possibly no sleep apnea after losing a bunch of weight?

[CPAPSteve]

So its been a while since I last posted and during my absence from this forum that I've lost about 20 lbs and continue to lose weight and my BMI has dropped from the low 30's to around 28 where I am slowly continue to lose weight.

I continue to use my cpap but i am truly starting to wonder if I can avoid using one altogether. CPAP for me, has been mostly a positive experience sans the super dry mouth that wakes me in the middle of the night but AHI has been consistently at 0.0 for literally weeks at a time. Looking at SH (I have yet to upgrade to OSCAR) that I rarely see ANY events. The odd RERA or the odd obstruction and that's about it. My min pressure is 11.4 and my average pressure is under 14. The sleep clinic that I go to every 6 months does a data download and says the machine is doing its job and there are no obstructions. When I asked if I needed the CPAP still they told me that because my 95% pressure hovers around 14 consistently with the minimum at 11.4 that they are certain that I need to use the machine to prevent apneas and that my treatment is working effectively and that no changes are needed. Is what my respiratory therapist saying accurate? Their explanation is that if I didn't have apneas that the machine would like always hover at around the minimum pressure but since it ramps up and holds at 14ish that its doing so because it detects a restriction. Since starting treatment back in 2018 that my night sweats have all but disappeared and my moodiness is far less wild than before using a CPAP so that is my only real tell tale sign that CPAP has clearly helped.

So why am I asking if I need to use a CPAP? DRY MOUTH! Despite using Xylimelts, soft collar, mouth guard, hard collar, etc that nothing beats sleeping with nothing attached to me. I was visiting my allergist the other day and he's somewhat knowledgeable in sleep disorders that he was kind enough to send me to a sleep specialist to double check my CPAP data (very boring and uneventful) to rule out a possible false positive OSA test done back in 2018 by another sleep clinic. To be honest I don't think I need to see a specialist but since my allergist referred me that I thought it wouldn't hurt to go and have a 2nd set of eyes to see if I really need a CPAP.

Has anyone here ever been misdiagnosed with OSA but was using a CPAP for years before they discovered they could've gone without one? From my understanding from then sleep specialist that the initial meet and greet is to take a look at the data on my cpap machine and then either make a recommendation or even possibly do an in clinic over night sleep test where they hook me up to a barrage of wires and sensors.

Your input on this would be appreciated,

[LSAT]

You need an overnight sleep test. The CPAP treats...it doesn't cure. Because you have few, if any, events with the machine doesn't mean you would be the same without.

[Pugsy]

When I asked if I needed the CPAP still they told me that because my 95% pressure hovers around 14 consistently with the minimum at 11.4 that they are certain that I need to use the machine to prevent apneas and that my treatment is working effectively and that no changes are needed. Is what my respiratory therapist saying accurate?

Probably.

Try using 4 cm fixed pressure all night and see if you AHI is still 0.0.

[chunkyfrog]

Pressure does not go from 11.4 to 14, and stay around there for no reason at all.
When you see zero AHI, it means it is working.
Weight loss does a lot of good things, but curing apnea is expecting too much.

[zonker]

Pressure does not go from 11.4 to 14, and stay around there for no reason at all.
When you see zero AHI, it means it is working.
Weight loss does a lot of good things, but curing apnea is expecting too much.

+1 well spotted, m'lady.

to the op: yes, it's the very definition of zero ahi. if you had ANY events, it wouldn't be zero.

it's working. the weight loss may be helping it work better.

[CPAPSteve]

So I tried as Pugsy had suggested and set my CPAP to a fixed pressure of 4 and the following happened:

1. Apparently even with the mask on at 4cms of fixed pressure my wife said I snored quite loudly - odd considering that I don't snore when I sometimes fall asleep when I am too tired to mask up.
2. I only wore the mask for 1.2 hours and then I took it off. Probably b/c I felt like I was suffocating with insufficient pressure. AHI reported during that 1.2 hour period was 0.0.
3. Apparently even after I took the cpap mask off that my spouse reported that again I was snoring which I normally do not do.

Will retry again tonight.

[CPAPSteve]

Well just after 4.4 hours of sleep with my cpap set to 4cms of pressure that I struggled to sleep well (felt starved for air) that I woke up to change my settings back to what they were. AHI was a mere 0.6 in the 4+ hour window. Does that mean I have OSA? Yes to a tiny degree but those 4 hours were the crappiest sleep ever.

Setting my pressure back to 11.4-20cms and going back to bed...

[palerider]

Now do you believe that you *need* the CPAP?

[CPAPSteve]

Apparently so... even though I have a super low AHI to start with that it feels weird to. It have my cpap operating at the proper pressures. The moment I cranked the pressure back up and put everything back on I fell asleep without issue.

That being said I guess there must be something wrong with my breathing even though I have lost a bunch of weight.

[palerider]

Apparently so... even though I have a super low AHI to start with that it feels weird to. It have my cpap operating at the proper pressures. The moment I cranked the pressure back up and put everything back on I fell asleep without issue.

"a super low AHI" .... When?

That being said I guess there must be something wrong with my breathing even though I have lost a bunch of weight.

What makes you think that weight is the cause of sleep apnea?

[chunkyfrog]

My OSA is easily addressed by cpap.
My weight is another matter.
(Please insert profanity here.)

[CPAPSteve]

It is just amazing that for a diagnosis 2 years ago with borderline OSA (as in BARELY qualifying for a CPAP) that I would've thought that dropping 20lbs would've helped bring me under the limit of not having to need one.

I can sleep without a CPAP for a couple of days and not notice too much initially but by day 3 I start getting moody. The tell tale truth will be what the supposed sleep specialist that I was referred to has to say and whether or not they feel compelled enough to put through an over night sleep study which I feel is a waste of time and money but if they insist on one to confirm whatever hypothesis they might have then I guess I'm game for it either way.

Thanks!

[Architect]

I lost 100 lbs, yeah I was 320 lbs one time in life now I'm 220-225 but my pressure continued to rise, so I asked sleep specialist why? Her reply was, throat relaxation, she states as individuals age, thier throats relax more, becomes more weak.