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Taking a break from CPAP
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Asjb Offline

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Post: #31
RE: Taking a break from CPAP
(06-06-2016 11:59 AM)0rangebear Wrote:  I sleep without the mask on night a week per my doctors prescription.
I do not feel any different on my off day. I do however, wake up more often on those nights.

I read on the forum that off days are unusual so I question my doctor. He is concerned about something called CPAP dependency that raises the risk of heart attack and stroke.

Hello Orangebear,

Oh my gosh! I have to say that in reading probably more than 300 peer-reviewed scientific articles about sleep apnoea I have never, ever, even come across 'CPAP dependency' as a phrase, let alone as a described concept, let alone a scientific review of it's risks...

I agree with Sleeprider - the only references out there to 'CPAP dependency' would appear to be from ENT doctors keen to 'cure' sleep apnoea with surgery. This is one of my favourites:
http://drpaulose.com/laser-treatment/cpap-dependency-in-osa-patients

You say in your later post that your doctor is an 'expert on sleep apnoea' and you mention he is an endocrinologist? If so he probably looks after people with Type 1 Diabetes. So, to expand a little on what andyjh64 posted - could you possibly ask your doctor next time you see him if he recommends that diabetics under his care also have a day off a week from treatment to reduce the risk of 'insulin dependency'?

And why does he recommend that 6/7 use of xPAP is a Good Thing but 7/7 use of xPAP is 'dependency' and therefore a Bad Thing. I am truly alert with anticipation to see his evidence. (And in my humble opinion I am only able to be alert at all thanks to my xPAP treatment). And does his advice vary with the severity of his patients' diagnostic AHIs? Maybe he recommends that if you only have 'moderate' sleep apnoea, alternate nights without treatment is fine, but if you have 'severe' sleep apnoea you should only stop treatment on, say, the third Thursday of every month?...

And does your doctor have an evidence-based opinion as to *which* day of the week it is a good idea for his patients to risk all those pesky oxygen desaturations, adrenergic cardiovascular responses, nocturia, micro-wakenings etc etc, that many/most of us had before xPAP treatment. Perhaps he has had a classical education so advises that Sundays should be the day of rest from xPAP treatment?

I think you get my drift by now! But, as always, I will take my words back if offered good quality peer-reviewed evidence to the contrary.

I personally wouldn't take a voluntary night off my xPAP treatment even if you were to pay me a very large sum of money. I am, simply speaking, 'CPAP dependent', and having been very symptomatic from undiagnosed sleep apnoea for many years I am extremely happy, given that I have effective xPAP treatment, to now be 'CPAP dependent'.

best wishes, asjb
................................................................................​.....................
All my opinions are only as an xPAP user trying to help other xPAP users.
No suggestions I may make should be taken as professional advice.
If you have medical concerns please consult a doctor
- but, a PS, for this post only 'perhaps not necessarily the same doctor as you are currently consulting'

My current pressures: Auto-ASV. EPAP 10-13. PS 3-10
(This post was last modified: 06-07-2016 08:51 AM by Asjb.)
06-07-2016 08:29 AM
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green wings Offline

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Post: #32
RE: Taking a break from CPAP
Ha ha, that article is really something! I had to double-check to see if I was reading "The Onion" for a minute there. Dielaughing

(06-07-2016 08:29 AM)Asjb Wrote:  This is one of my favourites:
http://drpaulose.com/laser-treatment/cpap-dependency-in-osa-patients
06-07-2016 09:40 AM
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green wings Offline

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Post: #33
RE: Taking a break from CPAP
But seriously...I know you to be a data-oriented person, OrangeBear, so I have no snark to direct at you or your doctor. I am very curious, however, to hear an explanation of the mechanism and results of CPAP dependency.

I've just recently learned how obstructive apneas cause high negative pressure in the thoracic cavity, that in turn cause the heart muscle to increase production of ANH (atrial natriuretic hormone), and thus cause excessive nighttime trips to the bathroom. xPAP therapy stops these high negative pressures from happening, so ANH levels return to normal, and nighttime urination goes back to normal.

That made me wonder about the difference in intrathoracic pressures in a healthy person without OSA and a person being treated with xPAP and whether that pressure difference is enough to cause any changes in the body.

I don't know what the magnitude of the normal pressure difference between room air and the lungs is, so I don't have a sense of whether the additional pressure provided by xPAP is significant compared to that.

I suppose I'm trying to say here that I wouldn't be entirely surprised if using xPAP causes some undesirable hormonal changes.
06-07-2016 10:02 AM
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Luvmyzzz Offline

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Post: #34
RE: Taking a break from CPAP
(06-07-2016 09:40 AM)green wings Wrote:  Ha ha, that article is really something! I had to double-check to see if I was reading "The Onion" for a minute there. Dielaughing
Giggling @ green wings thinkin: opinions can be onions....hehe Too-funny


(06-07-2016 08:29 AM)Asjb Wrote:  This is one of my favourites:
http://drpaulose.com/laser-treatment/cpap-dependency-in-osa-patients

I enjoy being with a group who like to share their "Hosehead" experiences, to remind me I am not alone.
06-07-2016 10:28 AM
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Luvmyzzz Offline

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Other Comments: First diagnosed with essential hypertension @ age 25 (precursor to CHF)

Sex: Female
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Post: #35
RE: Taking a break from CPAP
(06-07-2016 10:02 AM)green wings Wrote:  But seriously...I know you to be a data-oriented person, OrangeBear, so I have no snark to direct at you or your doctor. I am very curious, however, to hear an explanation of the mechanism and results of CPAP dependency.

I've just recently learned how obstructive apneas cause high negative pressure in the thoracic cavity, that in turn cause the heart muscle to increase production of ANH (atrial natriuretic hormone), and thus cause excessive nighttime trips to the bathroom. xPAP therapy stops these high negative pressures from happening, so ANH levels return to normal, and nighttime urination goes back to normal.

That made me wonder about the difference in intrathoracic pressures in a healthy person without OSA and a person being treated with xPAP and whether that pressure difference is enough to cause any changes in the body.

I don't know what the magnitude of the normal pressure difference between room air and the lungs is, so I don't have a sense of whether the additional pressure provided by xPAP is significant compared to that.

I suppose I'm trying to say here that I wouldn't be entirely surprised if using xPAP causes some undesirable hormonal changes.

That's a new one, I had never thought of xPAP use changing hormonal levels. It looks like I need to research this.Eat-popcorn ( research: a pass time for nothing else to do)

I enjoy being with a group who like to share their "Hosehead" experiences, to remind me I am not alone.
06-07-2016 10:36 AM
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Luvmyzzz Offline

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Post: #36
RE: Taking a break from CPAP
I did find this link (IF anyone should have some idle curiosity) : http://www.britishsnoring.co.uk/hormonal_aspects_of_OSA.php
I am doing my home work!!

I enjoy being with a group who like to share their "Hosehead" experiences, to remind me I am not alone.
06-07-2016 10:44 AM
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DariaVader Offline
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Post: #37
RE: Taking a break from CPAP
i have CPAP dependency. it is closely related to my breathing dependency Wink

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
06-07-2016 12:36 PM
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Luvmyzzz Offline

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Post: #38
RE: Taking a break from CPAP
(06-07-2016 12:36 PM)DariaVader Wrote:  i have CPAP dependency. it is closely related to my breathing dependency Wink

Dielaughing yah! like

I enjoy being with a group who like to share their "Hosehead" experiences, to remind me I am not alone.
06-07-2016 01:24 PM
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green wings Offline

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Machine: Respironics System One RemStar Pro (460)
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CPAP Software: SleepyHead

Other Comments: using CPAP since Jan. 2016

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Post: #39
RE: Taking a break from CPAP
Good article, Luvmyzzz.

Quote: "Hormonal derangements lead to an increased incidence of OSA, while abnormalities of breathing during sleep lead to altered hormone profiles in their own right."

That explains a lot. *hums* ~~where the deer and the antelope roam~~



(06-07-2016 10:44 AM)Luvmyzzz Wrote:  I did find this link (IF anyone should have some idle curiosity) : http://www.britishsnoring.co.uk/hormonal_aspects_of_OSA.php
I am doing my home work!!
06-07-2016 01:33 PM
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Asjb Offline

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Posts: 173
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Machine: Aircurve 10 CS Pacewave ASV. Before 11/2015 Airsense 10 Auto
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Mask Make & Model: FP Simplus & Remzzzs liner
Humidifier: Integral
CPAP Pressure: Current info in this post
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Undisclosed
Location: France

Post: #40
RE: Taking a break from CPAP
(06-07-2016 12:36 PM)DariaVader Wrote:  i have CPAP dependency. it is closely related to my breathing dependency Wink

Hello Daria,

Just perfect!

My best laugh of the evening so far - thank you.
06-07-2016 02:15 PM
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