Why is OSA usually treated with PAP therapy??

[mileena]

I read on another forum something to the effect of that if heart failure were treated like OSA is, they would put heart patients in a compression chamber for the rest of their lives. LOL

IOW, when prescribing PAP therapy, doctors are treating the symptoms, not the underlying cause. The correct way would be to go to the source of the problem and fix it, i.e., via surgery. Why isn't that done often? The human body is designed to be a biologically perfect mechanism. If your airway is being obstructed during sleep, something is wrong. There is nothing natural about OSA, meaning it can be medically corrected. Treating OSA by forcing air down the throat to open it up is not an ideal solution.

[Okie bipap]

Most surgeries for OSA are ineffective. Some offer partial relief, or temporary relief. As we age, muscle structures change. You would be hard pressed to find anyone who has died as a result of using CPAP, or has contacted serious infection from their machine. You see articles in the paper quite often where someone has died as a rest of surgery, or has contacted a major infection as a result of having surgery. I have tried surgery to correct my OSA and am now using a bilevel machine.

[palerider]

I read on another forum something to the effect of that if heart failure were treated like OSA is, they would put heart patients in a compression chamber for the rest of their lives. LOL

IOW, when prescribing PAP therapy, doctors are treating the symptoms, not the underlying cause. The correct way would be to go to the source of the problem and fix it, i.e., via surgery. Why isn't that done often? The human body is designed to be a biologically perfect mechanism. If your airway is being obstructed during sleep, something is wrong. There is nothing natural about OSA, meaning it can be medically corrected. Treating OSA by forcing air down the throat to open it up is not an ideal solution.

I would dearly LOVE for you to go have your jaw repositioned, and have nothing more to do with cpap.

The human body isn't "designed" for anything. it's the result of millions of years of mistakes and mutations.

[ChicagoGranny]

The human body is designed to be a biologically perfect mechanism.

Perfect for what? The only thing a successful living organism is perfect for is reproducing and raising the next generation to maturity.

[ChicagoGranny]

mistakes and mutations

Don't forget selection.

[mileena]

Most surgeries for OSA are ineffective. Some offer partial relief, or temporary relief. As we age, muscle structures change. You would be hard pressed to find anyone who has died as a result of using CPAP, or has contacted serious infection from their machine. You see articles in the paper quite often where someone has died as a rest of surgery, or has contacted a major infection as a result of having surgery. I have tried surgery to correct my OSA and am now using a bilevel machine.

I see your point. Surgery is always risky. So it many ways then, something like PAP therapy would be better.

The human body is designed to be a biologically perfect mechanism.

Perfect for what? The only thing a successful living organism is perfect for is reproducing and raising the next generation to maturity.

Agreed! Even for childbirth, there can be life-threatening complications.

[mileena]

I read on another forum something to the effect of that if heart failure were treated like OSA is, they would put heart patients in a compression chamber for the rest of their lives. LOL

IOW, when prescribing PAP therapy, doctors are treating the symptoms, not the underlying cause. The correct way would be to go to the source of the problem and fix it, i.e., via surgery. Why isn't that done often? The human body is designed to be a biologically perfect mechanism. If your airway is being obstructed during sleep, something is wrong. There is nothing natural about OSA, meaning it can be medically corrected. Treating OSA by forcing air down the throat to open it up is not an ideal solution.

I would dearly LOVE for you to go have your jaw repositioned, and have nothing more to do with cpap.

The human body isn't "designed" for anything. it's the result of millions of years of mistakes and mutations.

Ok, I see. Yeah I can imagine jaw repositioning would be painful.

[Stom]

I read on another forum something to the effect of that if heart failure were treated like OSA is, they would put heart patients in a compression chamber for the rest of their lives. LOL

IOW, when prescribing PAP therapy, doctors are treating the symptoms, not the underlying cause. The correct way would be to go to the source of the problem and fix it, i.e., via surgery.

You should probably read up on the efficacy rates of surgery and the complications. Unlike the tales of children getting their tonsils out and getting ice cream the next day I heard as a child, adult surgery to the throat is a painful nightmare. And even if it reduces obstructive sleep apnea, it may not actually cure it.

You are definitely right in one sense, some sleep apnea can be reduced the same way heart disease can be: by loosing weight. But realistically, not everybody will or can do that. And other factors, such as being postmenopausal or older, just can't be reversed. But for some, dental appliances can help. As can positional therapy.

You can ask your doctor about whether surgical options are indicated for your sleep apnea, but you really need to research them before deciding they are a better option that something as simple as using air pressure to help splint your airway open.

[mileena]

I read on another forum something to the effect of that if heart failure were treated like OSA is, they would put heart patients in a compression chamber for the rest of their lives. LOL

IOW, when prescribing PAP therapy, doctors are treating the symptoms, not the underlying cause. The correct way would be to go to the source of the problem and fix it, i.e., via surgery.

You should probably read up on the efficacy rates of surgery and the complications. Unlike the tales of children getting their tonsils out and getting ice cream the next day I heard as a child, adult surgery to the throat is a painful nightmare. And even if it reduces obstructive sleep apnea, it may not actually cure it.

You are definitely right in one sense, some sleep apnea can be reduced the same way heart disease can be: by loosing weight. But realistically, not everybody will or can do that. And other factors, such as being postmenopausal or older, just can't be reversed. But for some, dental appliances can help. As can positional therapy.

You can ask your doctor about whether surgical options are indicated for your sleep apnea, but you really need to research them before deciding they are a better option that something as simple as using air pressure to help splint your airway open.

Thanks stom! I will look more into it.

Actually, in my area, there was a well-publicized story of a juvenile girl dying from OSA surgery, so I know it can be very dangerous:

https://en.wikipedia.org/wiki/Jahi_McMath_case

According to court documents,[16] McMath was admitted to Children's Hospital Oakland on December 9, 2013, for an adenotonsillectomy, uvulopalatopharyngoplasty and submucous resection of bilateral inferior turbinates. It was hoped these procedures would provide improved airflow during her sleep at night. The hospital described these procedures as complicated. The family described the surgery as a routine tonsillectomy in media reports.[17][18]

After the surgeries were performed, McMath was conscious and according to her mother, Latasha "Nailah" Winkfield,[18][19][20] asked for a Popsicle while in the recovery room.[21] On December 9, 2013, McMath suffered massive blood loss and consequent cardiac arrest. According to McMath's doctors at Children's Hospital Oakland, the loss of blood circulation caused whole brain death. On December 12, 2013, her doctors declared her brain-dead.[3] Her family was informed that she was legally dead,[22] and that as a result, life support systems would be discontinued.[16]

[chunkyfrog]

We are all designed to live and die.
Other achievements are completely up to us,
including living longer than "designed" to,
(if we so choose--and can manage.)
I rather like the idea, and am comfortable with cpap helping me do this.
Life is not fair; and I relish spitting in the eye of fate.
Repeating the spurious claims of ersatz "studies" is ignorant and potentially harmful.
I do wish people were not so fond of hurting others . . .

[D.H.]

Surgery is risky, and may or may not fix the problem. Also, if the results of the surgery are worse than before, it can't be reversed. CPAP can be discontinued or adjusted. For instance if the pressure is too high, it can be lowered. If too much tissue is removed during surgery, they can't put some back.

[mileena]

Surgery is risky, and may or may not fix the problem. Also, if the results of the surgery are worse than before, it can't be reversed. CPAP can be discontinued or adjusted. For instance if the pressure is too high, it can be lowered. If too much tissue is removed during surgery, they can't put some back.

Well said. Also to chunkyfrog's post too.

[zoocrewphoto]

I read on another forum something to the effect of that if heart failure were treated like OSA is, they would put heart patients in a compression chamber for the rest of their lives. LOL

IOW, when prescribing PAP therapy, doctors are treating the symptoms, not the underlying cause. The correct way would be to go to the source of the problem and fix it, i.e., via surgery. Why isn't that done often? The human body is designed to be a biologically perfect mechanism. If your airway is being obstructed during sleep, something is wrong. There is nothing natural about OSA, meaning it can be medically corrected. Treating OSA by forcing air down the throat to open it up is not an ideal solution.

Many causes of sleep apnea are not fixable.

For example, central sleep apnea is a neurological problem, and they don't have a cure for it yet.

For many people with obstructive sleep apnea, we have a defective anatomical setup. For example. I have a small mouth, small chin, and very narrow airway. Typical scalloped tongue. Typical crowded teeth with removal of 4 teeth as a teenager (they know better now, but didn't then). So, I have a smaller airway to begin with. Add in allergies, inflamation, etc, and now the airway is even smaller. It doesn't take much of a collapse to block my airway.

I suspect that many people have the same collapse in their airway at night, but with a larger airway, it doesn't get blocked as much.

As to the current surgeries, some of them would not even touch the problem in some people. And for those who do have success, that success is defined as a 50% reduction of events. So, if you have 40 events per hour, and then have the surgery, you will be considered a success if your events go down to only 20 per hour. Did I mention that you would still ave sleep apnea in the moderate category? My untreated ahi is at leas 79. WIth "successful" surgery, I would STILL be in the severe category.

Did I mention that people who have the surgery often return to cpap a year or two later? That the recovery was very painful? And some of them have trouble with liquids coming out their nose?

I think I will stick to cpap until something TRULY successful comes along. We aren't there yet.

[grapeshly]

While the possibility of surgery to try and widen my very small airways was presented to me, the success rate is uncertain. You could even be left so that it is difficult to swallow. A dental appliance could also be used, which forces your lower jaw forward, but getting a comfortable fit can be difficult and time-consuming to achieve. The Cpap machine is the gold standard for treatment, and the most effective solution. Speaking for myself, I like my machine, and I feel healthier and more rested from using it. It seems to me that despite having to wear a "thing" on your face and head, it is the least obstrusive and most benign solution.

[chunkyfrog]

In answer to the title of the thread:
Because it works.