When is sleep therapy no longer needed?
I have been on bi-level therapy for one year during which I have lost over 40 pounds. AHI's in the beginning were greater than 15/hour but now are less than 1.0 with many days ZERO. When non-zero, the events are mostly clear airway occurring in the 30 minutes before awaking in the morning or hypopneas occurring during air leaks; no obstructive events for the last two months.
I have recently switched from an Amara View mask to a Brevida nasal pillow which caused a few more leaks, a few more clear airway and hypopnea events but always within 1.5/hours. Obstructive apneas continued to be zero.
My pressure settings started at (10,16) a year ago; for the last several months the settings have been (8,10).
If I were to continue to reduce the pressure settings and continue to get AHI's at the current low levels, would that indicate that sleep therapy is no longer needed?
I understand that a sleep study retest would provide the definitive answer, but could I use the idea of reducing pressure settings as an indication of when to get a retest?
Just wondering?
RE: When is sleep therapy no longer needed?
Well done on the weight loss, 40lbs is quite a lot of weight to loose.
You can only stop after you have had another sleep study to see how you are doing without a machine.
You may have a very low AHI at the moment, but that is with you using the machine, if you stopped using the machine, your AHI might shoot up.
You will need to have a sleep study done to answer your question.
Well done on the weight loss, it all helps and I bet you feel better for loosing the weight.
RE: When is sleep therapy no longer needed?
Hi rafimf,
CONGRATULATIONS! on your weight loss.!
Hang in there for more answers to your question.
trish6hundred
RE: When is sleep therapy no longer needed?
I had a Sleep Test done in November, AHI 70.
I have also managed to lower my pressure usage and am commonly under .5
I am confident that if I had a sleep test without CPAP I would once again be in the AHI 70's
Maintaining excellent AHIs at low pressures is very good, but it IS still therapy.
If/when you want to challenge it talk to your Dr and schedule it. And for sure let us know what happened.
(we see very few leave CPAP therapy)
Fred
RE: When is sleep therapy no longer needed?
If you could post some of you data than we can see you results. And watch your progress. Congratulations on the weight loss. It will be ineresting to watch.
RE: When is sleep therapy no longer needed?
In general, yes, you should have another sleep study. Not everybody has the finances for it. If you believe that your apnea is soley based on weight, your best bet, if cost is a factor, is to do one of two things. Gradually decrease pressure over several weeks and check Sleepyhead charts to see how you do. Alternatively, go cold turkey and stop using the machine for a couple of weeks and see how you feel. Then hook up the machine with a low starting pressure and the top wide open and see what happens.
When my sister discontinued cpap after surgery, the doc had her quit for a month before the study and even after the study, told her not to get rid of her machine for 6 months. Resolution can be temporary.
This advice is specifically for you with a simple apnea diagnosis. If you have other health issues involved, like diabetes, I would still recommend the study to confirm.
RE: When is sleep therapy no longer needed?
I don't recommend the cold turkey route.
But if you do go that way make sure you monitor your oxygen levels with a recording Oximeter.
RE: When is sleep therapy no longer needed?
I guess you could try something like this:
http://www.sleepreviewmag.com/2015/04/ap...art-phone/
and see what you get. Edit: As far as I can tell, the app still isn't available, so never mind.
My pulmonologist said that weight loss would likely reduce the CPAP pressures needed but would not fix the underlying condition. On the other hand, he also said he really didn't know because hardly anyone ever loses a significant amount of weight and keeps it off long enough to study.
I've lost about 20 lbs in the past year, and SleepyHead tells me I'm generally needing less pressure. But 20 lbs still leaves me significantly overweight. If I were to lose 30 more, maybe I'd have a story to tell, or maybe not. Obesity affects so many systems in the body that anything is possible. The Internet is full of testimonials from people who claim they "cured" their sleep apnea, but typically short on details of how they determined they were cured.
RE: When is sleep therapy no longer needed?
Get a recording oximeter. Set a baseline by wearing it for several nights, downloading the data in the mornings. This establishes what your nighttime blood O2 is doing with the machine.
Then go one or two nights without the machine but using the oximeter. Compare the results.
One or two nights is not a trend. If you do decide to stop using the CPAP, use the oximeter for a while, to ensure you are still taking care of yourself. Tell your GP you are stopping it. That way they can guide you in what to watch out for as well as keep an eye on your blood pressure.
It is neck size that matters more than waist size. And not all involved in the airway collapse is fat.
PaulaO
Take a deep breath and count to zen.
RE: When is sleep therapy no longer needed?
(09-11-2017, 01:18 PM)PaulaO2 Wrote: Get a recording oximeter. Set a baseline by wearing it for several nights, downloading the data in the mornings. This establishes what your nighttime blood O2 is doing with the machine.
This is really the best answer. After all, it's the O2 that ultimately matters, not the AHI. If the AHI were high but it somehow didn't decrease O2 levels there would be no medical reason to try to bring the AHI down.
