeps_alot Offline

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Post: #6
RE: OSA w/o Cpap? Help!
That's an interesting theory. My sleep study has no info about the duration of my desats, only the max, min, and average. Not very helpful.

My AHI on my back was 51.4 and on my side it was 90.3. However, my RDI on my back (85.7) is quite similiar to the RDI on my side (92.8). This means, I think, that I wake up pretty much the same amount on my back and side for breathing problems? Not sure what to do with that.

When I'm feeling better, I'll have to do some experimenting. I'm just too tired to puzzle it out right now.

Thanks for the ideas everyone.

I'm really hoping the insurance company isn't going to take too long. I don't have a mild or questionable case of apnea and I am positive I have coverage for cpap. If the new company starts dragging their feet, I will definitely ask the doc to advocate on my behalf.

I did look online at some used cpaps but they are just a bit out of my price range. The cheapest I found for used was $299 (not including shipping). Any tips on finding cheaper ones are appreciated. If I had $300, I most definitely would buy one but I just don't have it. Insurance most definitely will have come through by the time I saved up enough for one. Any tips on finding cheaper ones are appreciated.

Luckily, my insurance will pay 100% for cpap, supplies, and sleep related appointments. But the waiting in challenging. But I'd rather wait and have insurance than not have insurance at all. Oh yes.

Best wishes,
Sid

(10-30-2013 07:33 PM)PaulaO2 Wrote:  Even the cheaper ones have an alarm that can be set to go off when the O2 goes below whatever level you set.

My theory is your AHI appears to drop when you are on your back because they are lasting LONGER.

Let's say you have an AHI of 60. That's one event a minute. You are on your side. When the event happens, you don't have to wake up very much for the muscles to "tense up" and reopen the airway. Now you are on your back. The airway closes. Your brain screams at you to wake up. You kinda do but now your muscles are also fighting gravity. The event lasts a few seconds longer. Your brain continues to yell. Your leg twitches. You wake up further. You finally wake up enough to open the airway completely. More than a minute has passed. You fall back asleep. You have another event. Repeat. So the AHI is less and it looks like it is better but, really, it is not.

If you have your sleep report, look to see if it tells you the length of time the events lasted while you were on your back.

Meanwhile, sleep in a recliner or some other method to stay off your back.

If you can, check Craigslist or some other local sales paper to see if someone has a used CPAP for sale. Before you buy one, though, check with us to make sure you get one that is good for you to use!
10-30-2013 09:13 PM
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jgjones1972 Offline

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Post: #7
RE: OSA w/o Cpap? Help!
I know it sounds uncomfortable, but sleeping while in a fairly upright position is probably your best shot at minimizing the apnea until you can get a CPAP. If you try this, make sure to recline at least enough to keep you from falling forward while you sleep or take some other precautions to guard against falling.

Best of luck and remember that the squeaky wheel gets the grease; so hound them relentlessly until you get your PAP.
10-30-2013 10:59 PM
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Peter_C Offline

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Post: #8
RE: OSA w/o Cpap? Help!
I can only suggest two things (well, a third, but it's not too practical).

1) Sleep in a chair/recliner

2) Buy a CMS50F Pulse Oximeter (has an alarm) set the low O2 for 75-80, so it will wake you if you dip too low. Conversely, if it isn't waking you up, then you need not worry so much as your O2 is staying decent.

3) ** Have your partner/spouse/etc stay awake and stare at you while you sleep, and have them wake you every time you stop breathing for more than 30 seconds - when you get enough rest that you are tired of them doing that, they can then go to sleep.

Seriously, I got my meter for the simple benefit of having it wake me if I go below XX numbers. It does work, because if I turn the alarm off, and read the data I will see that I indeed went much lower.

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-30-2013 11:48 PM
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sir_sleeps_alot Offline

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Post: #9
RE: OSA w/o Cpap? Help!
I have a pulse ox but I can't recall the model. It's the model below the one you wear on your wrist--A little thingy that clips on your finger and transfers data via a usb cord.

I set the alarm last night and when it went off, it said my O2 was 58%. Is that realistic? The low alarm is factory set for 88%. I'm not sure why it would go off at that low of a reading and not higher, so I'm hoping it was a false reading.

I don't have anyone who'd sit next to me and poke me from time to time so maybe I'll move out to the living room. Not sure how my housemate will feel about it, though I'm not sure I care.

Thanks.

(10-30-2013 11:48 PM)Peter_C Wrote:  I can only suggest two things (well, a third, but it's not too practical).

1) Sleep in a chair/recliner

2) Buy a CMS50F Pulse Oximeter (has an alarm) set the low O2 for 75-80, so it will wake you if you dip too low. Conversely, if it isn't waking you up, then you need not worry so much as your O2 is staying decent.

3) ** Have your partner/spouse/etc stay awake and stare at you while you sleep, and have them wake you every time you stop breathing for more than 30 seconds - when you get enough rest that you are tired of them doing that, they can then go to sleep.

Seriously, I got my meter for the simple benefit of having it wake me if I go below XX numbers. It does work, because if I turn the alarm off, and read the data I will see that I indeed went much lower.
10-31-2013 09:48 PM
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Peter_C Offline

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Post: #10
RE: OSA w/o Cpap? Help!
Without loading data and looking at it, the types of Oximeters we would buy run the risk of 'static' or hiccups, besides the fact that they can read +/- 2 points.

If the alarm is supposed to go off at 88, and if, like me you'd wake up 5-20 seconds after it starts chirping, I can't see how you could drop from 88 to 58 in less than 20 seconds. That said, if the data said you went from (say) 90 to 58 in 5-15 seconds, I wouldn't believe it, but if data plots show that you dropped from 90 to 88, then 90 to 82, and on and on over a 10-40 minute period - that's real in my book.

So, the alarm will wake you for one of two possible reasons; it falses (for me, maybe 0-2 times nightly - based on motion), or, it caught you with your O2 on the way down, but you waking up stopped it.

This is why you also need to look at the data on a computer over an entire sleep period - if you look at what I have posted, you can see both my O2 and pulse being pretty steady, and then start going all wonky, then getting better, then getting worse again. Make sense?

*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
10-31-2013 10:23 PM
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