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is my sleep apnea cured?
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PaulaO2 Offline
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Post: #11
RE: is my sleep apnea cured?
If you take high blood pressure meds and your blood pressure stays low, does that mean you're "cured"? No, it means the medication is working. Same with the CPAP. We watch the data and make changes if any need to be made just as medication changes happen with high blood pressure, diabetes, and many other conditions.

If the machine is moving, as in raising the pressure, then yes, you still have sleep apnea.

What you could do is set the Autoset on "straight" CPAP at, say, 5 since that is your median. If you can tolerate that low a pressure (you may feel suffocated), use it like that for at least two weeks.

My bet is your AHI increases. It may not go high, but it will increase. If you continue it at 5, my next bet would be you will slowly start to feel more tired and have other symptoms return.

Weight loss is good! Congrats on that, by the way. But skinny people have sleep apnea, too. Some people have the stomach band surgery and are able to lower their pressures but most still have to use the CPAP.

If you'd rather not use the machine and you feel the weight loss has lowered your apnea events enough, and you do not want to do another expensive sleep test, you could try a few things. One would be to fix it so you never sleep on your back. Tennis balls in pockets between the shoulder blades would possibly work. The next would be to invest in a finger oximeter. You can get a cheap simple model from Supplier #19 on the Supplier's list (link at the top of every page). By watching that data, you would see how low your blood O2 is getting at night and whether or not going without the machine is "working" for you.

Just maintain a realistic attitude about this. It would be freakin' great if you are able to wean off the CPAP.

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.
08-11-2013 01:03 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Post: #12
RE: is my sleep apnea cured?
(08-11-2013 10:34 AM)inferno272 Wrote:  Pressure: Median 5.0
95th: 8.2
Max: 10.2

Assuming you have the low end of the range set at the lowest possible setting of 4, the machine is raising above that for some reason. We'd assume it's because you're still experiencing events. One way to prove that would be to set it in CPAP at 4 and see if your AHI goes above 5. If it does, you still need your CPAP machine. If it doesn't the only way to tell for sure is to have a sleep study done.

Since you are not yet at your target weight, I would stay on the CPAP machine at least until you get there. It can't hurt.

Sleepster
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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.
08-11-2013 03:04 PM
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inferno272 Offline

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Post: #13
RE: is my sleep apnea cured?
thanks guys, i think i'll wait till im at the target weight, then try your suggestions out.
08-12-2013 08:58 PM
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DreamDiver Offline

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Post: #14
RE: is my sleep apnea cured?
(08-12-2013 08:58 PM)inferno272 Wrote:  thanks guys, i think i'll wait till im at the target weight, then try your suggestions out.
inferno272,

Since you've sort of been self-titrating from the start, and doctors may be a little out of your reach, there is one more thing you can try.

Get an oximeter: about ~$70 from one of the online vendors (maybe less if you're willing to buy from overseas and wait a couple weeks.) Get the one that's compatible with SleepyHead: Contec Recording PulseOximeter 50D+.

I would Syncronize the times of my S9 and oximeter. Then I'd take some oximetry readings while I sleep with the machine and see whether or not my oxygen dips below acceptable levels. If it doesn't dip dangerously while I'm on CPAP, I might try using the oximeter alone for a night without CPAP. If I see no dips below 90, I might want to try it another night. If my oximetry is still pretty good, I could try it for a few more nights without CPAP - but always use the oximeter until I'm sure my SpO2 is stable without CPAP. Ideally, it should be between 94 and 98 throughout the night. Some of us can't even achieve that with CPAP, so if you can, you might really not need CPAP anymore.

Again, I'm not a doctor. These are things I would try if I were in your shoes. I'm sure someone will step in and help guide you in a more fruitful direction if there is a better way of gauging Sp02 from home in an effort to determine whether CPAP is still appropriate.

dreamdiver.org
08-12-2013 09:18 PM
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jgjones1972 Offline

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Post: #15
RE: is my sleep apnea cured?
inferno272,

Think of it this way; if somebody who doesn't have Obstructive Apnea AT ALL uses a ResMed S9 AutoSet that is set to 4cmH2O - 20cmH2O; then the Median Pressure should be 4cmH2O, the 95% Pressure should be 4cmH2O and the Max Pressure should be 4cmH2O. The AutoSet does not raise pressure unless the airway is obstructed in some way. 4cmH2O is the lowest setting available due to the need to wash exhaled CO2 from the interface. It would still be possible for even the low pressure of 4cmH2O to be clearing or preventing some events; so it would be possible for somebody to experience apnea events without PAP, yet never have the AutoSet raise above 4cmH2O when used. When the pressure raises to 8cmH2O in response to obstruction, it isn't only clearing the airway of the obstruction it was responding too, it also is preventing all of the potential obstructions that would have occurred at a lower pressure.

You run an average 95% pressure >8cmH2O and an average Max Pressure >10cmH2O; which, to me, indicates that the machine is defeating quite a few obstructions.

The weight loss most likely has helped a lot in reducing the pressure needed to defeat obstruction; but it hasn't eliminated the need for at least some pressure to defeat them. If the AutoSet left your pressure flat at 4cmH2O all night regularly, then there might be a chance you could be OK going without; but, this isn't the case.

A question: Do you feel the PAP therapy has in any way made it easier to lose the weight you lost? If the symptoms of untreated apnea came back gradually, over time, do you think it would be more difficult to keep the weight off? Do you think it would be possible to slip into a downward spiral in which the apnea makes you gain weight and the gained weight makes the apnea worse?

If you do decide to suspend PAP therapy; just be on the look-out for ANY of the symptoms (I'm sure you know them all too well) and don't hesitate to hook back up to the machine before you put too much undue stress on your ticker.

Sleep-well
08-12-2013 10:08 PM
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RonWessels Offline

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Post: #16
RE: is my sleep apnea cured?
jgjones1972, while your logic is mostly correct, you are overlooking one fact. The AutoSet machine will use indications like flow limitation and snoring to detect the potential for an upcoming event and raise the pressure proactively to prevent any event from occurring. It would be possible for someone to have these indications but never actually get any apnea events. Not everyone who snores has obstructive sleep apnea. But it will still prompt the AutoSet to raise the pressure.

Now, having said that, with a 95% pressure of more than 4 cmH2O higher than the minimum limit, there really is something going on.
08-13-2013 04:41 PM
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Paptillian Offline

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Post: #17
RE: is my sleep apnea cured?
(08-13-2013 04:41 PM)RonWessels Wrote:  Not everyone who snores has obstructive sleep apnea. But it will still prompt the AutoSet to raise the pressure.

I don't understand the necessity of measuring snore separate from flow limitation. Is a snore not itself a flow limitation? Something needs to vibrate in order to produce the snore.

Going out on a limb then, are all snorers not exhibiting at least some degree of sleep disordered breathing (regardless of whether or not it is considered clinically relevant)?
08-13-2013 09:43 PM
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DreamDiver Offline

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Post: #18
RE: is my sleep apnea cured?
(08-13-2013 09:43 PM)Paptillian Wrote:  
(08-13-2013 04:41 PM)RonWessels Wrote:  Not everyone who snores has obstructive sleep apnea. But it will still prompt the AutoSet to raise the pressure.

I don't understand the necessity of measuring snore separate from flow limitation. Is a snore not itself a flow limitation? Something needs to vibrate in order to produce the snore.

Going out on a limb then, are all snorers not exhibiting at least some degree of sleep disordered breathing (regardless of whether or not it is considered clinically relevant)?
Asthma, bronchitis and COPD can evince severe flow limitation that is very different from snore. They don't sound at all the same. Perhaps flow limitation readings for this instance are more about lungs and less about the soft palate.

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(This post was last modified: 08-13-2013 10:07 PM by DreamDiver.)
08-13-2013 10:04 PM
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Sleepster Offline
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Machine: ResMed AirCurve10 VAuto
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Post: #19
RE: is my sleep apnea cured?
(08-13-2013 09:43 PM)Paptillian Wrote:  I don't understand the necessity of measuring snore separate from flow limitation. Is a snore not itself a flow limitation? Something needs to vibrate in order to produce the snore.

I think the CPAP machine looks for a periodic change in the pressure at certain frequencies to determine if there's a snore. I'm not sure if there's any reason to detect a snore separate from other forms of flow limitation. Maybe they just do it to show off.

Quote:Going out on a limb then, are all snorers not exhibiting at least some degree of sleep disordered breathing (regardless of whether or not it is considered clinically relevant)?

It's probably all semantics. If it's not clinically significant maybe it's not considered a disorder. Dont-know

Sleepster
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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.
08-14-2013 12:53 PM
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RonWessels Offline

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Post: #20
RE: is my sleep apnea cured?
(08-13-2013 09:43 PM)Paptillian Wrote:  I don't understand the necessity of measuring snore separate from flow limitation. Is a snore not itself a flow limitation? Something needs to vibrate in order to produce the snore.

Going out on a limb then, are all snorers not exhibiting at least some degree of sleep disordered breathing (regardless of whether or not it is considered clinically relevant)?

The two determinations are different. A flow limitation is a flattening-out of the top of the flow rate curve, rather than a normal rounded peak. A snore is a vibratory variation in the inhale flow rate.

As to whether they are classed as "sleep disorder breathing" is starting to walk a very fine line. Yes, they are both flow limitations, but if there is no other effect, does it really matter? What about those first 5 apnea events per hour? If a tree falls in the forest ...
08-14-2013 02:12 PM
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