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wondering if I really still need my. CPAP machine
#1
wondering if I really still need my. CPAP machine
Curious. It's been a long time since I have had a sleep study. And wondering if I really still need my. CPAP machine. And thought, couldn't I just reset my pressures  To not start so early or maybe set to start at a high pressure for one night 
And see if my AHI is within specs. Appreciate any advice.
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#2
RE: wondering if I really still need my. CPAP machine
While you can often use a CPAP device to verify Obstructive Sleep Apnea, you can't use one to determine if one doesn't have OSA.

This is because your device is *always* apply pressure, so it's never measuring without some pressure being applied. 

Are your Flow Limitations, Hypopneas, Snores and OAs at zero or near zero?


By all means test to see if the severity has gone done.  Take you minimum pressure and lower it a bit, use it at that pressure for a few days, then repeat. 

Your FLs, Hs, OAs and Snores should remain at or near zero, if they don't, it's likely you still have OSA. 

Many people will find lower pressures to uncomfortable to breathe.
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#3
RE: wondering if I really still need my. CPAP machine
I started on CPAP Therapy in early Sept. of 2018. All went very well from the get-go. No mask or sleeping issues. My AHI #'s were low from the very 1st night of use. 

But......it's been about 6 months now since I stopped the therapy. After three years, I wasn't feeling any better or any worse. My machine is still setting on my bedside stand, but it's not getting used. 

I'm retired and have been now for over 12 years. If I feel tired at times, I can take a power nap. That seems to work the best for me. My DME keeps sending me supplies right on schedule. I have three storage tubs full of supplies. I'm gonna have to call them and tell them to stop. 

I suppose I wasn't willing to keep investing time in my therapy. If you don't feel any improvement after three years, then how long do you wait? 

Anyways, I'm sleeping fine thru the night. That was never an issue. Never woke up gasping for air or any other problem. It was my family doctor that suggested I have a sleep study. I'm thinking he referred me to a sleep lab when it really wasn't necessary.  Eat-popcorn
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#4
RE: wondering if I really still need my. CPAP machine
(07-20-2022, 03:52 AM)Gil Wrote: Curious. It's been a long time since I have had a sleep study. And wondering if I really still need my. CPAP machine.

Probably. You're older now and as we age sleep apnea gets worse.

Quote:And thought, couldn't I just reset my pressures

Put your machine in CPAP mode and set the pressure to 4 cm. (That's as low as you can set it because they need to keep the hose purged of exhaled air.)

Take a look at the data. If you don't have any events at 4 cm of pressure you probably don't need the machine but only a sleep study can confirm. But ... the opposite outcome is the more likely one. If the data shows you are still having a significant number of events at a pressure of 4 cm then you know for sure that you still need your CPAP machine. And that the pressure needs to be set higher than 4 cm.
Sleepster

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.
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#5
RE: wondering if I really still need my. CPAP machine
(07-20-2022, 11:01 AM)Big Guy Wrote: If you don't feel any improvement after three years, then how long do you wait? 

Even if you feel fine sleep apnea increases your risk of cardiovascular disease.
Sleepster

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.
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#6
RE: wondering if I really still need my. CPAP machine
If you have a smart phone and it has an audio recording app, why not sleep one night or three without your CPAP applied?  Record the sounds of your sleep and then you'll need to spend hours listening.  Maybe you'll get lucky and find sooner than later that you begin to snore loudly, to gurgle and snort, and all the other audible signs of disordered nighttime breathing.
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#7
RE: wondering if I really still need my. CPAP machine
There are a few issues with doing a test a night or two. Firstly the most obvious being that you could have good nights and you could have bad nights and your test just happens to be on a good night and gives you a false negative. The other issue is that you would need to stop for a while before you got realistic results, kind of like how if I forget my Thyroid medication one or two days I may not even realize it until a week later because it is not an on/off switch, when you stop there is still going to be residual effects for a fair while. 

With that said you could do a test to see how it is looking BUT odds are you will get a false negative unless you completely stop for an extended period of time before testing, and also as someone has already said while a CPAP machine can tell you if you are still having apneas with the machine it can not tell you if you are not having apneas without the machine because there is no way to set it to 0 pressure and as such even on the lowest possible settings you are still getting some form of treatment. 

The only way to know for sure is to have a sleep study done, you could simply talk to your doctor saying "Hey I want to find out if I still need to be on CPAP can we do a sleep study to see if maybe the original cause of the apneas has gone away?" If they agree you might not need it any more then they would probably have you stop using it for a few weeks and then have you do a study to see if your causes of your apneas have cleared up.
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#8
RE: You really should get it checked
Some time back after I had lost a lot of weight and my machine was malfunctioning, I had thought I was OK apnea-wise. I don't recall why I went in for a new sleep study but boy was I wrong; to the tune of 20 - 30 evente per hour,  Be safe. Get checked.
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#9
RE: wondering if I really still need my. CPAP machine
I agree in principle that a small sampling of sleeps isn't going to be very representative, but I don't believe it's a good idea to compare a drug's effects, with their typical half-life efficacy, to something like CPAP which stops as soon as the machine stops.  They're simply not the same thing.... at all.  A typical statin has a half-life of near 24 hours.  My apixaban has a half-life of about 12 hours.  The effects of last night's PAP therapy won't spill over to the next night when one has obstructive sleep apnea.  If you're sleeping, and your machine isn't in place and running, you're going to experience the 'untreated' rate of apneas and hypopneas.
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#10
RE: wondering if I really still need my. CPAP machine
Agree with Sleepster's comments the most.

Just to be controversial and promote taking the arguments a bit further, no offense intended...

It was said that " There are a few issues with doing a test a night or two." Totally agree with that. That is the Key Point.

Then it was suggested to have a sleep study. This may be a good idea but for how long? For how many nights? Maybe for one night only? What if that was a good night for you and showed no significant events?  Or each night for a whole week? And obtain an average? What a hassle!

Each/every/any/all medical tests have false positives and false negatives. Just to make life more difficult. Phew!

On my 'good nights' I have zero AHI and no events (AHI = 0.0) but those are nights of restlessness and light sleep, and I know not to take the AHI = 0 seriously at all, just a reflection of light or poor restless sleep, too much brain activity/stress/whatever.
On my 'not so good nights' I sleep deeply (red wine or sleep aid) and have higher AHIs. But am still rested.

With both my sleep studies (diagnostic and titration) I certainly never slept well in the strange environment/bed/noises/horrible pillows etc and suspect the results were skewed in favour of lower AHI. Therefore I would likely review a repeat study with some scepticism.

I would only add this: if I were to try this without CPAP for a few nights I would simply ask my wife to make a comment on the amount of snoring she heard, and the amount of sleep disruption she experienced! She would soon put me right!

Of course, I would love a repeat sleep study to show no Apnea, that way I might be able to get rid of the drivers' licensing issue.
How to fake the sleep study to show low AHI? Stay awake? Fake sleep? Not feasible with EEG monitoring I am afraid, they would spot that a mile off.

Hate it as I do, my CPAP is here to stay. 


Your mileage may vary, especially if you had low AHI to start off with, I think we would all be interested in how things pan out for you.








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