Doctor says therapy has been effective.Quit or continue ?

[Gabylady]

January 21/2015--- Doctor diagnosis is mild to moderate apnea ----10 to 15 events/hour. Not bad but advises CPAP therapy. ( I move to Egypt - De nile- for the next week)
January 28/2015--- Signed up for a machine and waited to be told it was a mistake, not needed. No such luck! -------- I did not take well to this intrusion in my life. Ranging between outright terror of suffocation and anxiety ridden claustrophobia, a certainty that I was going to die. All this with the nasal pillows! little to no sleep, most nights I wasn't sure if I was awake or dozing. However I was determined to do what must be done! Stay connected for at least 2 hours and work up to 4 maybe. Compliance was the new watchword.
After much tweaking and adjustments including my husband talking me down off the ceiling, I have become somewhat accepting, even comfortable with THE MACHINE. Some nights are good some not so good. I now look forward to the positive effect this will have on my future health and life in general. The benefits are not obvious yet but I can see the possibilities.
March 23/2015--- Time to appear in front of Doctor with my report (Odyssey) in hand. After some thought he says the therapy has been effective and I don't really need the CPAP but I can continue if I prefer (??!!!). He is concerned with my poor sleep habits which have not changed very much. If I feel like continuing not to worry about taking a week-end off periodically. The intent now is for healthy sleep. Meantime he will see me in a month and re-evaluate.
I did ask about the future if I stopped CPAP now. Would I be starting all over again some day? He said he didn't have a crystal ball.
The respiration tech who has worked with me through this feels I should stay with the machine, there are benefits still to be discovered and starting over is not a good thought.
I know Sleep Hygiene is important and will work on it. You can see my question? What to do?

[shaner]

Were you tested again in March without a CPAP machine to see if you still require one? If not, I don't know how else your doctor could tell you it's not needed. If your AHI is under control while using a CPAP machine, that doesn't mean you don't need it anymore, that means the machine is working. Only way to know is to have a sleep study done again

[BlackSpinner]

March 23/2015--- Time to appear in front of Doctor with my report (Odyssey) in hand. After some thought he says the therapy has been effective and I don't really need the CPAP but I can continue if I prefer (??!!!). He is concerned with my poor sleep habits which have not changed very much. If I feel like continuing not to worry about taking a week-end off periodically. The intent now is for healthy sleep. Meantime he will see me in a month and re-evaluate.
I did ask about the future if I stopped CPAP now. Would I be starting all over again some day? He said he didn't have a crystal ball.
The respiration tech who has worked with me through this feels I should stay with the machine, there are benefits still to be discovered and starting over is not a good thought.
I know Sleep Hygiene is important and will work on it. You can see my question? What to do?

That sounds bizarre. Unless you have lost a lot of weight in the meantime it doesn't make sense. If the cpap therapy has been effective - reducing your AHI down to less then 5 - then you needed it and it is working for you and you should continue to use it. Having an AHI of 15 means that every hour you stop breathing 15 times for a minimum of 10 seconds.
At 3 months you are just starting to get the benefits of the therapy.

[Gabylady]

I thought same as you. CPAP is working. No further testing done just reading of reports has been the only follow thru. I have seen the doctor twice for about 20 minutes, maybe.

[Pugsy]

CPAP works when you use it...it doesn't fix stuff so you can do without it later unless something else changes.
It's like being diabetic with insulin...you have to take the insulin daily and monitor it...you can't take the insulin for 3 months and suddenly not need it anymore unless the underlying cause of the diabetes has been fixed by some other measure.

About 4 years into cpap therapy I had to sleep without my machine one night....horrible night with all the usual sleep apnea symptoms that I had before I started therapy...4 years didn't fix me so that I didn't need the cpap therapy anymore.

Work on the bad sleep stuff....these machines can only fix bad sleep that is totally related to sleep apnea and we all know that there's a LONG list of stuff that causes bad sleep that is totally unrelated to sleep apnea by itself.

Use the cpap machine while working on the other bad sleep causes...whatever they are.

[Gabylady]

lost no weight....sad to say.
My AHI 2.2 as of MARCH 23. But will it stay there? I am told that this doctor is of the new breed, progressive and young

[LSAT]

I thought same as you. CPAP is working. No further testing done just reading of reports has been the only follow thru. I have seen the doctor twice for about 20 minutes, maybe.

I assume that the report your doctor looked at was with you wearing your CPAP. Sounds like your doctor is not capable of monitoring sleep apnea . I have never heard of anyone going from 10-15 events per hour untreated to under 5 in 3 months unless the original sleep study was flawed.

[Julie]

Apnea is a condition, not something you get over in a few days, weeks, years. You have it... but what you may need is another doctor who should have explained it to you.

[Gabylady]

I feel there is something I have done wrong. How could the doctor be wrong?
I will see him again on May 4/2015.
Possibly he has a new sleep study planned(??) For sure more information (?)
My machine was on APAP up until April 1/2015. They switched it to CPAP then. I am having an adjustment period with the constant flow. That might make a difference.

I will require more data before I stop therapy.

[Gabylady]

I have not seen my report and doubt I would get much help reading it if I did. It was given to me in a sealed envelope to take to the doctor.
Make me feel not too bright!
Is it that this is how things are handled in Canada?

[chunkyfrog]

What do you call a person who graduated medical school at the BOTTOM of the class?
----Doctor!

[robysue]

lost no weight....sad to say.
My AHI 2.2 as of MARCH 23. But will it stay there?

Since you have NOT had a second sleep test without the CPAP, your AHI = 2.3 as of March 23 is your CPAP-treated AHI. In other words, the CPAP is preventing most of your apneas from occurring in the first place. With CPAP you still have roughly 2 apneas/hypopneas per hour, but that's far lower than what you were experiencing before you started CPAP.

If/When you go back to sleeping without the PAP, your AHI rises back up to your diagnostic numbers, and without CPAP you have roughly 10-15 apneas/hypopneas per hour.

March 23/2015--- Time to appear in front of Doctor with my report (Odyssey) in hand.
...
I did ask about the future if I stopped CPAP now. Would I be starting all over again some day? He said he didn't have a crystal ball.

It's true the doc can't say for sure what may happen many years down the line. And it's possible that your mild-to-moderate untreated OSA won't get any worse over the years. And it's possible that your daytime OSA symptoms won't get any worse over the years. And it's possible that you are "happy enough" with the quality of your life while living with the current level of daytime OSA symptoms. But ....

Most people who have untreated (and usually undiagnosed) OSA find that the symptoms get worse over the years because the OSA itself gets worse over the years. Today, your untreated AHI is 10-15. In 5-10 years of not treating your OSA, your untreated AHI is likely to rise. In 10-20 years of not treating your OSA, your untreated AHI is likely to rise even more. And as the untreated AHI goes from 10-15 to 20-25 to 30+, the daytime OSA symptoms are likely to increase.

So if you just quit now, there is a high probability that the untreated OSA will continue to get worse. And as it gets worse, your daytime symptoms will get worse. And eventually those symptoms will likely be significant enough for you to get another sleep test, which results in a much higher diagnostic AHI, which will lead to being told, "You must start CPAP now.". And chances are, it won't be any easier to adjust to CPAP several years from now (when you're older) than it is now.

[The doctor] is concerned with my poor sleep habits which have not changed very much. If I feel like continuing not to worry about taking a week-end off periodically. The intent now is for healthy sleep. Meantime he will see me in a month and re-evaluate.

Poor sleep habits make it much, much harder to adjust to CPAP.

Poor sleep habits contribute directly to bad sleep, which leads to waking up feeling unrested and tired.

Poor sleep habits contribute directly to bad sleep, which increases your daytime symptoms of excessive sleepiness and fatigue.

But working on fixing the poor sleep habits and working on adjusting to CPAP are not mutually exclusive. Right now you need to work on both things at the same time.

You also write:

The intent now is for healthy sleep.
...
I know Sleep Hygiene is important and will work on it. You can see my question? What to do?

Let's start by defining some of the terms used to describe your sleep problems and taking inventory of the size of your bad sleep problem.

Since your "intent for now is healthy sleep", let's start there: What does the phrase healthy sleep mean to you?

Since you know "Sleep Hygiene is important", let's also start there: What does the phrase Sleep Hygiene mean to you?

Since you've been told you have poor sleep habits and that the poor sleep habits are contributing to your sleep problems, let's also start there: What does the phrase poor sleep habits mean to you? And what poor sleep habits are you willing to admit to doing on a regular basis? And which of your poor sleep habits do you think most adversely affect the overall quality of your sleep?

Since you "will work on" your sleep hygiene, let's also start there: How specifically do you intend on working on improving the sleep hygiene? In other words, what behavioral changes are you willing to make right now in an effort to get better sleep? What kinds of behavioral changes are you willing to make and stick with (forever) in order to get better sleep? What kinds of behavioral changes are you NOT willing to make in an effort to get better sleep?

Once you've answered those questions---for yourself as much as us---a coherent plan for "fixing" the bad sleep problem should be easier to come up with and implement.

[shaner]

I have not seen my report and doubt I would get much help reading it if I did. It was given to me in a sealed envelope to take to the doctor.
Make me feel not too bright!
Is it that this is how things are handled in Canada?

It varies from doctor to doctor, but in my experience, the care we receive in Canada is far inferior to what is received by those in the US. Our doctors are overworked and are all about quantity, not quality. It comes down to money and our system is underfunded. I would go back to your family doctor and ask for a referral to a different sleep doctor.

[Gabylady]

Thank you, Chunkyfrog and Robysue,

First a giggle from Chunkyfrog followed by serious motivation from Robysue ( I will print that)

[Gabylady]

shaner, We are on same wavelength. I don't believe that Tommy Douglas envisioned universal health for Canada this way. Originally it was separate from government manipulation. Tired under paid doctors who are told how much time they can spend with each patient regardless of need.
Usually I don't need to spend much time in the system but my luck ran out this time. I will be looking for a referral but have little hope. there are only two overbooked sleep clinics in this city and their doctors and techs know each other very well. Who knows my luck may return.