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feel better vs treated?
12-24-2014, 10:03 AM
Curious - it seems to be a pattern where someone is diagnosed with severe sleep apnea and the main treatment method offered is CPAP therapy due to that being the go-to solution that yields the most success today and blessed by health insurance (true in my case). The magic question asked by doctors and posters here after CPAP therapy successfully lowers your nightly average AHI to under 5 (teated) is 'how do you feel?'. What about those poor souls who don't feel rested, or even end up feeling worse, yet are treated "successfuly" by CPAP therapy? It seems somehow they need to get their AHI down, whether they feel ok or not (excluding medically worse side-effects), to avoid very serious health risks from high AHI, correct? I realize there are other non-prefered therapy techniques, but I wonder if there then starts a conversation with the individual on this. I have personally spoken with a few people I know who choose to not wear their CPAP masks because it is inconvenient or they just accept the risks. So very sad, as many of my friends and relatives who fit the risk profile of someone who likely has undiagnosed sleep apnea don't want to get tested or wear a "contraption on their face at night". I am certainly an advocate for CPAP, but I also would rather something more convenient and less intrusive, so long as my AHI is treated. I do believe that we all are responsible for ourselves and our life choices, and I am by no means condoning destructive or irresponsible behavior. Thoughts? Thank you for being supportive of my therapy.....and Happy Holidays to everyone, including our military troops everywhere. Dan
(12-24-2014, 10:03 AM)BlueHorseshoe Wrote: The magic question asked by doctors and posters here after CPAP therapy successfully lowers your nightly average AHI to under 5 (teated) is 'how do you feel?'. What about those poor souls who don't feel rested, or even end up feeling worse, yet are treated "successfuly" by CPAP therapy?
The problem is that you're not using the "Medical Industry to English" Dictionary.
"Treated (AHI < 5)" = "Doctor gets paid and can claim success"
"5" doesn't necessarily mean you feel better. "5" means that ON AVERAGE you stopped breathing 5 times every hour. And it's an average. The average temperature of the wood in my fireplace is 80 degrees. It was 30 degrees outside for the last couple of years, and 800 degrees for an hour. Averages aren't really useful.
Actually feeling good can easily require an AHI very close to zero. I don't feel very well if I go above 0.3 or 0.4. You may have to be assertive with your doc and get an accurate diagnosis of your sleep problems, possibly get your pressure adjusted, and maybe get your mask/machine/usage methods changed.
Also, a better measurement is RDI (Respiratory Disturbance Index) which takes other types of breathing problems into account. It's entirely possibly to not be breathing well and still have a low AHI.
SleepyHead software has an option to display RDI instead of AHI.
12-24-2014, 01:14 PM
But unless you have a machine that records RERA, you will not be able to use it... Now that I know more - and find that my sleep study showed a bazillion RERA in addition to a qualifying AHI (in spite of barely sleeping...) I really wish I *was* recording those on my S9 Autoset
12-24-2014, 03:17 PM
Apnea is like smoking. CPAP is like quitting smoking.
You may not feel better when you quit smoking, but if you don't quit, the cigarettes are slowly killing you.
Some smokers have problems like coughing, shortness of breath, etc. that will go away when they stop. Some don't have smoking side effects yet. Some smokers only improve slowly when they quit, some don't improve. Some have withdrawal symptoms.
Whether they feel better or not, smokers improve their health when they quit.
I think most apneacs feel better pretty quickly when they start CPAP, but no all people do.
People also tend to expect CPAP to fix everything. Even if you fix your apnea, you may have other problems that make you feel bad. You still need to fix your apnea.
12-24-2014, 05:16 PM
I agree with what's been written, but I think there are two other issues at play which can make you feel bad even if your AHI is low. Mask leaks can greatly disturb your sleep, even if they are of short duration or below the magic 24 threshold. And general discomfort from the mask, headgear, hose or pressure can also stop you getting a good night's sleep. Your disordered breathing may be well under control, but you're still not getting enough restful sleep. The leaks may show up on the graphs but the other factors won't. An observant and helpful bed-partner is often the key to success with the other issues.
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